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NURS 660 Psychopharmacology &
Advanced Mental Health Exam 3 2026 |
100-Question Practice Exam with
Answers & Detailed Rationales |
Complete Study Guide
1.
A patient with generalized anxiety disorder is starting an SSRI. Which information
should the PMHNP provide about the expected onset of therapeutic benefit?
A. Improvement should occur within several hours
B. Meaningful improvement commonly takes several weeks
C. Maximum benefit occurs after the first dose
D. Therapeutic effects generally occur within 24 hours
Rationale: SSRIs generally require several weeks of consistent treatment before
their full therapeutic effects become apparent.
2.
Which neurotransmitter system is most directly associated with the mechanism of
action of benzodiazepines?
,A. Dopamine
B. Serotonin
C. Gamma-aminobutyric acid (GABA)
D. Glutamate
Rationale: Benzodiazepines enhance the inhibitory effects of GABA at GABA-A
receptors, producing anxiolytic, sedative, anticonvulsant, and muscle-relaxant
effects.
3.
A patient taking lithium develops coarse tremor, vomiting, diarrhea, and
confusion. What is the priority concern?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Lithium toxicity
D. Anticholinergic toxicity
Rationale: Gastrointestinal symptoms, worsening tremor, confusion, and
neurologic changes can indicate lithium toxicity and require prompt evaluation.
4.
Which laboratory value is particularly important to monitor in a patient receiving
lithium?
A. Hemoglobin A1c only
B. Serum creatinine and renal function
C. Amylase
D. Bilirubin only
Rationale: Lithium is primarily eliminated by the kidneys, so renal function must
be monitored during therapy.
5.
Which medication is commonly used as an antidote for benzodiazepine toxicity?
,A. Naloxone
B. Naltrexone
C. Flumazenil
D. Atropine
Rationale: Flumazenil is a benzodiazepine receptor antagonist that can reverse
benzodiazepine effects in selected clinical situations.
6.
A patient taking an SSRI develops agitation, diaphoresis, diarrhea, hyperreflexia,
and clonus. Which condition should the PMHNP suspect?
A. Lithium toxicity
B. Neuroleptic malignant syndrome
C. Serotonin syndrome
D. Withdrawal delirium
Rationale: Serotonin syndrome commonly presents with mental-status changes,
autonomic instability, gastrointestinal symptoms, hyperreflexia, and clonus.
7.
Which antidepressant class primarily inhibits the reuptake of both serotonin and
norepinephrine?
A. TCAs
B. MAOIs
C. SNRIs
D. Benzodiazepines
Rationale: SNRIs increase serotonergic and noradrenergic neurotransmission by
inhibiting reuptake of both neurotransmitters.
8.
Which medication is classified as an SNRI?
, A. Sertraline
B. Fluoxetine
C. Duloxetine
D. Trazodone
Rationale: Duloxetine is an SNRI commonly used for depressive and anxiety
disorders and certain chronic pain conditions.
9.
Which adverse effect is particularly important to discuss with a patient beginning
an SSRI?
A. Permanent hearing loss
B. Sexual dysfunction
C. Severe hypoglycemia in every patient
D. Cataract formation
Rationale: Sexual adverse effects, including decreased libido, delayed orgasm,
and erectile dysfunction, can occur with SSRIs.
10.
Which medication is commonly associated with sedation and is sometimes used
when insomnia accompanies depression?
A. Atomoxetine
B. Trazodone
C. Buspirone
D. Methylphenidate
Rationale: Trazodone has significant sedating properties and is frequently
prescribed when insomnia occurs with depressive symptoms.
11.
Which neurotransmitter is particularly important in the neurobiology of anxiety?
NURS 660 Psychopharmacology &
Advanced Mental Health Exam 3 2026 |
100-Question Practice Exam with
Answers & Detailed Rationales |
Complete Study Guide
1.
A patient with generalized anxiety disorder is starting an SSRI. Which information
should the PMHNP provide about the expected onset of therapeutic benefit?
A. Improvement should occur within several hours
B. Meaningful improvement commonly takes several weeks
C. Maximum benefit occurs after the first dose
D. Therapeutic effects generally occur within 24 hours
Rationale: SSRIs generally require several weeks of consistent treatment before
their full therapeutic effects become apparent.
2.
Which neurotransmitter system is most directly associated with the mechanism of
action of benzodiazepines?
,A. Dopamine
B. Serotonin
C. Gamma-aminobutyric acid (GABA)
D. Glutamate
Rationale: Benzodiazepines enhance the inhibitory effects of GABA at GABA-A
receptors, producing anxiolytic, sedative, anticonvulsant, and muscle-relaxant
effects.
3.
A patient taking lithium develops coarse tremor, vomiting, diarrhea, and
confusion. What is the priority concern?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Lithium toxicity
D. Anticholinergic toxicity
Rationale: Gastrointestinal symptoms, worsening tremor, confusion, and
neurologic changes can indicate lithium toxicity and require prompt evaluation.
4.
Which laboratory value is particularly important to monitor in a patient receiving
lithium?
A. Hemoglobin A1c only
B. Serum creatinine and renal function
C. Amylase
D. Bilirubin only
Rationale: Lithium is primarily eliminated by the kidneys, so renal function must
be monitored during therapy.
5.
Which medication is commonly used as an antidote for benzodiazepine toxicity?
,A. Naloxone
B. Naltrexone
C. Flumazenil
D. Atropine
Rationale: Flumazenil is a benzodiazepine receptor antagonist that can reverse
benzodiazepine effects in selected clinical situations.
6.
A patient taking an SSRI develops agitation, diaphoresis, diarrhea, hyperreflexia,
and clonus. Which condition should the PMHNP suspect?
A. Lithium toxicity
B. Neuroleptic malignant syndrome
C. Serotonin syndrome
D. Withdrawal delirium
Rationale: Serotonin syndrome commonly presents with mental-status changes,
autonomic instability, gastrointestinal symptoms, hyperreflexia, and clonus.
7.
Which antidepressant class primarily inhibits the reuptake of both serotonin and
norepinephrine?
A. TCAs
B. MAOIs
C. SNRIs
D. Benzodiazepines
Rationale: SNRIs increase serotonergic and noradrenergic neurotransmission by
inhibiting reuptake of both neurotransmitters.
8.
Which medication is classified as an SNRI?
, A. Sertraline
B. Fluoxetine
C. Duloxetine
D. Trazodone
Rationale: Duloxetine is an SNRI commonly used for depressive and anxiety
disorders and certain chronic pain conditions.
9.
Which adverse effect is particularly important to discuss with a patient beginning
an SSRI?
A. Permanent hearing loss
B. Sexual dysfunction
C. Severe hypoglycemia in every patient
D. Cataract formation
Rationale: Sexual adverse effects, including decreased libido, delayed orgasm,
and erectile dysfunction, can occur with SSRIs.
10.
Which medication is commonly associated with sedation and is sometimes used
when insomnia accompanies depression?
A. Atomoxetine
B. Trazodone
C. Buspirone
D. Methylphenidate
Rationale: Trazodone has significant sedating properties and is frequently
prescribed when insomnia occurs with depressive symptoms.
11.
Which neurotransmitter is particularly important in the neurobiology of anxiety?
