NRNP 6645 MIDTERM EXAM ACTUAL QUESTIONS &
ANSWERS (LATEST UPDATE) 100%
GUARANTEE PASS (VERIFIED ANSWERS)
1.
A patient with major depressive disorder is started on an SSRI. Which
neurotransmitter system is primarily targeted by this medication class?
A. Dopamine
B. Gamma-aminobutyric acid
C. Serotonin
D. Acetylcholine
Answer: C. Serotonin
Rationale: SSRIs inhibit the serotonin transporter, increasing serotonin availability
in the synaptic cleft. They are commonly used as first-line treatments for
depressive and several anxiety disorders.
2.
A patient taking sertraline reports nausea during the first week of treatment.
What is the most appropriate response?
A. Discontinue sertraline immediately
B. Switch immediately to a tricyclic antidepressant
C. Explain that gastrointestinal effects can occur early and often improve with
continued treatment
D. Add a stimulant medication
Answer: C. Explain that gastrointestinal effects can occur early and often
improve with continued treatment
,Rationale: Nausea and other gastrointestinal symptoms are common early
adverse effects of SSRIs and frequently diminish as the patient adjusts to
treatment.
3.
Which finding is most concerning in a patient taking an antidepressant?
A. Mild dry mouth
B. Transient nausea
C. Mild headache
D. New suicidal thoughts after initiating treatment
Answer: D. New suicidal thoughts after initiating treatment
Rationale: New or worsening suicidal ideation requires prompt assessment and
safety planning, particularly when an antidepressant has recently been initiated or
the dose changed.
4.
A patient taking phenelzine asks which food should be avoided because of its
tyramine content.
A. Fresh apples
B. White rice
C. Aged cheese
D. Lettuce
Answer: C. Aged cheese
Rationale: Monoamine oxidase inhibitors require avoidance of high-tyramine
foods because excessive tyramine can precipitate a potentially dangerous
hypertensive reaction.
5.
,A patient taking an MAOI develops severe headache, palpitations, diaphoresis,
and markedly elevated blood pressure after eating aged cheese. Which
complication is most likely?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Hypertensive crisis
D. Acute dystonia
Answer: C. Hypertensive crisis
Rationale: Excess tyramine in a patient taking an MAOI can cause a rapid increase
in catecholamines and produce a hypertensive crisis.
6.
Which antidepressant is associated with a relatively high risk of sexual adverse
effects?
A. Bupropion
B. Paroxetine
C. Mirtazapine
D. Vortioxetine
Answer: B. Paroxetine
Rationale: SSRIs, particularly paroxetine, commonly cause decreased libido,
delayed orgasm, and other sexual dysfunction.
7.
Which antidepressant is generally considered least likely to cause sexual
dysfunction?
A. Paroxetine
B. Sertraline
C. Escitalopram
D. Bupropion
, Answer: D. Bupropion
Rationale: Bupropion has a lower incidence of sexual adverse effects than many
serotonergic antidepressants and may sometimes be used when SSRI-related
sexual dysfunction occurs.
8.
Which adverse effect is particularly associated with mirtazapine?
A. Severe akathisia
B. Increased appetite and weight gain
C. Hypertensive crisis
D. Urinary retention as the primary effect
Answer: B. Increased appetite and weight gain
Rationale: Mirtazapine can increase appetite and body weight and is also
associated with sedation, especially at lower doses.
9.
A patient with depression has significant insomnia and poor appetite. Which
medication may be particularly useful?
A. Fluoxetine
B. Bupropion
C. Mirtazapine
D. Venlafaxine
Answer: C. Mirtazapine
Rationale: Mirtazapine can promote sleep and increase appetite, making it
potentially useful in depressed patients with insomnia and reduced appetite.
10.
ANSWERS (LATEST UPDATE) 100%
GUARANTEE PASS (VERIFIED ANSWERS)
1.
A patient with major depressive disorder is started on an SSRI. Which
neurotransmitter system is primarily targeted by this medication class?
A. Dopamine
B. Gamma-aminobutyric acid
C. Serotonin
D. Acetylcholine
Answer: C. Serotonin
Rationale: SSRIs inhibit the serotonin transporter, increasing serotonin availability
in the synaptic cleft. They are commonly used as first-line treatments for
depressive and several anxiety disorders.
2.
A patient taking sertraline reports nausea during the first week of treatment.
What is the most appropriate response?
A. Discontinue sertraline immediately
B. Switch immediately to a tricyclic antidepressant
C. Explain that gastrointestinal effects can occur early and often improve with
continued treatment
D. Add a stimulant medication
Answer: C. Explain that gastrointestinal effects can occur early and often
improve with continued treatment
,Rationale: Nausea and other gastrointestinal symptoms are common early
adverse effects of SSRIs and frequently diminish as the patient adjusts to
treatment.
3.
Which finding is most concerning in a patient taking an antidepressant?
A. Mild dry mouth
B. Transient nausea
C. Mild headache
D. New suicidal thoughts after initiating treatment
Answer: D. New suicidal thoughts after initiating treatment
Rationale: New or worsening suicidal ideation requires prompt assessment and
safety planning, particularly when an antidepressant has recently been initiated or
the dose changed.
4.
A patient taking phenelzine asks which food should be avoided because of its
tyramine content.
A. Fresh apples
B. White rice
C. Aged cheese
D. Lettuce
Answer: C. Aged cheese
Rationale: Monoamine oxidase inhibitors require avoidance of high-tyramine
foods because excessive tyramine can precipitate a potentially dangerous
hypertensive reaction.
5.
,A patient taking an MAOI develops severe headache, palpitations, diaphoresis,
and markedly elevated blood pressure after eating aged cheese. Which
complication is most likely?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Hypertensive crisis
D. Acute dystonia
Answer: C. Hypertensive crisis
Rationale: Excess tyramine in a patient taking an MAOI can cause a rapid increase
in catecholamines and produce a hypertensive crisis.
6.
Which antidepressant is associated with a relatively high risk of sexual adverse
effects?
A. Bupropion
B. Paroxetine
C. Mirtazapine
D. Vortioxetine
Answer: B. Paroxetine
Rationale: SSRIs, particularly paroxetine, commonly cause decreased libido,
delayed orgasm, and other sexual dysfunction.
7.
Which antidepressant is generally considered least likely to cause sexual
dysfunction?
A. Paroxetine
B. Sertraline
C. Escitalopram
D. Bupropion
, Answer: D. Bupropion
Rationale: Bupropion has a lower incidence of sexual adverse effects than many
serotonergic antidepressants and may sometimes be used when SSRI-related
sexual dysfunction occurs.
8.
Which adverse effect is particularly associated with mirtazapine?
A. Severe akathisia
B. Increased appetite and weight gain
C. Hypertensive crisis
D. Urinary retention as the primary effect
Answer: B. Increased appetite and weight gain
Rationale: Mirtazapine can increase appetite and body weight and is also
associated with sedation, especially at lower doses.
9.
A patient with depression has significant insomnia and poor appetite. Which
medication may be particularly useful?
A. Fluoxetine
B. Bupropion
C. Mirtazapine
D. Venlafaxine
Answer: C. Mirtazapine
Rationale: Mirtazapine can promote sleep and increase appetite, making it
potentially useful in depressed patients with insomnia and reduced appetite.
10.
