NR 546 Psychopharmacology — 2026 Exam
Questions with Correct Answers
(VerifiedAnswers) Plus Rationales | 2026 Q&A
Instant Download PDF
1. A patient is being started on an SSRI for major depressive
disorder. Which neurotransmitter system is most directly
targeted?
A. Dopamine
B. GABA
C. Serotonin
D. Acetylcholine
Correct answer: C. Serotonin
Rationale: SSRIs selectively inhibit the serotonin transporter,
reducing reuptake of serotonin into the presynaptic neuron and
thereby increasing serotonergic neurotransmission in the
synaptic cleft. Although downstream adaptations involve
multiple intracellular and neuronal processes, their primary
pharmacologic action is enhancement of serotonin signaling.
SSRIs are commonly used as first-line pharmacologic options for
major depressive disorder because of their efficacy, tolerability,
and relative safety compared with older antidepressant classes.
,2. Which neurotransmitters are classically included in the
monoamine hypothesis of depression?
A. GABA, glutamate, and acetylcholine
B. Serotonin, norepinephrine, and dopamine
C. GABA, dopamine, and glutamate
D. Acetylcholine, histamine, and GABA
Correct answer: B. Serotonin, norepinephrine, and dopamine
Rationale: The traditional monoamine hypothesis associates
depressive symptoms with dysregulation of serotonin,
norepinephrine, and dopamine. Serotonin is strongly associated
with mood, anxiety, and several behavioral functions;
norepinephrine contributes to arousal, attention, and energy;
and dopamine is particularly important in reward, motivation,
pleasure, and reinforcement. Modern theories recognize that
depression is more complex than a simple deficiency of these
neurotransmitters and involves receptor adaptations,
intracellular signaling, neuroplasticity, stress systems, and other
mechanisms.
3. Which medication is an SSRI?
A. Venlafaxine
B. Bupropion
,C. Mirtazapine
D. Escitalopram
Correct answer: D. Escitalopram
Rationale: Escitalopram is an SSRI that primarily inhibits
serotonin reuptake. Venlafaxine is an SNRI, bupropion is a
norepinephrine-dopamine reuptake inhibitor, and mirtazapine is
classified as a noradrenergic and specific serotonergic
antidepressant. Recognizing antidepressant classes is essential
because each class has distinct mechanisms, adverse effects,
interactions, and clinical advantages.
4. A patient taking an SSRI develops agitation, diaphoresis,
diarrhea, tremor, and hyperreflexia after another serotonergic
medication is added. What is the most concerning diagnosis?
A. Neuroleptic malignant syndrome
B. Anticholinergic toxicity
C. Serotonin syndrome
D. Lithium toxicity
Correct answer: C. Serotonin syndrome
Rationale: Serotonin syndrome results from excessive
serotonergic activity and can develop when serotonergic
medications are combined. Typical findings include mental-
status changes, autonomic instability, gastrointestinal
, symptoms, tremor, hyperreflexia, clonus, and potentially
hyperthermia. The combination of serotonergic agents should
therefore be evaluated carefully. Severe cases require urgent
medical management and discontinuation of contributing
serotonergic medications.
5. Which finding is particularly characteristic of serotonin
syndrome rather than classic antipsychotic-induced
parkinsonism?
A. Bradykinesia
B. Rigidity
C. Masked facies
D. Hyperreflexia and clonus
Correct answer: D. Hyperreflexia and clonus
Rationale: Hyperreflexia, inducible or spontaneous clonus,
tremor, and autonomic abnormalities strongly support
serotonin toxicity. Antipsychotic-induced parkinsonism more
typically produces rigidity, bradykinesia, resting tremor, and
masked facial expression. Distinguishing these syndromes is
clinically important because their causes and treatments differ
substantially.
Questions with Correct Answers
(VerifiedAnswers) Plus Rationales | 2026 Q&A
Instant Download PDF
1. A patient is being started on an SSRI for major depressive
disorder. Which neurotransmitter system is most directly
targeted?
A. Dopamine
B. GABA
C. Serotonin
D. Acetylcholine
Correct answer: C. Serotonin
Rationale: SSRIs selectively inhibit the serotonin transporter,
reducing reuptake of serotonin into the presynaptic neuron and
thereby increasing serotonergic neurotransmission in the
synaptic cleft. Although downstream adaptations involve
multiple intracellular and neuronal processes, their primary
pharmacologic action is enhancement of serotonin signaling.
SSRIs are commonly used as first-line pharmacologic options for
major depressive disorder because of their efficacy, tolerability,
and relative safety compared with older antidepressant classes.
,2. Which neurotransmitters are classically included in the
monoamine hypothesis of depression?
A. GABA, glutamate, and acetylcholine
B. Serotonin, norepinephrine, and dopamine
C. GABA, dopamine, and glutamate
D. Acetylcholine, histamine, and GABA
Correct answer: B. Serotonin, norepinephrine, and dopamine
Rationale: The traditional monoamine hypothesis associates
depressive symptoms with dysregulation of serotonin,
norepinephrine, and dopamine. Serotonin is strongly associated
with mood, anxiety, and several behavioral functions;
norepinephrine contributes to arousal, attention, and energy;
and dopamine is particularly important in reward, motivation,
pleasure, and reinforcement. Modern theories recognize that
depression is more complex than a simple deficiency of these
neurotransmitters and involves receptor adaptations,
intracellular signaling, neuroplasticity, stress systems, and other
mechanisms.
3. Which medication is an SSRI?
A. Venlafaxine
B. Bupropion
,C. Mirtazapine
D. Escitalopram
Correct answer: D. Escitalopram
Rationale: Escitalopram is an SSRI that primarily inhibits
serotonin reuptake. Venlafaxine is an SNRI, bupropion is a
norepinephrine-dopamine reuptake inhibitor, and mirtazapine is
classified as a noradrenergic and specific serotonergic
antidepressant. Recognizing antidepressant classes is essential
because each class has distinct mechanisms, adverse effects,
interactions, and clinical advantages.
4. A patient taking an SSRI develops agitation, diaphoresis,
diarrhea, tremor, and hyperreflexia after another serotonergic
medication is added. What is the most concerning diagnosis?
A. Neuroleptic malignant syndrome
B. Anticholinergic toxicity
C. Serotonin syndrome
D. Lithium toxicity
Correct answer: C. Serotonin syndrome
Rationale: Serotonin syndrome results from excessive
serotonergic activity and can develop when serotonergic
medications are combined. Typical findings include mental-
status changes, autonomic instability, gastrointestinal
, symptoms, tremor, hyperreflexia, clonus, and potentially
hyperthermia. The combination of serotonergic agents should
therefore be evaluated carefully. Severe cases require urgent
medical management and discontinuation of contributing
serotonergic medications.
5. Which finding is particularly characteristic of serotonin
syndrome rather than classic antipsychotic-induced
parkinsonism?
A. Bradykinesia
B. Rigidity
C. Masked facies
D. Hyperreflexia and clonus
Correct answer: D. Hyperreflexia and clonus
Rationale: Hyperreflexia, inducible or spontaneous clonus,
tremor, and autonomic abnormalities strongly support
serotonin toxicity. Antipsychotic-induced parkinsonism more
typically produces rigidity, bradykinesia, resting tremor, and
masked facial expression. Distinguishing these syndromes is
clinically important because their causes and treatments differ
substantially.
