NU 578 Advanced Pharmacology – Unit
5 Exam Questions And Answers Plus
Rationales | Qs & Ans 2026 | Instant Pdf
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1. A patient with generalized anxiety disorder is prescribed
buspirone. Which statement about buspirone is correct?
A. It has immediate anxiolytic effects (within 30 minutes)
B. It has high abuse potential and dependence risk
C. It has a delayed onset of 2–4 weeks and no sedation or dependence
D. It is a benzodiazepine
Answer: C
Rationale: Buspirone is a non-benzodiazepine anxiolytic (5-HT1A partial
agonist) with delayed onset (2–4 weeks), no sedation, no dependence,
and no abuse potential.
2. A patient with panic disorder is started on alprazolam (Xanax).
Which finding is most concerning for long-term use?
A. Tolerance and physical dependence
B. Nausea
C. Headache
D. Blurred vision
,Answer: A
Rationale: Alprazolam (benzodiazepine) causes tolerance, physical
dependence, and withdrawal seizures if abruptly discontinued. It also has
high abuse potential.
3. A patient with insomnia is prescribed zolpidem (Ambien). Which
instruction is most important?
A. “Take with a full meal for better absorption.”
B. “Take immediately before bedtime with at least 7–8 hours available for
sleep.”
C. “It is safe for long-term daily use.”
D. “It has no risk of complex sleep behaviors.”
Answer: B
Rationale: Zolpidem can cause next-day sedation and complex sleep
behaviors (sleep-driving, sleep-eating). Use short-term (≤4 weeks) and
only if 7–8 hours of sleep is available.
4. A patient with major depression and insomnia is prescribed
trazodone. Which statement about trazodone is correct?
A. It is a first-line antidepressant for depression without sedation
B. It is primarily used off-label for insomnia due to its sedating properties
C. It has a high risk of priapism (rare but serious)
D. Both B and C
Answer: D
Rationale: Trazodone (SARI) is sedating and often used off-label for
,insomnia at lower doses (50–100 mg). Priapism is a rare but serious
adverse effect.
5. A patient with depression is started on fluoxetine (Prozac). Which
finding indicates serotonin syndrome?
A. Agitation, hyperreflexia, clonus, diaphoresis, hyperthermia
B. Drowsiness and weight gain
C. Sexual dysfunction
D. Dry mouth and constipation
Answer: A
Rationale: Serotonin syndrome (excess serotonin) causes agitation,
confusion, hyperreflexia, clonus, diaphoresis, hyperthermia, and
autonomic instability. Often seen with SSRI + MAOI or SSRI + linezolid.
6. A patient with major depression has failed two SSRIs and is
started on venlafaxine (Effexor XR). Which statement about
venlafaxine is correct?
A. It is a selective serotonin reuptake inhibitor (SSRI) only
B. It is a serotonin-norepinephrine reuptake inhibitor (SNRI); at higher
doses, it also inhibits norepinephrine reuptake
C. It has no discontinuation syndrome
D. It is not effective for anxiety
Answer: B
Rationale: Venlafaxine is an SNRI; at low doses primarily serotonin, at
, higher doses adds norepinephrine reuptake inhibition. Discontinuation
syndrome (dizziness, nausea, “brain zaps”) is common.
7. A patient with depression and chronic neuropathic pain is started
on duloxetine (Cymbalta). Which statement is correct?
A. Duloxetine is an SSRI
B. Duloxetine is approved for diabetic peripheral neuropathy and
fibromyalgia
C. Duloxetine has no drug interactions
D. Duloxetine causes weight loss in most patients
Answer: B
Rationale: Duloxetine (SNRI) is approved for depression, GAD, diabetic
peripheral neuropathy, fibromyalgia, and chronic musculoskeletal pain. It
has CYP1A2 and CYP2D6 interactions.
8. A patient with bipolar disorder is started on lithium. Which
finding indicates early lithium toxicity?
A. Fine hand tremor
B. Serum lithium level 0.8 mEq/L
C. Nausea, vomiting, diarrhea, and drowsiness
D. Polyuria and polydipsia
Answer: C
Rationale: Early lithium toxicity (level 1.5–2.0 mEq/L) causes GI
symptoms (nausea, vomiting, diarrhea), drowsiness, and coarse tremor.
Polyuria (diabetes insipidus) is a common adverse effect, not toxicity.
