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Wilkes NSG 533 Exam 1 Advanced Pharmacology
2026/2027, BRANDNEW VERSION !!!!
Which of the following SSRIs requires up to a 5-week washout period
because of the
long half-life of its potent active metabolite?
A. Escitalopram
B. Fluvoxamine
C. Fluoxetine
D. Sertraline - ANSWER -C
Which of the following symptoms is most likely to improve within
approximately 1 week
of starting treatment?
A. Depressed mood
B. Suicidal thoughts
C. Anhedonia
D. Sleep - ANSWER -D
Of the following combinations of medications, which one would you
want to avoid?
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A. Fluoxetine-lithium
B. Fluoxetine-phenelzine
C. Citalopram-valproic acid
D. Citalopram-aripiprazole - ANSWER -B
A 26-year-old man with a history of depression has been taking
sertraline 200 mg/day for 12 weeks with no response. The patient has
no other complications. The physician asks for your recommendation.
The most reasonable recommendation would be to:
A. Increase sertraline
B. Add fluoxetine
C. Switch to amitriptyline
D. Change to venlafaxine
E. Decrease sertraline - ANSWER -D
Which of the following is a dangerous combination?
A. MAOI-lorazepam
B. MAOI-acetaminophen
C. MAOI-meperidine
D. MAOI-ziprasidone - ANSWER -C
A 23-year-old married white woman comes to the outpatient psychiatric
clinic
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complaining of decreased sleep, decreased appetite, decreased
concentration, depressed
mood, thoughts of death, and lack of interest in activities for 6 weeks'
duration. She has
no history of psychiatric illness and takes no medications except for
Ortho-Tri Cyclen Lo
daily. Based upon the patients symptoms, choose the best medication
to treat this patient.
A. Nefazodone 100 mg po twice daily
B. Paroxetine 20 mg po daily
C. St. John's wort 300 mg po three times daily
D. Amitriptyline 25 mg at bedtime - ANSWER -B
A 36-year-old man is admitted to the hospital for a severe methicillin-
resistant Staphylococcus aureus diabetic foot infection and is started on
linezolid 600 mg IV every 12 hours. His medication profile includes
paroxetine 40 mg every morning, trazodone 100 mg at bedtime as
needed for sleep, and metformin 1000 mg po twice daily. After 3
days on these medications, the patient becomes agitated, confused,
and diaphoretic and develops myoclonic jerks. Which of the following is
the most likely diagnosis?
A. Overdose of metformin
B. Bacterial meningitis
C. Neuroleptic malignant syndrome
D. Serotonin syndrome - ANSWER -D
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A 46-year-old woman presents to the psychiatric outpatient clinic for
follow-up treatment of major depression. She is currently on paroxetine
10 mg at bedtime, which she started taking 2 months ago when
admitted to the psychiatric hospital for suicidal ideation. During the
interview, she says that she does not think the medication is working
because she is just as depressed as she was before taking the
medication and has recently started drinking eight to 10 beers daily to
alleviate the depression. Before this episode, she was
sober for 4 years. Which of the following treatment strategies would be
the appropriate choice for this patient?
A. Stop the paroxetine and start nefazodone 100 mg po twice daily
B. Increase the dose of paroxetine to 20 mg po at bedtime
C. Stop the paroxetine and start duloxetine 20 mg/day
D. Continue the paroxetine at them same dose for a longer period of
time to evaluate
whether she will res - ANSWER -B
Which of the following is a flaw in the monoamine hypothesis of
depression?
A. Concentrations of neurotransmitters are reduced in the synaptic cleft
B. A switch to a different class of antidepressants does not improve
response
Wilkes NSG 533 Exam 1 Advanced Pharmacology
2026/2027, BRANDNEW VERSION !!!!
Which of the following SSRIs requires up to a 5-week washout period
because of the
long half-life of its potent active metabolite?
A. Escitalopram
B. Fluvoxamine
C. Fluoxetine
D. Sertraline - ANSWER -C
Which of the following symptoms is most likely to improve within
approximately 1 week
of starting treatment?
A. Depressed mood
B. Suicidal thoughts
C. Anhedonia
D. Sleep - ANSWER -D
Of the following combinations of medications, which one would you
want to avoid?
,2|Page
A. Fluoxetine-lithium
B. Fluoxetine-phenelzine
C. Citalopram-valproic acid
D. Citalopram-aripiprazole - ANSWER -B
A 26-year-old man with a history of depression has been taking
sertraline 200 mg/day for 12 weeks with no response. The patient has
no other complications. The physician asks for your recommendation.
The most reasonable recommendation would be to:
A. Increase sertraline
B. Add fluoxetine
C. Switch to amitriptyline
D. Change to venlafaxine
E. Decrease sertraline - ANSWER -D
Which of the following is a dangerous combination?
A. MAOI-lorazepam
B. MAOI-acetaminophen
C. MAOI-meperidine
D. MAOI-ziprasidone - ANSWER -C
A 23-year-old married white woman comes to the outpatient psychiatric
clinic
,3|Page
complaining of decreased sleep, decreased appetite, decreased
concentration, depressed
mood, thoughts of death, and lack of interest in activities for 6 weeks'
duration. She has
no history of psychiatric illness and takes no medications except for
Ortho-Tri Cyclen Lo
daily. Based upon the patients symptoms, choose the best medication
to treat this patient.
A. Nefazodone 100 mg po twice daily
B. Paroxetine 20 mg po daily
C. St. John's wort 300 mg po three times daily
D. Amitriptyline 25 mg at bedtime - ANSWER -B
A 36-year-old man is admitted to the hospital for a severe methicillin-
resistant Staphylococcus aureus diabetic foot infection and is started on
linezolid 600 mg IV every 12 hours. His medication profile includes
paroxetine 40 mg every morning, trazodone 100 mg at bedtime as
needed for sleep, and metformin 1000 mg po twice daily. After 3
days on these medications, the patient becomes agitated, confused,
and diaphoretic and develops myoclonic jerks. Which of the following is
the most likely diagnosis?
A. Overdose of metformin
B. Bacterial meningitis
C. Neuroleptic malignant syndrome
D. Serotonin syndrome - ANSWER -D
, 4|Page
A 46-year-old woman presents to the psychiatric outpatient clinic for
follow-up treatment of major depression. She is currently on paroxetine
10 mg at bedtime, which she started taking 2 months ago when
admitted to the psychiatric hospital for suicidal ideation. During the
interview, she says that she does not think the medication is working
because she is just as depressed as she was before taking the
medication and has recently started drinking eight to 10 beers daily to
alleviate the depression. Before this episode, she was
sober for 4 years. Which of the following treatment strategies would be
the appropriate choice for this patient?
A. Stop the paroxetine and start nefazodone 100 mg po twice daily
B. Increase the dose of paroxetine to 20 mg po at bedtime
C. Stop the paroxetine and start duloxetine 20 mg/day
D. Continue the paroxetine at them same dose for a longer period of
time to evaluate
whether she will res - ANSWER -B
Which of the following is a flaw in the monoamine hypothesis of
depression?
A. Concentrations of neurotransmitters are reduced in the synaptic cleft
B. A switch to a different class of antidepressants does not improve
response
