NR546 Week 8 Final Exam Due 1st March 2026 Complete
Actual Exam Questions 1- 75 NR546 Advanced
Psychopharmacology for The PMHNP NR 546 Midterm and
Finals Examplify Online Proctored Exam Questions and
Answers 100% Pass Guaranteed Graded A+
1. A patient with major depressive disorder is started on an SSRI. Which neurotransmitter is
primarily increased in the synaptic cleft?
A. Dopamine
B. Serotonin
C. GABA
D. Glutamate
Answer: B. Serotonin
Rationale: SSRIs inhibit the serotonin transporter (SERT), reducing serotonin reuptake and
increasing serotonergic activity in the synaptic cleft.
2. Which medication is a selective serotonin reuptake inhibitor?
A. Venlafaxine
B. Bupropion
C. Sertraline
D. Mirtazapine
Answer: C. Sertraline
Rationale: Sertraline is an SSRI commonly used for depressive and anxiety disorders.
3. A patient taking an SSRI develops agitation, diaphoresis, hyperreflexia, clonus, and fever.
Which condition should be suspected?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
,C. Anticholinergic toxicity
D. Lithium toxicity
Answer: B. Serotonin syndrome
Rationale: Serotonin syndrome is characterized by autonomic instability, altered mental status,
and neuromuscular hyperactivity such as clonus and hyperreflexia.
4. Which medication is most appropriate for immediate treatment of severe serotonin
syndrome?
A. Cyproheptadine
B. Flumazenil
C. Naloxone
D. Benztropine
Answer: A. Cyproheptadine
Rationale: Cyproheptadine is a serotonin antagonist that may be used in moderate-to-severe
serotonin toxicity in addition to supportive management.
5. Which antidepressant is least likely to cause sexual dysfunction?
A. Paroxetine
B. Sertraline
C. Escitalopram
D. Bupropion
Answer: D. Bupropion
Rationale: Bupropion generally has a lower risk of sexual adverse effects than serotonergic
antidepressants.
6. Which antidepressant should generally be avoided in a patient with a seizure disorder
because it can lower the seizure threshold?
A. Bupropion
B. Sertraline
C. Escitalopram
D. Fluoxetine
,Answer: A. Bupropion
Rationale: Bupropion can lower the seizure threshold, with risk increasing at higher doses and
in susceptible patients.
7. A patient taking paroxetine wants to discontinue treatment abruptly. What is the primary
concern?
A. Severe hypertension
B. Antidepressant discontinuation syndrome
C. Agranulocytosis
D. Hypercalcemia
Answer: B. Antidepressant discontinuation syndrome
Rationale: Paroxetine has a relatively short half-life and is particularly associated with
discontinuation symptoms such as dizziness, irritability, flu-like sensations, and electric-shock
sensations.
8. Which SSRI has the longest half-life and therefore tends to cause fewer discontinuation
symptoms?
A. Paroxetine
B. Fluoxetine
C. Sertraline
D. Fluvoxamine
Answer: B. Fluoxetine
Rationale: Fluoxetine has a long half-life, including an active metabolite, which provides a
gradual decline in serotonergic activity after discontinuation.
9. A patient taking an SSRI develops suicidal thoughts shortly after starting treatment. What is
the most appropriate PMHNP action?
A. Ignore the symptom because it is expected
B. Immediately discontinue all medication without assessment
C. Perform a suicide risk assessment and establish appropriate safety measures
D. Double the antidepressant dose
, Answer: C. Perform a suicide risk assessment and establish appropriate safety measures
Rationale: Emergent suicidal thoughts require immediate clinical assessment and safety
planning, particularly during early treatment and dose changes.
10. Which antidepressant is an SNRI?
A. Duloxetine
B. Fluoxetine
C. Trazodone
D. Bupropion
Answer: A. Duloxetine
Rationale: Duloxetine inhibits reuptake of serotonin and norepinephrine.
11. Which SNRI is particularly useful when depression coexists with diabetic peripheral
neuropathic pain?
A. Duloxetine
B. Fluvoxamine
C. Vilazodone
D. Mirtazapine
Answer: A. Duloxetine
Rationale: Duloxetine has established efficacy for major depressive disorder and several chronic
pain conditions, including diabetic peripheral neuropathy.
12. Which adverse effect is associated with higher doses of SNRIs?
A. Hypotension only
B. Hypertension
C. Severe hypoglycemia
D. Agranulocytosis
Answer: B. Hypertension
Rationale: Increased norepinephrine activity can elevate blood pressure, particularly with
higher SNRI doses.
