NR 546 Psychopharmacology for PMHNPs – 100-
Question Final Exam Study Guide with Answers and
Rationales
,Introduction
This comprehensive NR 546 Psychopharmacology for PMHNP exam review is designed to
help nurse practitioner students master essential psychotropic medication concepts tested in
graduate-level courses and board-style exams.
It includes 100 high-yield multiple-choice questions, each followed by the correct answer and
concise rationale, covering every major pharmacologic domain relevant to psychiatric mental
health practice.
1. Which SSRI is most associated with QT prolongation risk?
A. Fluoxetine
B. Sertraline
C. Citalopram
D. Paroxetine
✅ Answer: C. Citalopram
Rationale: Citalopram can prolong the QT interval, especially at doses >40 mg/day. Use caution in
cardiac patients.
2. Which antidepressant is contraindicated in seizure disorders?
A. Sertraline
B. Bupropion
C. Venlafaxine
D. Escitalopram
✅ Answer: B. Bupropion
Rationale: Bupropion lowers the seizure threshold and is contraindicated in those with epilepsy or
eating disorders.
3. Which atypical antipsychotic has the highest metabolic side effect risk?
A. Aripiprazole
B. Ziprasidone
C. Clozapine
D. Lurasidone
, ✅ Answer: C. Clozapine
Rationale: Clozapine causes significant weight gain, dyslipidemia, and insulin resistance.
4. Which neurotransmitter is most associated with anxiety symptoms?
A. Dopamine
B. GABA
C. Acetylcholine
D. Glutamate
✅ Answer: B. GABA
Rationale: Low GABA levels are linked to anxiety; benzodiazepines enhance GABAergic transmission.
5. A patient on lithium presents with tremor, nausea, and ataxia. What should you do first?
A. Stop lithium and check serum level
B. Give propranolol
C. Increase fluid intake
D. Add valproic acid
✅ Answer: A. Stop lithium and check serum level
Rationale: Signs of lithium toxicity; serum levels must be checked immediately.
6. Which antidepressant is safest during pregnancy?
A. Paroxetine
B. Fluoxetine
C. Sertraline
D. Venlafaxine
✅ Answer: C. Sertraline
Rationale: Sertraline is considered safest (lowest teratogenic risk); paroxetine carries risk of cardiac
defects.
7. Which benzodiazepine has the shortest half-life?
A. Lorazepam
B. Diazepam
C. Alprazolam
D. Clonazepam
✅ Answer: C. Alprazolam
Rationale: Alprazolam has a short half-life and high risk for withdrawal symptoms.
Question Final Exam Study Guide with Answers and
Rationales
,Introduction
This comprehensive NR 546 Psychopharmacology for PMHNP exam review is designed to
help nurse practitioner students master essential psychotropic medication concepts tested in
graduate-level courses and board-style exams.
It includes 100 high-yield multiple-choice questions, each followed by the correct answer and
concise rationale, covering every major pharmacologic domain relevant to psychiatric mental
health practice.
1. Which SSRI is most associated with QT prolongation risk?
A. Fluoxetine
B. Sertraline
C. Citalopram
D. Paroxetine
✅ Answer: C. Citalopram
Rationale: Citalopram can prolong the QT interval, especially at doses >40 mg/day. Use caution in
cardiac patients.
2. Which antidepressant is contraindicated in seizure disorders?
A. Sertraline
B. Bupropion
C. Venlafaxine
D. Escitalopram
✅ Answer: B. Bupropion
Rationale: Bupropion lowers the seizure threshold and is contraindicated in those with epilepsy or
eating disorders.
3. Which atypical antipsychotic has the highest metabolic side effect risk?
A. Aripiprazole
B. Ziprasidone
C. Clozapine
D. Lurasidone
, ✅ Answer: C. Clozapine
Rationale: Clozapine causes significant weight gain, dyslipidemia, and insulin resistance.
4. Which neurotransmitter is most associated with anxiety symptoms?
A. Dopamine
B. GABA
C. Acetylcholine
D. Glutamate
✅ Answer: B. GABA
Rationale: Low GABA levels are linked to anxiety; benzodiazepines enhance GABAergic transmission.
5. A patient on lithium presents with tremor, nausea, and ataxia. What should you do first?
A. Stop lithium and check serum level
B. Give propranolol
C. Increase fluid intake
D. Add valproic acid
✅ Answer: A. Stop lithium and check serum level
Rationale: Signs of lithium toxicity; serum levels must be checked immediately.
6. Which antidepressant is safest during pregnancy?
A. Paroxetine
B. Fluoxetine
C. Sertraline
D. Venlafaxine
✅ Answer: C. Sertraline
Rationale: Sertraline is considered safest (lowest teratogenic risk); paroxetine carries risk of cardiac
defects.
7. Which benzodiazepine has the shortest half-life?
A. Lorazepam
B. Diazepam
C. Alprazolam
D. Clonazepam
✅ Answer: C. Alprazolam
Rationale: Alprazolam has a short half-life and high risk for withdrawal symptoms.
