NR 605 Psychopharmacology Exam 2026/2027 | Medication
Management Across the Lifespan | 300 Practice Questions & Detailed
Rationales
Questions 1–50: Antidepressants
1. Which neurotransmitter system is most directly affected by
selective serotonin reuptake inhibitors (SSRIs)?
A. Dopamine only
B. Serotonin
C. Acetylcholine
D. GABA
Answer: B
Rationale: SSRIs primarily block the serotonin transporter, increasing
serotonin availability in the synaptic cleft.
2. Which medication is an SSRI?
A. Venlafaxine
B. Bupropion
C. Sertraline
D. Duloxetine
Answer: C
Rationale: Sertraline is an SSRI commonly used for depressive and
anxiety disorders.
3. A patient starting an SSRI asks when improvement should be
expected. What is the most appropriate response?
A. Full improvement should occur within 24 hours
B. Benefits commonly develop over several weeks
C. The medication works only after six months
D. Improvement occurs only after the medication is stopped
Answer: B
Rationale: Antidepressant effects generally develop gradually, with
some symptoms improving before the full therapeutic response.
4. Which adverse effect is commonly associated with SSRIs?
A. Severe hypoglycemia
, B. Sexual dysfunction
C. Agranulocytosis in most patients
D. Permanent hearing loss
Answer: B
Rationale: Decreased libido, delayed orgasm, and other sexual
adverse effects are relatively common with SSRIs.
5. A patient abruptly stops paroxetine after long-term use. Which
problem is most likely?
A. Anticholinergic crisis
B. Discontinuation symptoms
C. Agranulocytosis
D. Neuroleptic malignant syndrome
Answer: B
Rationale: Paroxetine has a relatively short half-life, making
discontinuation symptoms more likely after abrupt cessation.
6. Which SSRI has a relatively long half-life and therefore tends to
produce fewer discontinuation symptoms?
A. Fluoxetine
B. Paroxetine
C. Fluvoxamine
D. Citalopram
Answer: A
Rationale: Fluoxetine and its active metabolite have long half-lives,
reducing the likelihood of abrupt withdrawal symptoms.
7. A patient taking an SSRI develops agitation, diaphoresis,
diarrhea, hyperreflexia, and clonus. Which condition should be
suspected?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Lithium toxicity
D. Anticholinergic toxicity
Answer: A
,Rationale: Clonus and hyperreflexia combined with autonomic and
gastrointestinal symptoms strongly suggest serotonin toxicity.
8. Which medication is an SNRI?
A. Venlafaxine
B. Sertraline
C. Bupropion
D. Mirtazapine
Answer: A
Rationale: Venlafaxine inhibits serotonin and norepinephrine
reuptake and is classified as an SNRI.
9. Which SNRI requires particular attention to blood pressure?
A. Venlafaxine
B. Sertraline
C. Fluoxetine
D. Mirtazapine
Answer: A
Rationale: Venlafaxine can increase blood pressure, particularly at
higher doses, so blood pressure monitoring is appropriate.
10. Duloxetine may be particularly useful when depression
occurs with:
A. Chronic pain
B. Severe neutropenia
C. Acute mania
D. Parkinson disease psychosis
Answer: A
Rationale: Duloxetine has antidepressant and pain-modulating
effects and is used for several chronic pain conditions.
11. Which antidepressant primarily affects norepinephrine and
dopamine rather than serotonin?
A. Bupropion
B. Fluoxetine
, C. Escitalopram
D. Paroxetine
Answer: A
Rationale: Bupropion inhibits norepinephrine and dopamine
reuptake and has relatively little direct serotonergic activity.
12. Which patient should generally avoid bupropion?
A. Patient with seasonal depressive symptoms
B. Patient with a seizure disorder
C. Patient with SSRI-related sexual dysfunction
D. Patient who wants help stopping tobacco use
Answer: B
Rationale: Bupropion lowers the seizure threshold and is
contraindicated in certain patients with seizure disorders and eating
disorders.
13. Which adverse effect is less prominent with bupropion
than with many SSRIs?
A. Sexual dysfunction
B. Insomnia
C. Anxiety
D. Headache
Answer: A
Rationale: Bupropion generally has a lower risk of sexual dysfunction
than serotonergic antidepressants.
14. Which antidepressant is commonly associated with
increased appetite and sedation?
A. Mirtazapine
B. Bupropion
C. Fluoxetine
D. Venlafaxine
Answer: A
Rationale: Mirtazapine can increase appetite and weight and is often
sedating, particularly at lower doses.
