BCPP reviewed test questions with
correct answers
25 year od patient with a history of MDD starting in college presents to the mental health clinic
with complaints of having no interest in seeing family or friends, early morning awakening,
having no energy, feeling excessive guilt, and losing weight. This individual endorses a
depressed mood that is very severe in the morning but may improve as the day progresses. The
patient admits to suicidal thoughts but denies plans of self-harm, and reports having these
symptoms and feeling this way for several months. Based on this patient's clinical presentation,
which of the following is the most likely diagnosis for the patient?
A) MDD, with atypical features
B) MDD, with catatonic features
C) MDD, with melancholic features
D) MDD, with mixed features - CORRECT ANSWERS-C
A 24-year-old women is 10 weeks into her first planned pregnancy. She presents to the mental
health clinic with complaints of anhedonia, feelings of worthlessness, insomnia, depressed
mood, and poor appetite. She is diagnosed with MDD and wants to start medications after a
lengthy conversation with her physician and pharmacist. Which of the following is the most
appropriate to initiate for this patient?
A) Amitriptyline
B) Paroxetine
C) Sertraline
D) Venlafaxine - CORRECT ANSWERS-C
A 26 year old female patient diagnosed with bipolar I disorder has been controlled on lithium ER
450 mg twice daily for the past 3 years with no relapse in symptoms and no adverse effects
experienced. She previously failed divalproex and aripiprazole, resulting in hospital admissions
for a manic episode. She presents to the clinic today and alerts the provider that she is currently
6 weeks pregnant. Which step should be taken to minimize the risk of fetal abnormalities?
,A) Continue lithium ER with increased serum concentration monitoring and no additional
pharmacotherapy
B) Increase lithium serum concentration monitoring and add folic acid 4 mg daily to her regimen
C) Increase lithium serum concentration monitoring and add Vitamin K 10 mg daily to her
regimen
D) Cross-taper lithium to olanzapine - CORRECT ANSWERS-A
A 26 year old patient presents to your clinic today for a medication check-up post-
hospitalization. While inpatient, the patient was started on carbamazepine for manic symptoms
and dose optimization was completed 1 month ago with serum concentration monitoring and
subsequent dose adjustment. Today, the patient is voicing trouble with depressive symptoms.
The patient also takes a multivitamin, Vitamin B complex, and fish oil supplement, but no other
prescriptive medications.
The psychiatric NP is weighing the option of starting lamotrigine for this patient due to
complaints of depressive symptoms. If lamotrigine is started in this patient, what is the correct
dose titration for the first four weeks of therapy?
A) 25 mg daily x 2 weeks, then 50 mg daily x 2 weeks
B) 25 mg BID x 2 weeks, then 50 mg BID x 2 weeks
C) 50 mg daily x 2 weeks, then 100 mg d x 2 weeks
D) 50 mg daily x 2 weeks, then 50 mg BID x 2 weeks - CORRECT ANSWERS-D
A 27-year-old patient is started on sertraline 50 mg by mouth daily, is increased to 100 mg by
mouth daily 2 weeks after initiating it, and is reassessed in 8 weeks. The patient reports little
improvement in her presenting symptoms which included a depressed mood, anhedonia,
concentration difficulties, insomnia, and excessive guilt. Based on findings from the STARD
trials, which of the following is the best course of action?
A) Increase sertraline to 150 mg/day
B) Augment sertraline with aripiprazole 5 mg/day
C) Switch sertraline to amitriptyline 25 mg/day
D) Switch sertraline to escitalopram 10 mg/day - CORRECT ANSWERS-D
A 28 year old patient recently diagnosed with MDD presents to the mental health clinic for a
follow-up assessment and medication check. This individual was started on bupropion
sustained-release 150 mg by mouth 2 weeks ago. The patient was to take this for 3 days, then
add in the second 150 mg dose by mouth (take in the late afternoon). The patient's physician
, administers the MADRS during the visit, and the patient's score is 33 today. This score on the
MADRS indicates which level of depression?
A) Mild
B) Moderate
C) Severe
D) Very severe - CORRECT ANSWERS-B
A 29-year-old patient new to antidepressant therapy comes to your patient medication education
group. The patient would like to know when an improvement in depressed mood will be seen.
Which of the following time frames do you provide?
A) After a few days of teatment
B) After the first week of treatment
C) After the fourth week of treatment
D) After the eighth week of treatment - CORRECT ANSWERS-C
A 35 year old patient recently diagnosed with MDD asks you about different antidepressant
options. The individual's medical co-morbidities include diabetes, neuropathic pain, and
seizures. Current medications include metformin 1000 mg by mouth twice daily and gabapentin
600 mg by mouth three times daily. All laboratory values and vital signs are within normal limits.
You inquire about the patient's daily adherence, and the patient reports very few missed
medication doses. Which of the following medications would be most appropriate to initiate for
this patient?
A) Amitriptyline
B) Bupropion
C) Duloxetine
D) Fluoxetine - CORRECT ANSWERS-C
A 35-year-old presents to the mental health clinic with SI, and admits to having these thoughts
since losing a best friend to cancer 5 months ago. The patient has no plan but is disturbed by
these thoughts. The patient is married with 2 children and resides with family members who are
described as supportive. The patient is currently taking venlafaxine 150 mg ER daily for MDD.
Besides the suicidal thoughts, the individual has no other symptoms of depression except
insomnia and excessive guilt. Based upon this patient's symptoms and demographics, what
level of suicide risk would this patient represent?
