MSN 672 MODULE 3 QUIZ QUESTIONS
COMPLETE SOLUTIONS PRACTICE
EVALUATION MODULE TEST 2026
GRADED A+
⩥ Why is Paroxetine associated with a higher risk of withdrawal
reactions compared to other SSRIs?.
Answer: Due to its lack of a long-acting metabolite and its
anticholinergic rebound effect when discontinued abruptly.
⩥ Which SSRI has the highest association with weight gain?.
Answer: Paroxetine (Paxil).
⩥ What is the typical starting dose and maximum dose for Paroxetine in
adults with MDD?.
Answer: Start at 20 mg/day; typical max is 60 mg/day (some protocols
may go up to 75 mg).
⩥ Categorize the CNS side effects of SSRIs: Insomnia, Anxiety,
Somnolence, Fatigue, Agitation..
Answer: Activating: Insomnia, Anxiety, Agitation; Sedating:
Somnolence, Fatigue.
,⩥ What are the most common gastrointestinal side effects when starting
an SSRI?.
Answer: Nausea, vomiting, abdominal pain, diarrhea, and constipation.
⩥ Which SSRI has the highest reported incidence of sexual
dysfunction?.
Answer: Fluoxetine (65%), followed by Paroxetine (59%).
⩥ Why should a patient be monitored for abnormal bruising while on an
SSRI?.
Answer: SSRIs inhibit the uptake of serotonin into platelets, necessary
for normal clotting.
⩥ When is the risk of activation or suicidal thoughts highest in patients
taking SSRIs?.
Answer: Particularly in children and adolescents, often during the initial
weeks of treatment or during dose adjustments.
⩥ How should a patient manage the common side effect of nausea?.
Answer: Take the medication with or after food to minimize GI distress.
⩥ If a patient experiences insomnia while on Paroxetine, when is the
best time for administration?.
Answer: Take the medication first thing in the morning.
, ⩥ What five other receptors or channels do TCAs block beyond NET
and SERT?.
Answer: Muscarinic acetylcholine receptors, H1 Histamine receptors,
Alpha-1 Adrenergic receptors, Voltage-sensitive Sodium channels,
5HT2A and 5HT2C receptors (some agents).
⩥ Why are TCAs considered 'dirty drugs' compared to SSRIs?.
Answer: Because they lack selectivity; their blockade of multiple non-
target receptors leads to a broad range of undesirable side effects.
⩥ Why do TCAs require careful titration when starting therapy?.
Answer: To minimize the intensity of side effects and allow the body to
adjust while slowly reaching a therapeutic dose.
⩥ Which specific TCA is the 'gold standard' for treating Obsessive-
Compulsive Disorder (OCD)?.
Answer: Clomipramine (Anafranil).
⩥ Name three conditions in a Primary Care setting for which TCAs are
frequently prescribed..
Answer: Chronic Pain (Neuropathy/Fibromyalgia), Migraine Prevention,
Insomnia (Sleep).
COMPLETE SOLUTIONS PRACTICE
EVALUATION MODULE TEST 2026
GRADED A+
⩥ Why is Paroxetine associated with a higher risk of withdrawal
reactions compared to other SSRIs?.
Answer: Due to its lack of a long-acting metabolite and its
anticholinergic rebound effect when discontinued abruptly.
⩥ Which SSRI has the highest association with weight gain?.
Answer: Paroxetine (Paxil).
⩥ What is the typical starting dose and maximum dose for Paroxetine in
adults with MDD?.
Answer: Start at 20 mg/day; typical max is 60 mg/day (some protocols
may go up to 75 mg).
⩥ Categorize the CNS side effects of SSRIs: Insomnia, Anxiety,
Somnolence, Fatigue, Agitation..
Answer: Activating: Insomnia, Anxiety, Agitation; Sedating:
Somnolence, Fatigue.
,⩥ What are the most common gastrointestinal side effects when starting
an SSRI?.
Answer: Nausea, vomiting, abdominal pain, diarrhea, and constipation.
⩥ Which SSRI has the highest reported incidence of sexual
dysfunction?.
Answer: Fluoxetine (65%), followed by Paroxetine (59%).
⩥ Why should a patient be monitored for abnormal bruising while on an
SSRI?.
Answer: SSRIs inhibit the uptake of serotonin into platelets, necessary
for normal clotting.
⩥ When is the risk of activation or suicidal thoughts highest in patients
taking SSRIs?.
Answer: Particularly in children and adolescents, often during the initial
weeks of treatment or during dose adjustments.
⩥ How should a patient manage the common side effect of nausea?.
Answer: Take the medication with or after food to minimize GI distress.
⩥ If a patient experiences insomnia while on Paroxetine, when is the
best time for administration?.
Answer: Take the medication first thing in the morning.
, ⩥ What five other receptors or channels do TCAs block beyond NET
and SERT?.
Answer: Muscarinic acetylcholine receptors, H1 Histamine receptors,
Alpha-1 Adrenergic receptors, Voltage-sensitive Sodium channels,
5HT2A and 5HT2C receptors (some agents).
⩥ Why are TCAs considered 'dirty drugs' compared to SSRIs?.
Answer: Because they lack selectivity; their blockade of multiple non-
target receptors leads to a broad range of undesirable side effects.
⩥ Why do TCAs require careful titration when starting therapy?.
Answer: To minimize the intensity of side effects and allow the body to
adjust while slowly reaching a therapeutic dose.
⩥ Which specific TCA is the 'gold standard' for treating Obsessive-
Compulsive Disorder (OCD)?.
Answer: Clomipramine (Anafranil).
⩥ Name three conditions in a Primary Care setting for which TCAs are
frequently prescribed..
Answer: Chronic Pain (Neuropathy/Fibromyalgia), Migraine Prevention,
Insomnia (Sleep).
