Advanced Pharmacology: Psychopharmacology
for the Psychiatric-Mental Health Nurse
Practitioner | Chamberlain University | Verified
Questions and Answers | 100% Correct | Grade A
Questions and Verified Answers | New!! – Chamberlain
This final exam for NR546 Advanced Pharmacology Psychopharmacology (2025/2026) includes
80 verified questions on psychotropic medications, mechanisms, side effects, interactions,
dosing, and lifespan considerations. Questions are multiple-choice with four options, correct
answer in RED, and rationales with evidence-based practice.
Question 1: What is the primary mechanism of action of selective serotonin reuptake
inhibitors like sertraline?
A. Dopamine reuptake inhibition
B. Serotonin reuptake inhibition
C. Norepinephrine reuptake inhibition
D. GABA enhancement
Correct Answer: B. Serotonin reuptake inhibition
Rationale: Blocks the serotonin transporter, increasing synaptic serotonin levels. First-line for
depression and anxiety disorders.
Question 2: A 30-year-old female is started on fluoxetine 20 mg daily. What is the expected
onset of therapeutic effect?
A. 1–2 days
B. 1–2 weeks
C. 4–6 weeks
D. 8–12 weeks
Correct Answer: C. 4–6 weeks
Rationale: Requires 4–6 weeks for full effect due to downstream adaptations like BDNF
upregulation. Monitor for response at 4–6 weeks.
,Question 3: Which SSRI has the highest risk of sexual dysfunction?
A. Sertraline
B. Paroxetine
C. Escitalopram
D. Fluoxetine
Correct Answer: B. Paroxetine
Rationale: Strongest affinity for SERT and anticholinergic effects. Switch to bupropion if
intolerable.
Question 4: A 25-year-old male with panic disorder is prescribed sertraline. Initial dose?
A. 50 mg daily
B. 25 mg daily
C. 100 mg daily
D. 200 mg daily
Correct Answer: B. 25 mg daily
Rationale: Start low to minimize anxiety exacerbation; titrate to 50 mg after 1 week.
Question 5: Lithium is the gold standard for:
A. Depression
B. Bipolar mania maintenance
C. Anxiety
D. ADHD
Correct Answer: B. Bipolar mania maintenance
Rationale: Reduces relapse by 50%; therapeutic level 0.6–1.2 mEq/L.
Question 6: A patient on lithium has tremor and nausea. Suspected cause?
A. Hyponatremia
B. Lithium toxicity
C. Hypothyroidism
D. Dehydration
Correct Answer: B. Lithium toxicity
Rationale: Level >1.5 mEq/L; symptoms include tremor, nausea, diarrhea.
Question 7: Valproic acid is preferred for bipolar in:
A. Pregnancy
B. Renal impairment
C. Liver disease
D. Rapid cycling
, Correct Answer: D. Rapid cycling
Rationale: Effective for mixed states and rapid cycling.
Question 8: Lamotrigine is best for:
A. Mania
B. Bipolar depression
C. Psychosis
D. Anxiety
Correct Answer: B. Bipolar depression
Rationale: Maintenance and depression prophylaxis; slow titration to avoid rash.
Question 9: A 40-year-old is started on buspirone. Onset of action?
A. 1 hour
B. 1–2 weeks
C. 4–6 weeks
D. 8–12 weeks
Correct Answer: C. 4–6 weeks
Rationale: 5-HT1A partial agonist; non-addictive anxiolytic.
Question 10: Benzodiazepines are first-line for:
A. Long-term anxiety
B. Acute panic attack
C. OCD
D. PTSD
Correct Answer: B. Acute panic attack
Rationale: Rapid onset; short-term use due to dependence risk.
Question 11: A 55-year-old with depression and insomnia. Best agent?
A. Fluoxetine
B. Mirtazapine
C. Bupropion
D. Venlafaxine
Correct Answer: B. Mirtazapine
Rationale: Sedating; H1 antagonist.