NR 546 Final Practice Exam Questions & Answers 2026 |
Psychopharmacology | Graded A+
1. If a pregnant patient in a methadone MAT program experiences increased
cravings and anxiety, what should be the next step in her treatment plan?
Adjust the methadone dose to better manage her symptoms.
Switch her to a different medication without consulting her.
Advise her to stop all medications immediately.
Increase her dosage of naloxone.
2. A patient with a history of anxiety and recent onset of insomnia is being
treated with Paroxetine. If the patient reports worsening insomnia after two
weeks, what would be an appropriate next step in management?
Discontinue Paroxetine and start an MAOI.
Advise the patient to stop all medications.
Increase the dose of Paroxetine immediately.
Consider switching to a different SSRI or adding a sleep aid.
3. You are treating a 75-year-old patient for early signs of depression. He has a
complex medical history, and brought you a list of 20+ drugs that he currently
takes. Which medication should you choose to treat his depression that will
have the least likelihood of interacting with his other medications?
Fluvoxamine - SSRI; used for OCD more commonly
Paroxetine - SSRI; potent inhibition of CYP2D6
Escitalopram - SSRI (Lexapro; better tolerated with fewer DDIs;
more common for depression and GAD)
, Sertraline - SSRI (Zoloft; more common for depression, OCD, other
mental health conditions)
4. In a clinical scenario where a patient is experiencing anxiety and depression,
which medication might be considered if they have not responded to
traditional SSRIs?
Vilazodone
Phenelzine
Fluoxetine
Trazodone
5. Which medication is known to have a black box warning for a potentially life-
threatening skin rash?
Lithium
Lurasidone
Lamotrigine
Lorazepam
6. Describe why SSRIs are often chosen as the first line treatment for
depression compared to other classes of antidepressants.
SSRIs are often chosen as the first line treatment for depression due
to their favorable side effect profile and efficacy in improving
mood.
SSRIs are less effective than MAOIs in treating depression.
SSRIs have the highest risk of severe side effects compared to other
antidepressants.
SSRIs are the only medications available for treating depression.
,7. Identify the first-line treatment for depression.
BZD's
SSRI's
MAOI's
TCA's
8. A 14-year-old presents to clinic for depressive symptoms and the psychiatric
nurse practitioner elects to initiate pharmacotherapy. Which of the following
medications is the most suitable first line therapy?
Venlafaxine
Escitalopram
Phenobarbital
Paroxetine
9. Which of the following neuronal pathways leads to the reward center?
nigrostriatal pathway
mesolimbic pathway
hypothalamic pathway
mesocortical pathway
10. Describe why escitalopram is often chosen for patients with major
depressive disorder who are on multiple medications.
Escitalopram is often chosen due to its favorable side effect profile
and lower potential for drug interactions compared to other
antidepressants.
Escitalopram has no side effects, making it ideal for all patients.
, Escitalopram is the only medication approved for major depressive
disorder.
Escitalopram is the most effective medication for all types of
depression.
11. Most tolerable ADM and Less DDIs
Which SSRI does this statement refer to?
Fluoxetine
Escitalopram
Citalopram
Paroxetine
12. Describe the importance of monitoring lithium levels after a dosage
adjustment in a patient.
Lithium levels should be monitored only once a year regardless of
dosage changes.
Monitoring is not needed if the patient feels well after the dosage
change.
It is only necessary to monitor lithium levels if the patient experiences
side effects.
Monitoring lithium levels after a dosage adjustment is crucial to
ensure therapeutic effectiveness and prevent toxicity.
13. Which medication is specifically indicated for the treatment of ADHD and is
considered safe for use in pregnant women?
Methylphenidate
Lisdexamfetamine
Psychopharmacology | Graded A+
1. If a pregnant patient in a methadone MAT program experiences increased
cravings and anxiety, what should be the next step in her treatment plan?
Adjust the methadone dose to better manage her symptoms.
Switch her to a different medication without consulting her.
Advise her to stop all medications immediately.
Increase her dosage of naloxone.
2. A patient with a history of anxiety and recent onset of insomnia is being
treated with Paroxetine. If the patient reports worsening insomnia after two
weeks, what would be an appropriate next step in management?
Discontinue Paroxetine and start an MAOI.
Advise the patient to stop all medications.
Increase the dose of Paroxetine immediately.
Consider switching to a different SSRI or adding a sleep aid.
3. You are treating a 75-year-old patient for early signs of depression. He has a
complex medical history, and brought you a list of 20+ drugs that he currently
takes. Which medication should you choose to treat his depression that will
have the least likelihood of interacting with his other medications?
Fluvoxamine - SSRI; used for OCD more commonly
Paroxetine - SSRI; potent inhibition of CYP2D6
Escitalopram - SSRI (Lexapro; better tolerated with fewer DDIs;
more common for depression and GAD)
, Sertraline - SSRI (Zoloft; more common for depression, OCD, other
mental health conditions)
4. In a clinical scenario where a patient is experiencing anxiety and depression,
which medication might be considered if they have not responded to
traditional SSRIs?
Vilazodone
Phenelzine
Fluoxetine
Trazodone
5. Which medication is known to have a black box warning for a potentially life-
threatening skin rash?
Lithium
Lurasidone
Lamotrigine
Lorazepam
6. Describe why SSRIs are often chosen as the first line treatment for
depression compared to other classes of antidepressants.
SSRIs are often chosen as the first line treatment for depression due
to their favorable side effect profile and efficacy in improving
mood.
SSRIs are less effective than MAOIs in treating depression.
SSRIs have the highest risk of severe side effects compared to other
antidepressants.
SSRIs are the only medications available for treating depression.
,7. Identify the first-line treatment for depression.
BZD's
SSRI's
MAOI's
TCA's
8. A 14-year-old presents to clinic for depressive symptoms and the psychiatric
nurse practitioner elects to initiate pharmacotherapy. Which of the following
medications is the most suitable first line therapy?
Venlafaxine
Escitalopram
Phenobarbital
Paroxetine
9. Which of the following neuronal pathways leads to the reward center?
nigrostriatal pathway
mesolimbic pathway
hypothalamic pathway
mesocortical pathway
10. Describe why escitalopram is often chosen for patients with major
depressive disorder who are on multiple medications.
Escitalopram is often chosen due to its favorable side effect profile
and lower potential for drug interactions compared to other
antidepressants.
Escitalopram has no side effects, making it ideal for all patients.
, Escitalopram is the only medication approved for major depressive
disorder.
Escitalopram is the most effective medication for all types of
depression.
11. Most tolerable ADM and Less DDIs
Which SSRI does this statement refer to?
Fluoxetine
Escitalopram
Citalopram
Paroxetine
12. Describe the importance of monitoring lithium levels after a dosage
adjustment in a patient.
Lithium levels should be monitored only once a year regardless of
dosage changes.
Monitoring is not needed if the patient feels well after the dosage
change.
It is only necessary to monitor lithium levels if the patient experiences
side effects.
Monitoring lithium levels after a dosage adjustment is crucial to
ensure therapeutic effectiveness and prevent toxicity.
13. Which medication is specifically indicated for the treatment of ADHD and is
considered safe for use in pregnant women?
Methylphenidate
Lisdexamfetamine
