NR 546 FINAL EXAM CHAMBERLAIN
PSYCHOPHARMACOLOGY 2026
UPDATED QUESTIONS WITH
CORRECT ANSWERS AND DETAILED
RATIONALES VERIFIED GRADED A+
1. What is the primary mechanism of action of selective serotonin reuptake
inhibitors (SSRIs)?
A. Irreversible inhibition of monoamine oxidase
B. Blockade of presynaptic serotonin reuptake pumps
C. Direct agonism of postsynaptic serotonin receptors
D. Inhibition of serotonin synthesis
CORRECT ANSWER: B. Blockade of presynaptic serotonin reuptake pumps
RATIONALE: SSRIs work by blocking the serotonin transporter (SERT) on the
presynaptic membrane, increasing serotonin concentration in the synaptic cleft.
2. A patient is prescribed a drug with a half-life of 24 hours. Approximately how
many days will it take to reach steady-state concentration?
A. 1 to 2 days
B. 3 to 4 days
C. 5 to 7 days
D. 10 to 14 days
CORRECT ANSWER: C. 5 to 7 days
,RATIONALE: Steady state is typically achieved after 4 to 5 half-lives. For a 24-hour
half-life, this equals 4 to 5 days (up to 7 days for complete steady state).
3. Which cytochrome P450 enzyme is primarily responsible for the metabolism of
most SSRIs?
A. CYP1A2
B. CYP2D6
C. CYP3A4
D. CYP2C19
CORRECT ANSWER: B. CYP2D6
RATIONALE: CYP2D6 is a major hepatic enzyme responsible for metabolizing many
psychotropic drugs, including most SSRIs and TCAs.
4. Which of the following neurotransmitters is primarily excitatory in the central
nervous system?
A. Gamma-aminobutyric acid (GABA)
B. Serotonin
C. Glutamate
D. Glycine
CORRECT ANSWER: C. Glutamate
RATIONALE: Glutamate is the primary excitatory neurotransmitter in the CNS,
whereas GABA and glycine are primarily inhibitory.
,5. A patient taking phenelzine (an MAOI) consumes aged cheese and develops a
hypertensive crisis. This is due to the accumulation of which substance?
A. Serotonin
B. Tyramine
C. Histamine
D. Acetylcholine
CORRECT ANSWER: B. Tyramine
RATIONALE: MAOIs inhibit the breakdown of tyramine. Ingestion of tyramine-rich
foods (like aged cheese) leads to a massive release of norepinephrine, causing a
hypertensive crisis.
6. What is the therapeutic serum concentration range for lithium in the
maintenance treatment of bipolar disorder?
A. 0.2 to 0.4 mEq/L
B. 0.6 to 1.2 mEq/L
C. 1.5 to 2.0 mEq/L
D. 2.5 to 3.0 mEq/L
CORRECT ANSWER: B. 0.6 to 1.2 mEq/L
RATIONALE: The therapeutic range for lithium maintenance is typically 0.6 to 1.2
mEq/L. Levels above 1.5 mEq/L are considered toxic.
7. Which atypical antipsychotic is most strongly associated with metabolic
syndrome, including significant weight gain and dyslipidemia?
A. Aripiprazole
, B. Ziprasidone
C. Olanzapine
D. Lurasidone
CORRECT ANSWER: C. Olanzapine
RATIONALE: Olanzapine and clozapine have the highest risk of metabolic side
effects, including weight gain, diabetes, and dyslipidemia, among second-
generation antipsychotics.
8. The extrapyramidal symptoms (EPS) associated with first-generation
antipsychotics are primarily due to the blockade of which receptor?
A. Serotonin 5-HT2A
B. Dopamine D2
C. Histamine H1
D. Muscarinic M1
CORRECT ANSWER: B. Dopamine D2
RATIONALE: Blockade of dopamine D2 receptors in the nigrostriatal pathway is
the primary mechanism behind EPS, such as dystonia, akathisia, and
parkinsonism.
9. Which of the following medications is a norepinephrine-dopamine reuptake
inhibitor (NDRI) used for depression and smoking cessation?
