NRNP 6635 WEEK 5 COMPREHENSIVE
ASSESSMENT - MOOD DISORDERS AND
PSYCHOPHARMACOLOGY QUESTIONS
AND ANSWERS 100% VERIFIED BY
EXPERTS. 2026/2027
1. Which antidepressant is classified as a Selective Melatonin Receptor Agonist and Selective
Serotonin Receptor Antagonist (MASSA)?
A. Vortioxetine
B. Agomelatine
C. Vilazodone
D. Levomilnacipran
Answer: B
Conceptual Explanation: Agomelatine acts as an agonist at MT1 and MT2 melatonin
receptors and as an antagonist at 5-HT2C receptors, making it a unique treatment for
depression involving circadian rhythm disruption.
2. A patient with Bipolar I Disorder is started on Lithium. What is the target therapeutic
serum level for acute mania according to most clinical guidelines?
A. 0.8 to 1.2 mEq/L
,B. 0.4 to 0.6 mEq/L
C. 1.5 to 2.0 mEq/L
D. 2.5 to 3.0 mEq/L
Answer: A
Conceptual Explanation: For acute mania, lithium levels are typically targeted between
0.8 and 1.2 mEq/L. Levels above 1.5 mEq/L can lead to toxicity, while levels above 2.0
mEq/L are considered severe toxicity.
3. Which mechanism of action distinguishes Mirtazapine from SSRIs?
A. Reuptake inhibition of Norepinephrine and Dopamine
B. Antagonism of Alpha-2 adrenergic autoreceptors and heteroreceptors
C. Potent inhibition of the Serotonin transporter (SERT)
D. Irreversible inhibition of Monoamine Oxidase A
Answer: B
Conceptual Explanation: Mirtazapine is a NaSSA that works by blocking alpha-2
autoreceptors and heteroreceptors, which increases the release of both serotonin and
norepinephrine.
4. According to the STAR*D study, what is the approximate remission rate after the first level
of treatment with a single SSRI (Citalopram)?
A. 33%
, B. 15%
C. 50%
D. 67%
Answer: A
Conceptual Explanation: The STAR*D study showed that only about 33% of patients
achieved remission after the first step of treatment with Citalopram.
5. Which antidepressant requires a specific washout period of at least 5 weeks before starting
a Monoamine Oxidase Inhibitor (MAOI) due to its long-half life metabolite?
A. Sertraline
B. Paroxetine
C. Fluoxetine
D. Escitalopram
Answer: C
Conceptual Explanation: Fluoxetine has a very long half-life (and its metabolite
norfluoxetine), requiring a 5-week washout period to avoid serotonin syndrome when
switching to an MAOI.
6. A patient taking Valproic Acid for Bipolar Disorder presents with bruising and petechiae.
Which lab value is the priority to check?
A. Platelet count
ASSESSMENT - MOOD DISORDERS AND
PSYCHOPHARMACOLOGY QUESTIONS
AND ANSWERS 100% VERIFIED BY
EXPERTS. 2026/2027
1. Which antidepressant is classified as a Selective Melatonin Receptor Agonist and Selective
Serotonin Receptor Antagonist (MASSA)?
A. Vortioxetine
B. Agomelatine
C. Vilazodone
D. Levomilnacipran
Answer: B
Conceptual Explanation: Agomelatine acts as an agonist at MT1 and MT2 melatonin
receptors and as an antagonist at 5-HT2C receptors, making it a unique treatment for
depression involving circadian rhythm disruption.
2. A patient with Bipolar I Disorder is started on Lithium. What is the target therapeutic
serum level for acute mania according to most clinical guidelines?
A. 0.8 to 1.2 mEq/L
,B. 0.4 to 0.6 mEq/L
C. 1.5 to 2.0 mEq/L
D. 2.5 to 3.0 mEq/L
Answer: A
Conceptual Explanation: For acute mania, lithium levels are typically targeted between
0.8 and 1.2 mEq/L. Levels above 1.5 mEq/L can lead to toxicity, while levels above 2.0
mEq/L are considered severe toxicity.
3. Which mechanism of action distinguishes Mirtazapine from SSRIs?
A. Reuptake inhibition of Norepinephrine and Dopamine
B. Antagonism of Alpha-2 adrenergic autoreceptors and heteroreceptors
C. Potent inhibition of the Serotonin transporter (SERT)
D. Irreversible inhibition of Monoamine Oxidase A
Answer: B
Conceptual Explanation: Mirtazapine is a NaSSA that works by blocking alpha-2
autoreceptors and heteroreceptors, which increases the release of both serotonin and
norepinephrine.
4. According to the STAR*D study, what is the approximate remission rate after the first level
of treatment with a single SSRI (Citalopram)?
A. 33%
, B. 15%
C. 50%
D. 67%
Answer: A
Conceptual Explanation: The STAR*D study showed that only about 33% of patients
achieved remission after the first step of treatment with Citalopram.
5. Which antidepressant requires a specific washout period of at least 5 weeks before starting
a Monoamine Oxidase Inhibitor (MAOI) due to its long-half life metabolite?
A. Sertraline
B. Paroxetine
C. Fluoxetine
D. Escitalopram
Answer: C
Conceptual Explanation: Fluoxetine has a very long half-life (and its metabolite
norfluoxetine), requiring a 5-week washout period to avoid serotonin syndrome when
switching to an MAOI.
6. A patient taking Valproic Acid for Bipolar Disorder presents with bruising and petechiae.
Which lab value is the priority to check?
A. Platelet count
