NR 546 ADVANCED PHARMACOLOGY:
PSYCHOPHARMACOLOGY FOR THE
PSYCHIATRIC-MENTAL HEALTH NURSE
PRACTITIONER FINAL EXAM
(CHAMBERLAIN 2026)
1. What is the primary mechanism of action for selective serotonin
reuptake inhibitors (SSRIs)?
a. Block dopamine D2 receptors
b. Inhibit reuptake of serotonin at the synapse
c. Antagonize GABA-A receptors
d. Inhibit monoamine oxidase
Correct Answer b. Inhibit reuptake of serotonin at the synapse
Rationale SSRIs increase synaptic serotonin by blocking its
reuptake transporter.
2. Which neurotransmitter is most associated with positive
symptoms of schizophrenia?
a. Serotonin
b. Dopamine (excess in mesolimbic pathway)
c. GABA
d. Glutamate
Correct Answer b. Dopamine (excess in mesolimbic pathway)
, Rationale Hyperdopaminergia in mesolimbic pathway drives
hallucinations and delusions.
3. What is a common black box warning for atypical
antipsychotics in children/adolescents?
a. Agranulocytosis
b. Increased risk of suicidality
c. QT prolongation
d. Metabolic syndrome
Correct Answer b. Increased risk of suicidality
Rationale Aripiprazole and quetiapine carry warnings for
increased suicide risk in pediatric patients.
4. Which medication class is first-line for generalized anxiety
disorder (GAD)?
a. Benzodiazepines
b. SSRIs/SNRIs
c. Typical antipsychotics
d. Mood stabilizers
Correct Answer b. SSRIs/SNRIs
Rationale SSRIs/SNRIs provide sustained efficacy with lower
dependence risk than benzodiazepines.
,5. What is the primary receptor blocked by first-generation
antipsychotics?
a. 5-HT2A
b. D2 (dopamine)
c. GABA-A
d. NMDA
Correct Answer b. D2 (dopamine)
Rationale FGAs non-selectively block D2 receptors, causing
EPS but improving positive symptoms.
6. Which CYP450 enzyme metabolizes many psychotropics,
including SSRIs and antipsychotics?
a. CYP1A2
b. CYP2D6
c. CYP3A4
d. CYP2C19
Correct Answer b. CYP2D6 (also others like 3A4, 1A2)
Rationale CYP2D6 is key for codeine, many antidepressants,
and antipsychotics; poor metabolizers risk toxicity.
7. Off-label prescribing in psychopharmacology is:
a. Never allowed
, b. Permitted if evidence supports benefit and risks are
discussed
c. Only for controlled substances
d. Restricted to inpatients
Correct Answer b. Permitted if evidence supports benefit and
risks are discussed
Rationale Off-label use is common and legal when clinically
justified with informed consent.
8. What is a major adverse effect of long-term typical
antipsychotic use?
a. Tardive dyskinesia
b. Weight gain
c. Sedation only
d. Hypertension
Correct Answer a. Tardive dyskinesia
Rationale Chronic D2 blockade leads to tardive dyskinesia
(irreversible in some cases).
9. Which anxiolytic is preferred for short-term use in acute anxiety
due to rapid onset?
a. Buspirone
b. Lorazepam
c. Sertraline
PSYCHOPHARMACOLOGY FOR THE
PSYCHIATRIC-MENTAL HEALTH NURSE
PRACTITIONER FINAL EXAM
(CHAMBERLAIN 2026)
1. What is the primary mechanism of action for selective serotonin
reuptake inhibitors (SSRIs)?
a. Block dopamine D2 receptors
b. Inhibit reuptake of serotonin at the synapse
c. Antagonize GABA-A receptors
d. Inhibit monoamine oxidase
Correct Answer b. Inhibit reuptake of serotonin at the synapse
Rationale SSRIs increase synaptic serotonin by blocking its
reuptake transporter.
2. Which neurotransmitter is most associated with positive
symptoms of schizophrenia?
a. Serotonin
b. Dopamine (excess in mesolimbic pathway)
c. GABA
d. Glutamate
Correct Answer b. Dopamine (excess in mesolimbic pathway)
, Rationale Hyperdopaminergia in mesolimbic pathway drives
hallucinations and delusions.
3. What is a common black box warning for atypical
antipsychotics in children/adolescents?
a. Agranulocytosis
b. Increased risk of suicidality
c. QT prolongation
d. Metabolic syndrome
Correct Answer b. Increased risk of suicidality
Rationale Aripiprazole and quetiapine carry warnings for
increased suicide risk in pediatric patients.
4. Which medication class is first-line for generalized anxiety
disorder (GAD)?
a. Benzodiazepines
b. SSRIs/SNRIs
c. Typical antipsychotics
d. Mood stabilizers
Correct Answer b. SSRIs/SNRIs
Rationale SSRIs/SNRIs provide sustained efficacy with lower
dependence risk than benzodiazepines.
,5. What is the primary receptor blocked by first-generation
antipsychotics?
a. 5-HT2A
b. D2 (dopamine)
c. GABA-A
d. NMDA
Correct Answer b. D2 (dopamine)
Rationale FGAs non-selectively block D2 receptors, causing
EPS but improving positive symptoms.
6. Which CYP450 enzyme metabolizes many psychotropics,
including SSRIs and antipsychotics?
a. CYP1A2
b. CYP2D6
c. CYP3A4
d. CYP2C19
Correct Answer b. CYP2D6 (also others like 3A4, 1A2)
Rationale CYP2D6 is key for codeine, many antidepressants,
and antipsychotics; poor metabolizers risk toxicity.
7. Off-label prescribing in psychopharmacology is:
a. Never allowed
, b. Permitted if evidence supports benefit and risks are
discussed
c. Only for controlled substances
d. Restricted to inpatients
Correct Answer b. Permitted if evidence supports benefit and
risks are discussed
Rationale Off-label use is common and legal when clinically
justified with informed consent.
8. What is a major adverse effect of long-term typical
antipsychotic use?
a. Tardive dyskinesia
b. Weight gain
c. Sedation only
d. Hypertension
Correct Answer a. Tardive dyskinesia
Rationale Chronic D2 blockade leads to tardive dyskinesia
(irreversible in some cases).
9. Which anxiolytic is preferred for short-term use in acute anxiety
due to rapid onset?
a. Buspirone
b. Lorazepam
c. Sertraline
