NSG 552 Psychopharmacology Exam 2
Medication Review & Practice Questions
Wilkes University | 2026/2027
Academic Year
SECTION 1: ANXIETY 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 .
,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 can manage this activating
effect .
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 (20-80 hours)
C) It is too expensive
D) It causes weight gain
, Answer: B
Rationale: Diazepam is a long-acting benzodiazepine with a half-
life of 20-80 hours. In older adults, it carries increased risks of
sedation, cognitive impairment, and falls. It is on the BEERS criteria
list for potentially inappropriate medications in older adults .
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 to control physical symptoms. It is contraindicated in
patients with asthma or COPD because beta-blockade can cause
bronchospasm .
Medication Review & Practice Questions
Wilkes University | 2026/2027
Academic Year
SECTION 1: ANXIETY 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 .
,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 can manage this activating
effect .
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 (20-80 hours)
C) It is too expensive
D) It causes weight gain
, Answer: B
Rationale: Diazepam is a long-acting benzodiazepine with a half-
life of 20-80 hours. In older adults, it carries increased risks of
sedation, cognitive impairment, and falls. It is on the BEERS criteria
list for potentially inappropriate medications in older adults .
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 to control physical symptoms. It is contraindicated in
patients with asthma or COPD because beta-blockade can cause
bronchospasm .
