NU 643 Exam 2 V3 | NU 643 Advanced
Psychopharmacology | Actual Q&A with
Rationale (NU643 Exam 2) | Regis
University
1. A patient is prescribed Escitalopram for Major Depressive Disorder. Which mechanism of
action best describes this medication?
A. Inhibition of norepinephrine reuptake
B. Antagonism of 5HT-2A receptors
C. Selective inhibition of the serotonin transporter (SERT)
D. Dual inhibition of serotonin and dopamine transporters
Answer: C
Rationale: Escitalopram is a Selective Serotonin Reuptake Inhibitor (SSRI) that specifically
targets the serotonin transporter. By blocking the reuptake of serotonin into the
presynaptic neuron, it increases the concentration of serotonin in the synaptic cleft. This
action helps alleviate symptoms of depression and anxiety over time.
2. Which side effect of Venlafaxine (Effexor) requires regular monitoring of blood pressure?
A. Sustained diastolic hypertension
B. Orthostatic hypotension
C. Bradycardia
,D. Third-degree heart block
Answer: A
Rationale: Venlafaxine is a Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) that can
increase norepinephrine levels. At higher doses, the noradrenergic effects can lead to a
dose-dependent increase in blood pressure. Clinicians must monitor blood pressure at
baseline and throughout treatment to ensure safety.
3. A patient with depression and comorbid chronic neuropathic pain would likely benefit
most from which medication?
A. Citalopram
B. Fluoxetine
C. Sertraline
D. Duloxetine
Answer: D
Rationale: Duloxetine is an SNRI that is FDA-approved for both Major Depressive Disorder
and chronic pain conditions such as diabetic neuropathy and fibromyalgia. The dual action
on serotonin and norepinephrine modulates descending pain pathways in the spinal cord.
Other SSRIs listed do not have the same level of efficacy for physical pain symptoms.
4. Bupropion (Wellbutrin) is contraindicated in patients with which of the following
conditions?
A. Seizure disorder
, B. Sexual dysfunction
C. Hypersomnia
D. Nicotine dependence
Answer: A
Rationale: Bupropion is known to lower the seizure threshold, particularly at high doses
or in susceptible individuals. It is strictly contraindicated in patients with a history of
epilepsy or eating disorders like anorexia and bulimia due to electrolyte imbalances.
However, it is often favored for patients experiencing sexual side effects from other
antidepressants.
5. Which antidepressant is most likely to cause significant weight gain and sedation, making it
useful for elderly patients with insomnia and cachexia?
A. Mirtazapine
B. Fluoxetine
C. Tranylcypromine
D. Vortioxetine
Answer: A
Rationale: Mirtazapine acts as an alpha-2 antagonist and potent H1 histamine receptor
antagonist. The H1 antagonism leads to marked sedation and increased appetite, which can
Psychopharmacology | Actual Q&A with
Rationale (NU643 Exam 2) | Regis
University
1. A patient is prescribed Escitalopram for Major Depressive Disorder. Which mechanism of
action best describes this medication?
A. Inhibition of norepinephrine reuptake
B. Antagonism of 5HT-2A receptors
C. Selective inhibition of the serotonin transporter (SERT)
D. Dual inhibition of serotonin and dopamine transporters
Answer: C
Rationale: Escitalopram is a Selective Serotonin Reuptake Inhibitor (SSRI) that specifically
targets the serotonin transporter. By blocking the reuptake of serotonin into the
presynaptic neuron, it increases the concentration of serotonin in the synaptic cleft. This
action helps alleviate symptoms of depression and anxiety over time.
2. Which side effect of Venlafaxine (Effexor) requires regular monitoring of blood pressure?
A. Sustained diastolic hypertension
B. Orthostatic hypotension
C. Bradycardia
,D. Third-degree heart block
Answer: A
Rationale: Venlafaxine is a Serotonin-Norepinephrine Reuptake Inhibitor (SNRI) that can
increase norepinephrine levels. At higher doses, the noradrenergic effects can lead to a
dose-dependent increase in blood pressure. Clinicians must monitor blood pressure at
baseline and throughout treatment to ensure safety.
3. A patient with depression and comorbid chronic neuropathic pain would likely benefit
most from which medication?
A. Citalopram
B. Fluoxetine
C. Sertraline
D. Duloxetine
Answer: D
Rationale: Duloxetine is an SNRI that is FDA-approved for both Major Depressive Disorder
and chronic pain conditions such as diabetic neuropathy and fibromyalgia. The dual action
on serotonin and norepinephrine modulates descending pain pathways in the spinal cord.
Other SSRIs listed do not have the same level of efficacy for physical pain symptoms.
4. Bupropion (Wellbutrin) is contraindicated in patients with which of the following
conditions?
A. Seizure disorder
, B. Sexual dysfunction
C. Hypersomnia
D. Nicotine dependence
Answer: A
Rationale: Bupropion is known to lower the seizure threshold, particularly at high doses
or in susceptible individuals. It is strictly contraindicated in patients with a history of
epilepsy or eating disorders like anorexia and bulimia due to electrolyte imbalances.
However, it is often favored for patients experiencing sexual side effects from other
antidepressants.
5. Which antidepressant is most likely to cause significant weight gain and sedation, making it
useful for elderly patients with insomnia and cachexia?
A. Mirtazapine
B. Fluoxetine
C. Tranylcypromine
D. Vortioxetine
Answer: A
Rationale: Mirtazapine acts as an alpha-2 antagonist and potent H1 histamine receptor
antagonist. The H1 antagonism leads to marked sedation and increased appetite, which can