A) Mild
correct answers
25 year od patient with a history of MDD starting in college presents to the mental health clinic
with complaints of having no interest in seeing family or friends, early morning awakening,
having no energy, feeling excessive guilt, and losing weight. This individual endorses a
depressed mood that is very severe in the morning but may improve as the day progresses. The
patient admits to suicidal thoughts but denies plans of self-harm, and reports having these
symptoms and feeling this way for several months. Based on this patient's clinical presentation,
which of the following is the most likely diagnosis for the patient?
A) MDD, with atypical features
B) MDD, with catatonic features
C) MDD, with melancholic features
D) MDD, with mixed features - CORRECT ANSWERS-C
A 24-year-old women is 10 weeks into her first planned pregnancy. She presents to the mental
health clinic with complaints of anhedonia, feelings of worthlessness, insomnia, depressed
mood, and poor appetite. She is diagnosed with MDD and wants to start medications after a
lengthy conversation with her physician and pharmacist. Which of the following is the most
appropriate to initiate for this patient?
A) Amitriptyline
B) Paroxetine
C) Sertraline
D) Venlafaxine - CORRECT ANSWERS-C
A 26 year old female patient diagnosed with bipolar I disorder has been controlled on lithium ER
450 mg twice daily for the past 3 years with no relapse in symptoms and no adverse effects
experienced. She previously failed divalproex and aripiprazole, resulting in hospital admissions
for a manic episode. She presents to the clinic today and alerts the provider that she is currently
6 weeks pregnant. Which step should be taken to minimize the risk of fetal abnormalities?
,A) Continue lithium ER with increased serum concentration monitoring and no additional
pharmacotherapy
B) Increase lithium serum concentration monitoring and add folic acid 4 mg daily to her regimen
C) Increase lithium serum concentration monitoring and add Vitamin K 10 mg daily to her
regimen
D) Cross-taper lithium to olanzapine - CORRECT ANSWERS-A
A 26 year old patient presents to your clinic today for a medication check-up post-
hospitalization. While inpatient, the patient was started on carbamazepine for manic symptoms
and dose optimization was completed 1 month ago with serum concentration monitoring and
subsequent dose adjustment. Today, the patient is voicing trouble with depressive symptoms.
The patient also takes a multivitamin, Vitamin B complex, and fish oil supplement, but no other
prescriptive medications.
The psychiatric NP is weighing the option of starting lamotrigine for this patient due to
complaints of depressive symptoms. If lamotrigine is started in this patient, what is the correct
dose titration for the first four weeks of therapy?
A) 25 mg daily x 2 weeks, then 50 mg daily x 2 weeks
B) 25 mg BID x 2 weeks, then 50 mg BID x 2 weeks
C) 50 mg daily x 2 weeks, then 100 mg d x 2 weeks
D) 50 mg daily x 2 weeks, then 50 mg BID x 2 weeks - CORRECT ANSWERS-D
A 27-year-old patient is started on sertraline 50 mg by mouth daily, is increased to 100 mg by
mouth daily 2 weeks after initiating it, and is reassessed in 8 weeks. The patient reports little
improvement in her presenting symptoms which included a depressed mood, anhedonia,
concentration difficulties, insomnia, and excessive guilt. Based on findings from the STARD
trials, which of the following is the best course of action?
A) Increase sertraline to 150 mg/day
B) Augment sertraline with aripiprazole 5 mg/day
C) Switch sertraline to amitriptyline 25 mg/day
D) Switch sertraline to escitalopram 10 mg/day - CORRECT ANSWERS-D
A 28 year old patient recently diagnosed with MDD presents to the mental health clinic for a
follow-up assessment and medication check. This individual was started on bupropion
sustained-release 150 mg by mouth 2 weeks ago. The patient was to take this for 3 days, then
add in the second 150 mg dose by mouth (take in the late afternoon). The patient's physician
, administers the MADRS during the visit, and the patient's score is 33 today. This score on the
MADRS indicates which level of depression?
A) Mild
B) Moderate
C) Severe
D) Very severe - CORRECT ANSWERS-B
A 29-year-old patient new to antidepressant therapy comes to your patient medication education
group. The patient would like to know when an improvement in depressed mood will be seen.
Which of the following time frames do you provide?
A) After a few days of teatment
B) After the first week of treatment
C) After the fourth week of treatment
D) After the eighth week of treatment - CORRECT ANSWERS-C
A 35 year old patient recently diagnosed with MDD asks you about different antidepressant
options. The individual's medical co-morbidities include diabetes, neuropathic pain, and
seizures. Current medications include metformin 1000 mg by mouth twice daily and gabapentin
600 mg by mouth three times daily. All laboratory values and vital signs are within normal limits.
You inquire about the patient's daily adherence, and the patient reports very few missed
medication doses. Which of the following medications would be most appropriate to initiate for
this patient?
A) Amitriptyline
B) Bupropion
C) Duloxetine
D) Fluoxetine - CORRECT ANSWERS-C
A 35-year-old presents to the mental health clinic with SI, and admits to having these thoughts
since losing a best friend to cancer 5 months ago. The patient has no plan but is disturbed by
these thoughts. The patient is married with 2 children and resides with family members who are
described as supportive. The patient is currently taking venlafaxine 150 mg ER daily for MDD.
Besides the suicidal thoughts, the individual has no other symptoms of depression except
insomnia and excessive guilt. Based upon this patient's symptoms and demographics, what
level of suicide risk would this patient represent?
A) Mild