Management Across the Lifespan | 300 Practice Questions & Detailed
Rationales
Questions 1–50: Antidepressants
1. Which neurotransmitter system is most directly affected by
selective serotonin reuptake inhibitors (SSRIs)?
A. Dopamine only
B. Serotonin
C. Acetylcholine
D. GABA
Answer: B
Rationale: SSRIs primarily block the serotonin transporter, increasing
serotonin availability in the synaptic cleft.
2. Which medication is an SSRI?
A. Venlafaxine
B. Bupropion
C. Sertraline
D. Duloxetine
Answer: C
Rationale: Sertraline is an SSRI commonly used for depressive and
anxiety disorders.
3. A patient starting an SSRI asks when improvement should be
expected. What is the most appropriate response?
A. Full improvement should occur within 24 hours
B. Benefits commonly develop over several weeks
C. The medication works only after six months
D. Improvement occurs only after the medication is stopped
Answer: B
Rationale: Antidepressant effects generally develop gradually, with
some symptoms improving before the full therapeutic response.
4. Which adverse effect is commonly associated with SSRIs?
A. Severe hypoglycemia
, B. Sexual dysfunction
C. Agranulocytosis in most patients
D. Permanent hearing loss
Answer: B
Rationale: Decreased libido, delayed orgasm, and other sexual
adverse effects are relatively common with SSRIs.
5. A patient abruptly stops paroxetine after long-term use. Which
problem is most likely?
A. Anticholinergic crisis
B. Discontinuation symptoms
C. Agranulocytosis
D. Neuroleptic malignant syndrome
Answer: B
Rationale: Paroxetine has a relatively short half-life, making
discontinuation symptoms more likely after abrupt cessation.
6. Which SSRI has a relatively long half-life and therefore tends to
produce fewer discontinuation symptoms?
A. Fluoxetine
B. Paroxetine
C. Fluvoxamine
D. Citalopram
Answer: A
Rationale: Fluoxetine and its active metabolite have long half-lives,
reducing the likelihood of abrupt withdrawal symptoms.
7. A patient taking an SSRI develops agitation, diaphoresis,
diarrhea, hyperreflexia, and clonus. Which condition should be
suspected?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Lithium toxicity
D. Anticholinergic toxicity
Answer: A
,Rationale: Clonus and hyperreflexia combined with autonomic and
gastrointestinal symptoms strongly suggest serotonin toxicity.
8. Which medication is an SNRI?
A. Venlafaxine
B. Sertraline
C. Bupropion
D. Mirtazapine
Answer: A
Rationale: Venlafaxine inhibits serotonin and norepinephrine
reuptake and is classified as an SNRI.
9. Which SNRI requires particular attention to blood pressure?
A. Venlafaxine
B. Sertraline
C. Fluoxetine
D. Mirtazapine
Answer: A
Rationale: Venlafaxine can increase blood pressure, particularly at
higher doses, so blood pressure monitoring is appropriate.
10. Duloxetine may be particularly useful when depression
occurs with:
A. Chronic pain
B. Severe neutropenia
C. Acute mania
D. Parkinson disease psychosis
Answer: A
Rationale: Duloxetine has antidepressant and pain-modulating
effects and is used for several chronic pain conditions.
11. Which antidepressant primarily affects norepinephrine and
dopamine rather than serotonin?
A. Bupropion
B. Fluoxetine
, C. Escitalopram
D. Paroxetine
Answer: A
Rationale: Bupropion inhibits norepinephrine and dopamine
reuptake and has relatively little direct serotonergic activity.
12. Which patient should generally avoid bupropion?
A. Patient with seasonal depressive symptoms
B. Patient with a seizure disorder
C. Patient with SSRI-related sexual dysfunction
D. Patient who wants help stopping tobacco use
Answer: B
Rationale: Bupropion lowers the seizure threshold and is
contraindicated in certain patients with seizure disorders and eating
disorders.
13. Which adverse effect is less prominent with bupropion
than with many SSRIs?
A. Sexual dysfunction
B. Insomnia
C. Anxiety
D. Headache
Answer: A
Rationale: Bupropion generally has a lower risk of sexual dysfunction
than serotonergic antidepressants.
14. Which antidepressant is commonly associated with
increased appetite and sedation?
A. Mirtazapine
B. Bupropion
C. Fluoxetine
D. Venlafaxine
Answer: A
Rationale: Mirtazapine can increase appetite and weight and is often
sedating, particularly at lower doses.
