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NSG 552 Psychopharmacology Exam 2 Practice Questions Advanced / Hard
/ Mixed Difficulty Target Audience: PMHNP Students, Graduate Nursing
Students 100% Pass Guaranteed | Graded A+
Question 1
A 45-year-old combat veteran with PTSD reports frequent flashbacks, nightmares, and
hypervigilance. He has tried sertraline with partial response. Which medication would be most
appropriate to add for targeting nightmares and flashbacks?
A. Clonazepam
B. Prazosin
C. Quetiapine
D. Trazodone
Correct Answer: B
Explanation: Prazosin is an alpha-1 adrenergic antagonist effective for PTSD-related
nightmares and flashbacks. It works by reducing noradrenergic hyperactivity in the central
nervous system. Clonazepam should be avoided in PTSD due to risks of dependence and
impaired trauma processing. Quetiapine may be used as augmentation but does not specifically
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target nightmares. Trazodone helps with sleep but is not specifically indicated for PTSD
nightmares .
Question 2
A patient with treatment-resistant PTSD and severe self-injurious behaviors is being evaluated
for medication augmentation. Which medication works by blocking the endogenous opioid
reward associated with self-injury?
A. Naltrexone
B. Naloxone
C. Buprenorphine
D. Clonidine
Correct Answer: A
Explanation: Self-injurious behavior releases endogenous opioids (endorphins), creating a
reinforcing cycle. Naltrexone, an opioid antagonist, blocks these receptors, eliminating the
reinforcing effect and reducing the behavior. Naloxone is used for opioid overdose reversal,
buprenorphine is a partial agonist for opioid use disorder, and clonidine is used for withdrawal
symptoms .
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Question 3
Why should benzodiazepines be avoided in patients with PTSD?
A. They are ineffective for anxiety symptoms
B. They worsen avoidance, impair trauma processing, and increase dependence risk
C. They cause serotonin syndrome when combined with SSRIs
D. They are contraindicated in all psychiatric disorders
Correct Answer: B
Explanation: Benzodiazepines worsen avoidance behaviors, impair trauma processing in
psychotherapy, and increase the risk of dependence and misuse. They interfere with the
psychological processes needed to benefit from CBT, and there is a high rate of comorbid
substance use disorder with PTSD. Despite their anxiolytic effects, they are not recommended in
PTSD .
Question 4
Which class of medications is used as first-line pharmacologic therapy for PTSD?
A. SNRIs (duloxetine)
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B. SSRIs (sertraline and paroxetine)
C. Atypical antipsychotics
D. Tricyclic antidepressants
Correct Answer: B
Explanation: SSRIs (sertraline and paroxetine) are FDA-approved and recommended as
first-line pharmacologic treatment for PTSD. While trauma-focused psychotherapy is the overall
first-line approach, SSRIs are the first-line pharmacologic option. SNRIs like duloxetine may also
be used, but SSRIs have the strongest evidence base .
Question 5
A patient with PTSD and co-occurring depressive symptoms is being considered for medication
management. Which medication is FDA-approved for both PTSD and major depressive
disorder?
A. Fluoxetine
B. Paroxetine
C. Citalopram
D. Venlafaxine
NSG 552 Psychopharmacology Exam 2 Practice Questions Advanced / Hard
/ Mixed Difficulty Target Audience: PMHNP Students, Graduate Nursing
Students 100% Pass Guaranteed | Graded A+
Question 1
A 45-year-old combat veteran with PTSD reports frequent flashbacks, nightmares, and
hypervigilance. He has tried sertraline with partial response. Which medication would be most
appropriate to add for targeting nightmares and flashbacks?
A. Clonazepam
B. Prazosin
C. Quetiapine
D. Trazodone
Correct Answer: B
Explanation: Prazosin is an alpha-1 adrenergic antagonist effective for PTSD-related
nightmares and flashbacks. It works by reducing noradrenergic hyperactivity in the central
nervous system. Clonazepam should be avoided in PTSD due to risks of dependence and
impaired trauma processing. Quetiapine may be used as augmentation but does not specifically
,2
target nightmares. Trazodone helps with sleep but is not specifically indicated for PTSD
nightmares .
Question 2
A patient with treatment-resistant PTSD and severe self-injurious behaviors is being evaluated
for medication augmentation. Which medication works by blocking the endogenous opioid
reward associated with self-injury?
A. Naltrexone
B. Naloxone
C. Buprenorphine
D. Clonidine
Correct Answer: A
Explanation: Self-injurious behavior releases endogenous opioids (endorphins), creating a
reinforcing cycle. Naltrexone, an opioid antagonist, blocks these receptors, eliminating the
reinforcing effect and reducing the behavior. Naloxone is used for opioid overdose reversal,
buprenorphine is a partial agonist for opioid use disorder, and clonidine is used for withdrawal
symptoms .
,3
Question 3
Why should benzodiazepines be avoided in patients with PTSD?
A. They are ineffective for anxiety symptoms
B. They worsen avoidance, impair trauma processing, and increase dependence risk
C. They cause serotonin syndrome when combined with SSRIs
D. They are contraindicated in all psychiatric disorders
Correct Answer: B
Explanation: Benzodiazepines worsen avoidance behaviors, impair trauma processing in
psychotherapy, and increase the risk of dependence and misuse. They interfere with the
psychological processes needed to benefit from CBT, and there is a high rate of comorbid
substance use disorder with PTSD. Despite their anxiolytic effects, they are not recommended in
PTSD .
Question 4
Which class of medications is used as first-line pharmacologic therapy for PTSD?
A. SNRIs (duloxetine)
, 4
B. SSRIs (sertraline and paroxetine)
C. Atypical antipsychotics
D. Tricyclic antidepressants
Correct Answer: B
Explanation: SSRIs (sertraline and paroxetine) are FDA-approved and recommended as
first-line pharmacologic treatment for PTSD. While trauma-focused psychotherapy is the overall
first-line approach, SSRIs are the first-line pharmacologic option. SNRIs like duloxetine may also
be used, but SSRIs have the strongest evidence base .
Question 5
A patient with PTSD and co-occurring depressive symptoms is being considered for medication
management. Which medication is FDA-approved for both PTSD and major depressive
disorder?
A. Fluoxetine
B. Paroxetine
C. Citalopram
D. Venlafaxine
