NR 546 / NR546 Midterm Exam Tested
Questions and Revised Answers with
rationales, (A+ Guarantee)
2026\2027 update
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Questions and Ansẉers
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Expert-Verified rationales
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The PMHNP understands that a medication with high affinity and low
intrinsic activity at a receptor site is classified as a(n):
A. Agonist
B. Partial agonist
C. Competitive antagonist
D. Inverse agonist
Correct Answer: C. Competitive antagonist
Rationale: Affinity refers to how tightly a drug binds to a receptor,
while intrinsic activity refers to the drug's ability to produce a
response. An antagonist has high affinity (it binds tightly to the
receptor, blocking other molecules) but low/zero intrinsic activity (it
does not produce a biological response).
Which of the following statements is true regarding the cytochrome
P450 enzyme system?
A. Inhibitors speed up the metabolism of other drugs.
B. Inducers decrease the plasma concentration of other drugs.
C. Fluoxetine is a potent CYP2D6 inhibitor.
D. Smoking cigarettes induces CYP3A4.
Correct Answer: C. Fluoxetine is a potent CYP2D6 inhibitor.
Rationale: Fluoxetine (Prozac) and paroxetine are potent inhibitors
of CYP2D6, which can lead to increased plasma levels of drugs
metabolized by this enzyme. Inhibitors slow down metabolism
(increasing plasma levels), while inducers speed up metabolism
(decreasing plasma levels). Cigarette smoke induces CYP1A2, not
CYP3A4.
A patient is prescribed a drug that is a selective alpha-2 adrenergic
agonist. What is the primary clinical effect of this medication?
A. Increased norepinephrine release
B. Decreased norepinephrine release
C. Increased dopamine release
, D. Decreased serotonin release
Correct Answer: B. Decreased norepinephrine release
Rationale: Alpha-2 adrenergic agonists (like clonidine and
guanfacine) stimulate presynaptic alpha-2 receptors, which act as
autoreceptors. Stimulation of these autoreceptors provides negative
feedback to the neuron, inhibiting further release of norepinephrine.
Phospholipase C is activated by which of the following G-proteins?
A. Gs
B. Gi
C. Gq
D. Go
Correct Answer: C. Gq
Rationale: Gq proteins activate phospholipase C (PLC), which leads
to the cleavage of PIP2 into IP3 and DAG. Gs activates adenylate
cyclase (increasing cAMP), while Gi inhibits adenylate cyclase
(decreasing cAMP).
A patient with depression presents with significant psychomotor
agitation and insomnia. The PMHNP knows that a medication with
high affinity for which receptor would be most beneficial for these
specific symptoms?
A. Dopamine D2
B. Serotonin 5-HT1A
C. Histamine H1
D. Norepinephrine alpha-1
Correct Answer: B. Serotonin 5-HT1A
Rationale: 5-HT1A agonism or partial agonism is associated with
anxiolytic and antidepressant effects, helping to reduce agitation
and improve sleep. H1 antagonism causes sedation but not
necessarily anxiolysis. Alpha-1 antagonism causes orthostatic
hypotension and sedation. D2 antagonism is for psychosis.
Which of the following is an example of a pharmacokinetic
interaction?
A. Bupropion lowering the seizure threshold when taken with
another drug.
Questions and Revised Answers with
rationales, (A+ Guarantee)
2026\2027 update
This Exam contains:
Guarantee passing score
Questions and Ansẉers
format set of multiple-choice
Expert-Verified rationales
Verified ẉith trusted textbooks
,───────────────────────────────────────────────────────
─
The PMHNP understands that a medication with high affinity and low
intrinsic activity at a receptor site is classified as a(n):
A. Agonist
B. Partial agonist
C. Competitive antagonist
D. Inverse agonist
Correct Answer: C. Competitive antagonist
Rationale: Affinity refers to how tightly a drug binds to a receptor,
while intrinsic activity refers to the drug's ability to produce a
response. An antagonist has high affinity (it binds tightly to the
receptor, blocking other molecules) but low/zero intrinsic activity (it
does not produce a biological response).
Which of the following statements is true regarding the cytochrome
P450 enzyme system?
A. Inhibitors speed up the metabolism of other drugs.
B. Inducers decrease the plasma concentration of other drugs.
C. Fluoxetine is a potent CYP2D6 inhibitor.
D. Smoking cigarettes induces CYP3A4.
Correct Answer: C. Fluoxetine is a potent CYP2D6 inhibitor.
Rationale: Fluoxetine (Prozac) and paroxetine are potent inhibitors
of CYP2D6, which can lead to increased plasma levels of drugs
metabolized by this enzyme. Inhibitors slow down metabolism
(increasing plasma levels), while inducers speed up metabolism
(decreasing plasma levels). Cigarette smoke induces CYP1A2, not
CYP3A4.
A patient is prescribed a drug that is a selective alpha-2 adrenergic
agonist. What is the primary clinical effect of this medication?
A. Increased norepinephrine release
B. Decreased norepinephrine release
C. Increased dopamine release
, D. Decreased serotonin release
Correct Answer: B. Decreased norepinephrine release
Rationale: Alpha-2 adrenergic agonists (like clonidine and
guanfacine) stimulate presynaptic alpha-2 receptors, which act as
autoreceptors. Stimulation of these autoreceptors provides negative
feedback to the neuron, inhibiting further release of norepinephrine.
Phospholipase C is activated by which of the following G-proteins?
A. Gs
B. Gi
C. Gq
D. Go
Correct Answer: C. Gq
Rationale: Gq proteins activate phospholipase C (PLC), which leads
to the cleavage of PIP2 into IP3 and DAG. Gs activates adenylate
cyclase (increasing cAMP), while Gi inhibits adenylate cyclase
(decreasing cAMP).
A patient with depression presents with significant psychomotor
agitation and insomnia. The PMHNP knows that a medication with
high affinity for which receptor would be most beneficial for these
specific symptoms?
A. Dopamine D2
B. Serotonin 5-HT1A
C. Histamine H1
D. Norepinephrine alpha-1
Correct Answer: B. Serotonin 5-HT1A
Rationale: 5-HT1A agonism or partial agonism is associated with
anxiolytic and antidepressant effects, helping to reduce agitation
and improve sleep. H1 antagonism causes sedation but not
necessarily anxiolysis. Alpha-1 antagonism causes orthostatic
hypotension and sedation. D2 antagonism is for psychosis.
Which of the following is an example of a pharmacokinetic
interaction?
A. Bupropion lowering the seizure threshold when taken with
another drug.