5 Exam Questions And Answers Plus
Rationales | Qs & Ans 2026 | Instant Pdf
Download
1. A patient with generalized anxiety disorder is prescribed
buspirone. Which statement about buspirone is correct?
A. It has immediate anxiolytic effects (within 30 minutes)
B. It has high abuse potential and dependence risk
C. It has a delayed onset of 2–4 weeks and no sedation or dependence
D. It is a benzodiazepine
Answer: C
Rationale: Buspirone is a non-benzodiazepine anxiolytic (5-HT1A partial
agonist) with delayed onset (2–4 weeks), no sedation, no dependence,
and no abuse potential.
2. A patient with panic disorder is started on alprazolam (Xanax).
Which finding is most concerning for long-term use?
A. Tolerance and physical dependence
B. Nausea
C. Headache
D. Blurred vision
,Answer: A
Rationale: Alprazolam (benzodiazepine) causes tolerance, physical
dependence, and withdrawal seizures if abruptly discontinued. It also has
high abuse potential.
3. A patient with insomnia is prescribed zolpidem (Ambien). Which
instruction is most important?
A. “Take with a full meal for better absorption.”
B. “Take immediately before bedtime with at least 7–8 hours available for
sleep.”
C. “It is safe for long-term daily use.”
D. “It has no risk of complex sleep behaviors.”
Answer: B
Rationale: Zolpidem can cause next-day sedation and complex sleep
behaviors (sleep-driving, sleep-eating). Use short-term (≤4 weeks) and
only if 7–8 hours of sleep is available.
4. A patient with major depression and insomnia is prescribed
trazodone. Which statement about trazodone is correct?
A. It is a first-line antidepressant for depression without sedation
B. It is primarily used off-label for insomnia due to its sedating properties
C. It has a high risk of priapism (rare but serious)
D. Both B and C
Answer: D
Rationale: Trazodone (SARI) is sedating and often used off-label for
,insomnia at lower doses (50–100 mg). Priapism is a rare but serious
adverse effect.
5. A patient with depression is started on fluoxetine (Prozac). Which
finding indicates serotonin syndrome?
A. Agitation, hyperreflexia, clonus, diaphoresis, hyperthermia
B. Drowsiness and weight gain
C. Sexual dysfunction
D. Dry mouth and constipation
Answer: A
Rationale: Serotonin syndrome (excess serotonin) causes agitation,
confusion, hyperreflexia, clonus, diaphoresis, hyperthermia, and
autonomic instability. Often seen with SSRI + MAOI or SSRI + linezolid.
6. A patient with major depression has failed two SSRIs and is
started on venlafaxine (Effexor XR). Which statement about
venlafaxine is correct?
A. It is a selective serotonin reuptake inhibitor (SSRI) only
B. It is a serotonin-norepinephrine reuptake inhibitor (SNRI); at higher
doses, it also inhibits norepinephrine reuptake
C. It has no discontinuation syndrome
D. It is not effective for anxiety
Answer: B
Rationale: Venlafaxine is an SNRI; at low doses primarily serotonin, at
, higher doses adds norepinephrine reuptake inhibition. Discontinuation
syndrome (dizziness, nausea, “brain zaps”) is common.
7. A patient with depression and chronic neuropathic pain is started
on duloxetine (Cymbalta). Which statement is correct?
A. Duloxetine is an SSRI
B. Duloxetine is approved for diabetic peripheral neuropathy and
fibromyalgia
C. Duloxetine has no drug interactions
D. Duloxetine causes weight loss in most patients
Answer: B
Rationale: Duloxetine (SNRI) is approved for depression, GAD, diabetic
peripheral neuropathy, fibromyalgia, and chronic musculoskeletal pain. It
has CYP1A2 and CYP2D6 interactions.
8. A patient with bipolar disorder is started on lithium. Which
finding indicates early lithium toxicity?
A. Fine hand tremor
B. Serum lithium level 0.8 mEq/L
C. Nausea, vomiting, diarrhea, and drowsiness
D. Polyuria and polydipsia
Answer: C
Rationale: Early lithium toxicity (level 1.5–2.0 mEq/L) causes GI
symptoms (nausea, vomiting, diarrhea), drowsiness, and coarse tremor.
Polyuria (diabetes insipidus) is a common adverse effect, not toxicity.
