NSG 552 Exam 2 Practice Questions | Latest
Psychopharmacology Update
Wilkes University | 2026/2027 Academic Year
SECTION 1: ANXIETY AND PANIC DISORDERS
Question 1
What is the first-line treatment for Generalized Anxiety Disorder (GAD)?
A) Benzodiazepines
B) SSRIs (e.g., Sertraline, Escitalopram)
C) Buspirone alone
D) Antipsychotics
Answer: B
Rationale: SSRIs are first-line treatment for GAD. They are effective,
non-habit forming, and lack the dependence risk associated with
benzodiazepines. SNRIs are also first-line options.
Question 2
A 33-year-old male with GAD started on fluoxetine (Prozac) 1 week ago
,and reports worsening anxiety. There is no history of suicidal ideation.
What is the most appropriate next step?
A) Discontinue fluoxetine and switch to another SSRI
B) Continue fluoxetine and start alprazolam for initial activation
C) Increase fluoxetine dose immediately
D) Add an antipsychotic
Answer: B
Rationale: SSRIs can cause initial activation (increased anxiety)
during the first 1-2 weeks of treatment. Continuing the SSRI while
adding a short-term benzodiazepine (like alprazolam) can manage
this activating effect. The patient should be reassured that this is
temporary.
Question 3
Why should diazepam (Valium) be avoided in older adults?
A) It has no effect on older adults
B) Increased risk of sedation and falls due to long half-life
C) It is too expensive
D) It causes weight gain
Answer: B
Rationale: Diazepam is a long-acting benzodiazepine with active
metabolites. In older adults, it carries increased risks of sedation,
, cognitive impairment, and falls. Shorter-acting agents like
lorazepam or oxazepam are preferred when benzodiazepines are
necessary.
Question 4
Which medication is used for performance anxiety and what is its key
contraindication?
A) Alprazolam; contraindicated in liver disease
B) Propranolol; contraindicated in asthma/COPD due to bronchospasm
risk
C) Clonazepam; contraindicated in renal impairment
D) Buspirone; contraindicated in pregnancy
Answer: B
Rationale: Propranolol (a beta-blocker) is used for performance
anxiety. It is contraindicated in patients with asthma or COPD
because beta-blockade can cause bronchospasm.
Question 5
What is the mechanism of action of benzodiazepines?
Psychopharmacology Update
Wilkes University | 2026/2027 Academic Year
SECTION 1: ANXIETY AND PANIC DISORDERS
Question 1
What is the first-line treatment for Generalized Anxiety Disorder (GAD)?
A) Benzodiazepines
B) SSRIs (e.g., Sertraline, Escitalopram)
C) Buspirone alone
D) Antipsychotics
Answer: B
Rationale: SSRIs are first-line treatment for GAD. They are effective,
non-habit forming, and lack the dependence risk associated with
benzodiazepines. SNRIs are also first-line options.
Question 2
A 33-year-old male with GAD started on fluoxetine (Prozac) 1 week ago
,and reports worsening anxiety. There is no history of suicidal ideation.
What is the most appropriate next step?
A) Discontinue fluoxetine and switch to another SSRI
B) Continue fluoxetine and start alprazolam for initial activation
C) Increase fluoxetine dose immediately
D) Add an antipsychotic
Answer: B
Rationale: SSRIs can cause initial activation (increased anxiety)
during the first 1-2 weeks of treatment. Continuing the SSRI while
adding a short-term benzodiazepine (like alprazolam) can manage
this activating effect. The patient should be reassured that this is
temporary.
Question 3
Why should diazepam (Valium) be avoided in older adults?
A) It has no effect on older adults
B) Increased risk of sedation and falls due to long half-life
C) It is too expensive
D) It causes weight gain
Answer: B
Rationale: Diazepam is a long-acting benzodiazepine with active
metabolites. In older adults, it carries increased risks of sedation,
, cognitive impairment, and falls. Shorter-acting agents like
lorazepam or oxazepam are preferred when benzodiazepines are
necessary.
Question 4
Which medication is used for performance anxiety and what is its key
contraindication?
A) Alprazolam; contraindicated in liver disease
B) Propranolol; contraindicated in asthma/COPD due to bronchospasm
risk
C) Clonazepam; contraindicated in renal impairment
D) Buspirone; contraindicated in pregnancy
Answer: B
Rationale: Propranolol (a beta-blocker) is used for performance
anxiety. It is contraindicated in patients with asthma or COPD
because beta-blockade can cause bronchospasm.
Question 5
What is the mechanism of action of benzodiazepines?
