NURS 5359 Exam 2: Psychopharmacology
Questions with Answers| Updated| Pass Guaranteed
1. The primary mechanism of action of SSRIs is:
A. Blockade of alpha-2 receptors
B. Inhibition of MAO-A
C. NMDA receptor antagonism
D. Blockade of the serotonin transporter (SERT)
Answer: D. Blockade of the serotonin transporter (SERT)
Rationale: Blocking SERT increases synaptic serotonin. Therapeutic effect
requires downstream receptor adaptation over weeks.
2. SSRIs are considered first-line treatment for:
A. Schizophrenia
B. Acute mania
C. Narcolepsy
D. Major depressive disorder and most anxiety disorders
Answer: D. Major depressive disorder and most anxiety disorders
Rationale: They have a favorable safety profile compared with older
agents.
Page 1
,3. How long does it usually take to judge an adequate trial of an
antidepressant?
A. 2 to 3 days
B. 6 months
C. 1 week
D. 4 to 8 weeks at a therapeutic dose
Answer: D. 4 to 8 weeks at a therapeutic dose
Rationale: Early improvement at 2 weeks predicts response, but full effect
takes longer.
4. Which are common early adverse effects of SSRIs?
A. Nausea, headache, insomnia or activation, and sexual dysfunction
B. Bradycardia
C. Weight loss only
D. Hypoglycemia
Answer: A. Nausea, headache, insomnia or activation, and sexual
dysfunction
Rationale: GI effects tend to diminish within 1 to 2 weeks, while sexual
dysfunction often persists.
5. Which strategy can address SSRI-induced sexual dysfunction?
A. Dose reduction, or switching or augmenting with bupropion
B. Doubling the dose
C. Stopping all medications abruptly
D. Adding a second SSRI
Answer: A. Dose reduction, or switching or augmenting with
bupropion
Rationale: Bupropion has minimal sexual side effects.
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,6. A patient on fluoxetine must wait how long before starting an MAOI?
A. 5 weeks
B. 24 hours
C. 3 days
D. 14 days
Answer: A. 5 weeks
Rationale: Norfluoxetine has a half-life of 7 to 15 days.
7. Which SSRI is the most anticholinergic and has the worst
discontinuation syndrome?
A. Escitalopram
B. Sertraline
C. Paroxetine
D. Fluoxetine
Answer: C. Paroxetine
Rationale: It also carries a concern for first-trimester cardiac malformations.
8. Sertraline is often preferred in patients with:
A. Glaucoma only
B. Cardiac disease, because of its safety data after myocardial
infarction
C. Seizure disorder only
D. Narcolepsy
Answer: B. Cardiac disease, because of its safety data after
myocardial infarction
Rationale: The SADHART trial supported its use in post-MI depression.
Page 3
, 9. The maximum recommended citalopram dose is:
A. 120 mg/day
B. 40 mg/day, and 20 mg/day in those over 60 or with hepatic
impairment
C. 80 mg/day for all
D. 10 mg/day for all
Answer: B. 40 mg/day, and 20 mg/day in those over 60 or with hepatic
impairment
Rationale: Dose-dependent QTc prolongation led to the FDA limit.
10. Escitalopram is:
A. An MAOI
B. A tricyclic
C. The S-enantiomer of citalopram
D. A benzodiazepine
Answer: C. The S-enantiomer of citalopram
Rationale: The maximum dose is 20 mg/day.
11. Fluvoxamine is most notable for:
A. Potent CYP1A2 inhibition and approval for OCD
B. No drug interactions
C. Priapism
D. Hepatotoxicity
Answer: A. Potent CYP1A2 inhibition and approval for OCD
Rationale: It increases levels of clozapine, theophylline, and caffeine.
Page 4
Questions with Answers| Updated| Pass Guaranteed
1. The primary mechanism of action of SSRIs is:
A. Blockade of alpha-2 receptors
B. Inhibition of MAO-A
C. NMDA receptor antagonism
D. Blockade of the serotonin transporter (SERT)
Answer: D. Blockade of the serotonin transporter (SERT)
Rationale: Blocking SERT increases synaptic serotonin. Therapeutic effect
requires downstream receptor adaptation over weeks.
2. SSRIs are considered first-line treatment for:
A. Schizophrenia
B. Acute mania
C. Narcolepsy
D. Major depressive disorder and most anxiety disorders
Answer: D. Major depressive disorder and most anxiety disorders
Rationale: They have a favorable safety profile compared with older
agents.
Page 1
,3. How long does it usually take to judge an adequate trial of an
antidepressant?
A. 2 to 3 days
B. 6 months
C. 1 week
D. 4 to 8 weeks at a therapeutic dose
Answer: D. 4 to 8 weeks at a therapeutic dose
Rationale: Early improvement at 2 weeks predicts response, but full effect
takes longer.
4. Which are common early adverse effects of SSRIs?
A. Nausea, headache, insomnia or activation, and sexual dysfunction
B. Bradycardia
C. Weight loss only
D. Hypoglycemia
Answer: A. Nausea, headache, insomnia or activation, and sexual
dysfunction
Rationale: GI effects tend to diminish within 1 to 2 weeks, while sexual
dysfunction often persists.
5. Which strategy can address SSRI-induced sexual dysfunction?
A. Dose reduction, or switching or augmenting with bupropion
B. Doubling the dose
C. Stopping all medications abruptly
D. Adding a second SSRI
Answer: A. Dose reduction, or switching or augmenting with
bupropion
Rationale: Bupropion has minimal sexual side effects.
Page 2
,6. A patient on fluoxetine must wait how long before starting an MAOI?
A. 5 weeks
B. 24 hours
C. 3 days
D. 14 days
Answer: A. 5 weeks
Rationale: Norfluoxetine has a half-life of 7 to 15 days.
7. Which SSRI is the most anticholinergic and has the worst
discontinuation syndrome?
A. Escitalopram
B. Sertraline
C. Paroxetine
D. Fluoxetine
Answer: C. Paroxetine
Rationale: It also carries a concern for first-trimester cardiac malformations.
8. Sertraline is often preferred in patients with:
A. Glaucoma only
B. Cardiac disease, because of its safety data after myocardial
infarction
C. Seizure disorder only
D. Narcolepsy
Answer: B. Cardiac disease, because of its safety data after
myocardial infarction
Rationale: The SADHART trial supported its use in post-MI depression.
Page 3
, 9. The maximum recommended citalopram dose is:
A. 120 mg/day
B. 40 mg/day, and 20 mg/day in those over 60 or with hepatic
impairment
C. 80 mg/day for all
D. 10 mg/day for all
Answer: B. 40 mg/day, and 20 mg/day in those over 60 or with hepatic
impairment
Rationale: Dose-dependent QTc prolongation led to the FDA limit.
10. Escitalopram is:
A. An MAOI
B. A tricyclic
C. The S-enantiomer of citalopram
D. A benzodiazepine
Answer: C. The S-enantiomer of citalopram
Rationale: The maximum dose is 20 mg/day.
11. Fluvoxamine is most notable for:
A. Potent CYP1A2 inhibition and approval for OCD
B. No drug interactions
C. Priapism
D. Hepatotoxicity
Answer: A. Potent CYP1A2 inhibition and approval for OCD
Rationale: It increases levels of clozapine, theophylline, and caffeine.
Page 4
