CHAMBERLAIN UNIVERSITY – NR 546 FINAL
EXAM Advanced Pharmacology
Psychopharmacology for the PMHNP 200
Questions with Correct Answers and
Explanations
NEUROBIOLOGY & NEUROTRANSMITTERS
1. Which of the following best explains the monoamine hypothesis of depression?
A. Depression is caused by an excess of monoamine neurotransmission
B. Depression is caused by a deficiency of monoamine neurotransmitters
C. Depression results from maladaptive cognitions only
D. Depression is unrelated to neurotransmitter function
Answer: B. The monoamine hypothesis states that depression results from a deficiency
in the monoamine neurotransmitters: serotonin (5-HT), norepinephrine (NE), and
dopamine (DA) .
2. MAOIs (monoamine oxidase inhibitors) affect which neurotransmitters?
A. Serotonin, Dopamine, Norepinephrine
B. Serotonin, GABA, Glutamate
C. Acetylcholine, Dopamine, Norepinephrine
D. Dopamine, GABA, Acetylcholine
Answer: A. Monoamine oxidase inhibitors block the enzyme monoamine oxidase, which
metabolizes monoamine neurotransmitters. By inhibiting this enzyme, MAOIs increase
the availability of serotonin, norepinephrine, and dopamine in the synaptic cleft .
, 3. Which neurotransmitter is primarily associated with reward and addiction?
A. Norepinephrine
B. GABA
C. Dopamine
D. Histamine
Answer: C. Dopamine is the key neurotransmitter involved in the brain's reward
pathway and is central to addiction mechanisms .
4. In ADHD, selective attention arises from abnormalities in which brain circuit?
A. Dorsolateral prefrontal cortex (DLPFC)
B. Dorsal anterior cingulate cortex (dACC)
C. Orbitofrontal cortex
D. Cerebellum
Answer: B. The dorsal anterior cingulate cortex (dACC) is implicated in selective
attention deficits seen in ADHD .
5. In ADHD, difficulty sustaining attention and poor problem-solving arises from
abnormalities in which circuit?
A. Dorsolateral prefrontal cortex (DLPFC)
B. Dorsal anterior cingulate cortex (dACC)
C. Orbitofrontal cortex
D. Ventrolateral prefrontal cortex
Answer: A. The dorsolateral prefrontal cortex (DLPFC) is responsible for executive
functions including sustained attention and problem-solving .
, 6. In ADHD, impulsivity arises from abnormalities in which circuit?
A. Dorsolateral prefrontal cortex
B. Dorsal anterior cingulate cortex
C. Orbitofrontal cortex
D. Cerebellum
Answer: C. The orbitofrontal cortex is associated with impulse control and decision-
making .
MAJOR DEPRESSIVE DISORDER
7. When treating a patient for major depressive disorder, which medication would
the PMHNP consider first?
A. Depakote
B. Selegiline
C. Escitalopram
D. Isocarboxazid
Answer: C. Escitalopram is an SSRI considered first-line pharmacotherapy for major
depressive disorder due to its favorable efficacy and safety profile. Selegiline and
isocarboxazid are MAOIs reserved for treatment-resistant depression due to dietary
restrictions and side effect profiles .
8. Which of the following is considered first-line treatment for depression?
A. SSRI
B. FGA
C. SNRI
D. MAOI
Answer: A. SSRIs are the first-line pharmacological treatment for depression due to
their favorable side effect profile and efficacy .
, 9. A patient reports upset stomach and diarrhea 3 days after starting sertraline.
What is the most appropriate response?
A. "Start doubling the dose and symptoms will ease up"
B. "Most side effects subside after 4-5 days; your body is adjusting"
C. "Stop taking it immediately and go to the emergency room"
D. "You must take sertraline with food, or you will continue to have GI distress"
Answer: B. Gastrointestinal side effects (nausea, diarrhea) are common early adverse
effects of SSRIs due to increased serotonin activity in the gut. These symptoms are
typically transient and resolve within the first 1-2 weeks of treatment. Patient education
and reassurance are appropriate .
10. During a 2-week follow-up, a patient reports no improvement with
escitalopram. Which statement by the PMHNP is correct?
A. "Let's discontinue and start something stronger"
B. "It can take up to 6 weeks before you notice improvement"
C. "I am going to prescribe trazodone for sleep"
D. "Start taking two pills at a time"
Answer: B. The onset of antidepressant therapeutic effects typically requires 4-6 weeks
of consistent treatment. Two weeks is insufficient to evaluate efficacy. Early
discontinuation or unnecessary polypharmacy should be avoided unless there are severe
adverse effects .
11. Rashida is taking sertraline 25 mg for MDD. She reports slight improvement
but still has symptoms. What should the PMHNP do?
