,NSG 552 Exam 2 Psychopharmacology Questions And Answers
2026/2027 Wilkes University
Q1. Which neurotransmitter pattern is most closely associated with
autonomic hyperarousal in anxiety disorders?
A) Reduced acetylcholine activity
B) Increased norepinephrine activity
C) Reduced dopamine in the nigrostriatal pathway
D) Increased histamine activity
Correct Answer: B) Increased norepinephrine activity
Rationale: Norepinephrine contributes to the sympathetic fight-or-flight
response. Excessive noradrenergic activity can produce tachycardia, tremor,
diaphoresis, increased respiratory rate, and heightened vigilance commonly
associated with anxiety.
Q2. A patient with persistent excessive worry, muscle tension,
irritability, and insomnia has no previous pharmacologic treatment.
Which medication strategy is generally appropriate for long-term
management?
A) Begin an SSRI or SNRI
B) Start scheduled alprazolam indefinitely
C) Use zolpidem as the primary anxiolytic
D) Begin a stimulant
Correct Answer: A) Begin an SSRI or SNRI
Rationale: SSRIs and SNRIs are commonly used as first-line long-term
pharmacologic treatments for generalized anxiety disorder. Unlike
benzodiazepines, they do not produce the same degree of dependence or
tolerance with chronic use.
Q3. Which medical condition should be considered when a patient
develops new anxiety accompanied by tremor, weight loss, heat
intolerance, and persistent tachycardia?
A) Iron deficiency
B) Osteoarthritis
, C) Hypothyroidism
D) Hyperthyroidism
Correct Answer: D) Hyperthyroidism
Rationale: Hyperthyroidism can mimic or exacerbate anxiety by increasing
adrenergic activity. New-onset anxiety with prominent systemic symptoms
warrants assessment for medical, medication-related, and substance-related
causes before assuming a primary psychiatric disorder.
Q4. A patient asks to use buspirone only during episodes of severe
anxiety because it is “safer than a benzodiazepine.” Which response
is most accurate?
A) Buspirone produces immediate relief within minutes
B) Buspirone is intended primarily for acute panic attacks
C) Buspirone requires regular dosing and a delayed therapeutic onset
D) Buspirone is pharmacologically identical to lorazepam
Correct Answer: C) Buspirone requires regular dosing and a delayed
therapeutic onset
Rationale: Buspirone is not an effective PRN medication because its
anxiolytic benefit develops gradually with scheduled use. It has low abuse
potential and does not produce benzodiazepine-like rapid sedation.
Q5. Which receptor action best describes buspirone?
A) Dopamine D2 antagonism
B) GABA-A positive allosteric modulation
C) Partial agonism at serotonin 5-HT1A receptors
D) Irreversible monoamine oxidase inhibition
Correct Answer: C) Partial agonism at serotonin 5-HT1A receptors
Rationale: Buspirone primarily acts as a partial 5-HT1A receptor agonist.
This distinguishes it mechanistically from benzodiazepines, which enhance
GABA-A receptor activity.
Q6. Which characteristic is an advantage of buspirone compared
with benzodiazepines for chronic anxiety treatment?
2026/2027 Wilkes University
Q1. Which neurotransmitter pattern is most closely associated with
autonomic hyperarousal in anxiety disorders?
A) Reduced acetylcholine activity
B) Increased norepinephrine activity
C) Reduced dopamine in the nigrostriatal pathway
D) Increased histamine activity
Correct Answer: B) Increased norepinephrine activity
Rationale: Norepinephrine contributes to the sympathetic fight-or-flight
response. Excessive noradrenergic activity can produce tachycardia, tremor,
diaphoresis, increased respiratory rate, and heightened vigilance commonly
associated with anxiety.
Q2. A patient with persistent excessive worry, muscle tension,
irritability, and insomnia has no previous pharmacologic treatment.
Which medication strategy is generally appropriate for long-term
management?
A) Begin an SSRI or SNRI
B) Start scheduled alprazolam indefinitely
C) Use zolpidem as the primary anxiolytic
D) Begin a stimulant
Correct Answer: A) Begin an SSRI or SNRI
Rationale: SSRIs and SNRIs are commonly used as first-line long-term
pharmacologic treatments for generalized anxiety disorder. Unlike
benzodiazepines, they do not produce the same degree of dependence or
tolerance with chronic use.
Q3. Which medical condition should be considered when a patient
develops new anxiety accompanied by tremor, weight loss, heat
intolerance, and persistent tachycardia?
A) Iron deficiency
B) Osteoarthritis
, C) Hypothyroidism
D) Hyperthyroidism
Correct Answer: D) Hyperthyroidism
Rationale: Hyperthyroidism can mimic or exacerbate anxiety by increasing
adrenergic activity. New-onset anxiety with prominent systemic symptoms
warrants assessment for medical, medication-related, and substance-related
causes before assuming a primary psychiatric disorder.
Q4. A patient asks to use buspirone only during episodes of severe
anxiety because it is “safer than a benzodiazepine.” Which response
is most accurate?
A) Buspirone produces immediate relief within minutes
B) Buspirone is intended primarily for acute panic attacks
C) Buspirone requires regular dosing and a delayed therapeutic onset
D) Buspirone is pharmacologically identical to lorazepam
Correct Answer: C) Buspirone requires regular dosing and a delayed
therapeutic onset
Rationale: Buspirone is not an effective PRN medication because its
anxiolytic benefit develops gradually with scheduled use. It has low abuse
potential and does not produce benzodiazepine-like rapid sedation.
Q5. Which receptor action best describes buspirone?
A) Dopamine D2 antagonism
B) GABA-A positive allosteric modulation
C) Partial agonism at serotonin 5-HT1A receptors
D) Irreversible monoamine oxidase inhibition
Correct Answer: C) Partial agonism at serotonin 5-HT1A receptors
Rationale: Buspirone primarily acts as a partial 5-HT1A receptor agonist.
This distinguishes it mechanistically from benzodiazepines, which enhance
GABA-A receptor activity.
Q6. Which characteristic is an advantage of buspirone compared
with benzodiazepines for chronic anxiety treatment?
