NSG 552 Psychopharmacology Exam 2 Practice
Questions | Verified Answers and Rationales
Wilkes University | 2026/2027 Academic Year
SECTION 1: ANXIETY DISORDERS
Question 1
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. The patient should be reassured this is temporary .
,Question 2
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 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 that carries
increased risks of sedation, cognitive impairment, and falls in older
adults. It is on the BEERS criteria list of potentially inappropriate
medications for 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 .
Question 5
What is the mechanism of action of benzodiazepines?
A) Blocking serotonin reuptake
B) Potentiating the effects of GABA at the GABA-A receptor
C) Blocking dopamine D2 receptors
D) Inhibiting monoamine oxidase
Questions | Verified Answers and Rationales
Wilkes University | 2026/2027 Academic Year
SECTION 1: ANXIETY DISORDERS
Question 1
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. The patient should be reassured this is temporary .
,Question 2
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 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 that carries
increased risks of sedation, cognitive impairment, and falls in older
adults. It is on the BEERS criteria list of potentially inappropriate
medications for 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 .
Question 5
What is the mechanism of action of benzodiazepines?
A) Blocking serotonin reuptake
B) Potentiating the effects of GABA at the GABA-A receptor
C) Blocking dopamine D2 receptors
D) Inhibiting monoamine oxidase