A. Increase sertraline dose
B. Switch to fluoxetine
C. Add aripiprazole
D. Discontinue and start bupropion
EXAM Advanced Pharmacology
Psychopharmacology for the PMHNP 200
Questions with Correct Answers and
Explanations
NEUROBIOLOGY & NEUROTRANSMITTERS
1. Which of the following best explains the monoamine hypothesis of depression?
A. Depression is caused by an excess of monoamine neurotransmission
B. Depression is caused by a deficiency of monoamine neurotransmitters
C. Depression results from maladaptive cognitions only
D. Depression is unrelated to neurotransmitter function
Answer: B. The monoamine hypothesis states that depression results from a deficiency
in the monoamine neurotransmitters: serotonin (5-HT), norepinephrine (NE), and
dopamine (DA) .
2. MAOIs (monoamine oxidase inhibitors) affect which neurotransmitters?
A. Serotonin, Dopamine, Norepinephrine
B. Serotonin, GABA, Glutamate
C. Acetylcholine, Dopamine, Norepinephrine
D. Dopamine, GABA, Acetylcholine
Answer: A. Monoamine oxidase inhibitors block the enzyme monoamine oxidase, which
metabolizes monoamine neurotransmitters. By inhibiting this enzyme, MAOIs increase
the availability of serotonin, norepinephrine, and dopamine in the synaptic cleft .
, 3. Which neurotransmitter is primarily associated with reward and addiction?
A. Norepinephrine
B. GABA
C. Dopamine
D. Histamine
Answer: C. Dopamine is the key neurotransmitter involved in the brain's reward
pathway and is central to addiction mechanisms .
4. In ADHD, selective attention arises from abnormalities in which brain circuit?
A. Dorsolateral prefrontal cortex (DLPFC)
B. Dorsal anterior cingulate cortex (dACC)
C. Orbitofrontal cortex
D. Cerebellum
Answer: B. The dorsal anterior cingulate cortex (dACC) is implicated in selective
attention deficits seen in ADHD .
5. In ADHD, difficulty sustaining attention and poor problem-solving arises from
abnormalities in which circuit?
A. Dorsolateral prefrontal cortex (DLPFC)
B. Dorsal anterior cingulate cortex (dACC)
C. Orbitofrontal cortex
D. Ventrolateral prefrontal cortex
Answer: A. The dorsolateral prefrontal cortex (DLPFC) is responsible for executive
functions including sustained attention and problem-solving .
, 6. In ADHD, impulsivity arises from abnormalities in which circuit?
A. Dorsolateral prefrontal cortex
B. Dorsal anterior cingulate cortex
C. Orbitofrontal cortex
D. Cerebellum
Answer: C. The orbitofrontal cortex is associated with impulse control and decision-
making .
MAJOR DEPRESSIVE DISORDER
7. When treating a patient for major depressive disorder, which medication would
the PMHNP consider first?
A. Depakote
B. Selegiline
C. Escitalopram
D. Isocarboxazid
Answer: C. Escitalopram is an SSRI considered first-line pharmacotherapy for major
depressive disorder due to its favorable efficacy and safety profile. Selegiline and
isocarboxazid are MAOIs reserved for treatment-resistant depression due to dietary
restrictions and side effect profiles .
8. Which of the following is considered first-line treatment for depression?
A. SSRI
B. FGA
C. SNRI
D. MAOI
Answer: A. SSRIs are the first-line pharmacological treatment for depression due to
their favorable side effect profile and efficacy .
, 9. A patient reports upset stomach and diarrhea 3 days after starting sertraline.
What is the most appropriate response?
A. "Start doubling the dose and symptoms will ease up"
B. "Most side effects subside after 4-5 days; your body is adjusting"
C. "Stop taking it immediately and go to the emergency room"
D. "You must take sertraline with food, or you will continue to have GI distress"
Answer: B. Gastrointestinal side effects (nausea, diarrhea) are common early adverse
effects of SSRIs due to increased serotonin activity in the gut. These symptoms are
typically transient and resolve within the first 1-2 weeks of treatment. Patient education
and reassurance are appropriate .
10. During a 2-week follow-up, a patient reports no improvement with
escitalopram. Which statement by the PMHNP is correct?
A. "Let's discontinue and start something stronger"
B. "It can take up to 6 weeks before you notice improvement"
C. "I am going to prescribe trazodone for sleep"
D. "Start taking two pills at a time"
Answer: B. The onset of antidepressant therapeutic effects typically requires 4-6 weeks
of consistent treatment. Two weeks is insufficient to evaluate efficacy. Early
discontinuation or unnecessary polypharmacy should be avoided unless there are severe
adverse effects .
11. Rashida is taking sertraline 25 mg for MDD. She reports slight improvement
but still has symptoms. What should the PMHNP do?
A. Increase sertraline dose
B. Switch to fluoxetine
C. Add aripiprazole
D. Discontinue and start bupropion