Actual Exam Questions 1- 75 NR546 Advanced
Psychopharmacology for The PMHNP NR 546 Midterm and
Finals Examplify Online Proctored Exam Questions and
Answers 100% Pass Guaranteed Graded A+
1. A patient with major depressive disorder is started on an SSRI. Which neurotransmitter is
primarily increased in the synaptic cleft?
A. Dopamine
B. Serotonin
C. GABA
D. Glutamate
Answer: B. Serotonin
Rationale: SSRIs inhibit the serotonin transporter (SERT), reducing serotonin reuptake and
increasing serotonergic activity in the synaptic cleft.
2. Which medication is a selective serotonin reuptake inhibitor?
A. Venlafaxine
B. Bupropion
C. Sertraline
D. Mirtazapine
Answer: C. Sertraline
Rationale: Sertraline is an SSRI commonly used for depressive and anxiety disorders.
3. A patient taking an SSRI develops agitation, diaphoresis, hyperreflexia, clonus, and fever.
Which condition should be suspected?
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
,C. Anticholinergic toxicity
D. Lithium toxicity
Answer: B. Serotonin syndrome
Rationale: Serotonin syndrome is characterized by autonomic instability, altered mental status,
and neuromuscular hyperactivity such as clonus and hyperreflexia.
4. Which medication is most appropriate for immediate treatment of severe serotonin
syndrome?
A. Cyproheptadine
B. Flumazenil
C. Naloxone
D. Benztropine
Answer: A. Cyproheptadine
Rationale: Cyproheptadine is a serotonin antagonist that may be used in moderate-to-severe
serotonin toxicity in addition to supportive management.
5. Which antidepressant is least likely to cause sexual dysfunction?
A. Paroxetine
B. Sertraline
C. Escitalopram
D. Bupropion
Answer: D. Bupropion
Rationale: Bupropion generally has a lower risk of sexual adverse effects than serotonergic
antidepressants.
6. Which antidepressant should generally be avoided in a patient with a seizure disorder
because it can lower the seizure threshold?
A. Bupropion
B. Sertraline
C. Escitalopram
D. Fluoxetine
,Answer: A. Bupropion
Rationale: Bupropion can lower the seizure threshold, with risk increasing at higher doses and
in susceptible patients.
7. A patient taking paroxetine wants to discontinue treatment abruptly. What is the primary
concern?
A. Severe hypertension
B. Antidepressant discontinuation syndrome
C. Agranulocytosis
D. Hypercalcemia
Answer: B. Antidepressant discontinuation syndrome
Rationale: Paroxetine has a relatively short half-life and is particularly associated with
discontinuation symptoms such as dizziness, irritability, flu-like sensations, and electric-shock
sensations.
8. Which SSRI has the longest half-life and therefore tends to cause fewer discontinuation
symptoms?
A. Paroxetine
B. Fluoxetine
C. Sertraline
D. Fluvoxamine
Answer: B. Fluoxetine
Rationale: Fluoxetine has a long half-life, including an active metabolite, which provides a
gradual decline in serotonergic activity after discontinuation.
9. A patient taking an SSRI develops suicidal thoughts shortly after starting treatment. What is
the most appropriate PMHNP action?
A. Ignore the symptom because it is expected
B. Immediately discontinue all medication without assessment
C. Perform a suicide risk assessment and establish appropriate safety measures
D. Double the antidepressant dose
, Answer: C. Perform a suicide risk assessment and establish appropriate safety measures
Rationale: Emergent suicidal thoughts require immediate clinical assessment and safety
planning, particularly during early treatment and dose changes.
10. Which antidepressant is an SNRI?
A. Duloxetine
B. Fluoxetine
C. Trazodone
D. Bupropion
Answer: A. Duloxetine
Rationale: Duloxetine inhibits reuptake of serotonin and norepinephrine.
11. Which SNRI is particularly useful when depression coexists with diabetic peripheral
neuropathic pain?
A. Duloxetine
B. Fluvoxamine
C. Vilazodone
D. Mirtazapine
Answer: A. Duloxetine
Rationale: Duloxetine has established efficacy for major depressive disorder and several chronic
pain conditions, including diabetic peripheral neuropathy.
12. Which adverse effect is associated with higher doses of SNRIs?
A. Hypotension only
B. Hypertension
C. Severe hypoglycemia
D. Agranulocytosis
Answer: B. Hypertension
Rationale: Increased norepinephrine activity can elevate blood pressure, particularly with
higher SNRI doses.
