NR 546 Week 4 Exam V1 | NR 546 Advanced
Pharmacology Psychopharmacology for the
PMHNP | Actual Q&A with Rationale (NR546 Week
4 Exam) | Chamberlain University
1. Which neurotransmitter is primarily targeted by Selective Serotonin Reuptake Inhibitors
(SSRIs) to treat Major Depressive Disorder?
A. Serotonin
B. Norepinephrine
C. Dopamine
D. GABA
Correct Answer: A
Explanation: SSRIs specifically block the reabsorption of serotonin into neurons, making
more serotonin available to improve transmission of messages between neurons. By
increasing the level of serotonin in the synaptic cleft, these medications help regulate
mood, sleep, and appetite. This selective action is why they generally have fewer side
effects than older antidepressants like TCAs.
2. A patient taking Phenelzine (an MAOI) consumes aged cheese and wine. What life-
threatening condition are they at risk for?
A. Serotonin Syndrome
B. Metabolic Syndrome
,C. Hypertensive Crisis
D. Neuroleptic Malignant Syndrome
Correct Answer: C
Explanation: Phenelzine inhibits the breakdown of tyramine, an amino acid found in aged
and fermented foods. High levels of tyramine cause a massive release of norepinephrine,
leading to severe vasoconstriction. This clinical event can result in dangerously high blood
pressure, intracranial hemorrhage, or death if not managed immediately.
3. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Bupropion
B. Venlafaxine
C. Sertraline
D. Mirtazapine
Correct Answer: A
Explanation: Bupropion is known to lower the seizure threshold, especially at higher
doses. It is strictly contraindicated in patients with anorexia or bulimia due to the high risk
of electrolyte imbalances that further increase seizure risk. Clinicians must screen for these
conditions before initiating treatment with this norepinephrine-dopamine reuptake
inhibitor.
, 4. What is the mechanism of action of Duloxetine (Cymbalta)?
A. Selective inhibition of Serotonin reuptake only
B. Irreversible inhibition of Monoamine Oxidase
C. Antagonism of Alpha-2 receptors
D. Dual inhibition of Serotonin and Norepinephrine reuptake
Correct Answer: D
Explanation: Duloxetine belongs to the SNRI class, which inhibits the reuptake of both
serotonin and norepinephrine. By increasing norepinephrine, it is particularly effective for
treating physical pain symptoms associated with depression. This dual action also makes it
a first-line choice for fibromyalgia and neuropathic pain management.
5. A patient exhibits agitation, hyperreflexia, tremors, and diaphoresis after starting a new
antidepressant while already taking an SSRI. What is the most likely diagnosis?
A. Serotonin Syndrome
B. Benzodiazepine Withdrawal
C. Anticholinergic Toxicity
D. Discontinuation Syndrome
Correct Answer: A
Explanation: Serotonin Syndrome is caused by an excess of serotonin in the central
nervous system, often due to drug interactions. The triad of symptoms includes autonomic
Pharmacology Psychopharmacology for the
PMHNP | Actual Q&A with Rationale (NR546 Week
4 Exam) | Chamberlain University
1. Which neurotransmitter is primarily targeted by Selective Serotonin Reuptake Inhibitors
(SSRIs) to treat Major Depressive Disorder?
A. Serotonin
B. Norepinephrine
C. Dopamine
D. GABA
Correct Answer: A
Explanation: SSRIs specifically block the reabsorption of serotonin into neurons, making
more serotonin available to improve transmission of messages between neurons. By
increasing the level of serotonin in the synaptic cleft, these medications help regulate
mood, sleep, and appetite. This selective action is why they generally have fewer side
effects than older antidepressants like TCAs.
2. A patient taking Phenelzine (an MAOI) consumes aged cheese and wine. What life-
threatening condition are they at risk for?
A. Serotonin Syndrome
B. Metabolic Syndrome
,C. Hypertensive Crisis
D. Neuroleptic Malignant Syndrome
Correct Answer: C
Explanation: Phenelzine inhibits the breakdown of tyramine, an amino acid found in aged
and fermented foods. High levels of tyramine cause a massive release of norepinephrine,
leading to severe vasoconstriction. This clinical event can result in dangerously high blood
pressure, intracranial hemorrhage, or death if not managed immediately.
3. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Bupropion
B. Venlafaxine
C. Sertraline
D. Mirtazapine
Correct Answer: A
Explanation: Bupropion is known to lower the seizure threshold, especially at higher
doses. It is strictly contraindicated in patients with anorexia or bulimia due to the high risk
of electrolyte imbalances that further increase seizure risk. Clinicians must screen for these
conditions before initiating treatment with this norepinephrine-dopamine reuptake
inhibitor.
, 4. What is the mechanism of action of Duloxetine (Cymbalta)?
A. Selective inhibition of Serotonin reuptake only
B. Irreversible inhibition of Monoamine Oxidase
C. Antagonism of Alpha-2 receptors
D. Dual inhibition of Serotonin and Norepinephrine reuptake
Correct Answer: D
Explanation: Duloxetine belongs to the SNRI class, which inhibits the reuptake of both
serotonin and norepinephrine. By increasing norepinephrine, it is particularly effective for
treating physical pain symptoms associated with depression. This dual action also makes it
a first-line choice for fibromyalgia and neuropathic pain management.
5. A patient exhibits agitation, hyperreflexia, tremors, and diaphoresis after starting a new
antidepressant while already taking an SSRI. What is the most likely diagnosis?
A. Serotonin Syndrome
B. Benzodiazepine Withdrawal
C. Anticholinergic Toxicity
D. Discontinuation Syndrome
Correct Answer: A
Explanation: Serotonin Syndrome is caused by an excess of serotonin in the central
nervous system, often due to drug interactions. The triad of symptoms includes autonomic