A. Venlafaxine
B. Bupropion
C. Mirtazapine
PSYCHOPHARMACOLOGY 2026
UPDATED QUESTIONS WITH
CORRECT ANSWERS AND DETAILED
RATIONALES VERIFIED GRADED A+
1. What is the primary mechanism of action of selective serotonin reuptake
inhibitors (SSRIs)?
A. Irreversible inhibition of monoamine oxidase
B. Blockade of presynaptic serotonin reuptake pumps
C. Direct agonism of postsynaptic serotonin receptors
D. Inhibition of serotonin synthesis
CORRECT ANSWER: B. Blockade of presynaptic serotonin reuptake pumps
RATIONALE: SSRIs work by blocking the serotonin transporter (SERT) on the
presynaptic membrane, increasing serotonin concentration in the synaptic cleft.
2. A patient is prescribed a drug with a half-life of 24 hours. Approximately how
many days will it take to reach steady-state concentration?
A. 1 to 2 days
B. 3 to 4 days
C. 5 to 7 days
D. 10 to 14 days
CORRECT ANSWER: C. 5 to 7 days
,RATIONALE: Steady state is typically achieved after 4 to 5 half-lives. For a 24-hour
half-life, this equals 4 to 5 days (up to 7 days for complete steady state).
3. Which cytochrome P450 enzyme is primarily responsible for the metabolism of
most SSRIs?
A. CYP1A2
B. CYP2D6
C. CYP3A4
D. CYP2C19
CORRECT ANSWER: B. CYP2D6
RATIONALE: CYP2D6 is a major hepatic enzyme responsible for metabolizing many
psychotropic drugs, including most SSRIs and TCAs.
4. Which of the following neurotransmitters is primarily excitatory in the central
nervous system?
A. Gamma-aminobutyric acid (GABA)
B. Serotonin
C. Glutamate
D. Glycine
CORRECT ANSWER: C. Glutamate
RATIONALE: Glutamate is the primary excitatory neurotransmitter in the CNS,
whereas GABA and glycine are primarily inhibitory.
,5. A patient taking phenelzine (an MAOI) consumes aged cheese and develops a
hypertensive crisis. This is due to the accumulation of which substance?
A. Serotonin
B. Tyramine
C. Histamine
D. Acetylcholine
CORRECT ANSWER: B. Tyramine
RATIONALE: MAOIs inhibit the breakdown of tyramine. Ingestion of tyramine-rich
foods (like aged cheese) leads to a massive release of norepinephrine, causing a
hypertensive crisis.
6. What is the therapeutic serum concentration range for lithium in the
maintenance treatment of bipolar disorder?
A. 0.2 to 0.4 mEq/L
B. 0.6 to 1.2 mEq/L
C. 1.5 to 2.0 mEq/L
D. 2.5 to 3.0 mEq/L
CORRECT ANSWER: B. 0.6 to 1.2 mEq/L
RATIONALE: The therapeutic range for lithium maintenance is typically 0.6 to 1.2
mEq/L. Levels above 1.5 mEq/L are considered toxic.
7. Which atypical antipsychotic is most strongly associated with metabolic
syndrome, including significant weight gain and dyslipidemia?
A. Aripiprazole
, B. Ziprasidone
C. Olanzapine
D. Lurasidone
CORRECT ANSWER: C. Olanzapine
RATIONALE: Olanzapine and clozapine have the highest risk of metabolic side
effects, including weight gain, diabetes, and dyslipidemia, among second-
generation antipsychotics.
8. The extrapyramidal symptoms (EPS) associated with first-generation
antipsychotics are primarily due to the blockade of which receptor?
A. Serotonin 5-HT2A
B. Dopamine D2
C. Histamine H1
D. Muscarinic M1
CORRECT ANSWER: B. Dopamine D2
RATIONALE: Blockade of dopamine D2 receptors in the nigrostriatal pathway is
the primary mechanism behind EPS, such as dystonia, akathisia, and
parkinsonism.
9. Which of the following medications is a norepinephrine-dopamine reuptake
inhibitor (NDRI) used for depression and smoking cessation?
A. Venlafaxine
B. Bupropion
C. Mirtazapine
