NR 546 – Psychopharmacology for the Psychiatric-Mental Health Nurse Practitioner (Chamberlain College of Nursing, 2025/2026) | Midterm Exam | Verified Questions and Correct Answers | New!!

NR 546 – Psychopharmacology for the
Psychiatric-Mental Health Nurse Practitioner
(Chamberlain College of Nursing) | Midterm
Exam 2025/2026 – Verified Questions and
Answers | New!!
Instructions: This midterm exam review contains 100 multiple-choice questions covering
neurobiology, pharmacokinetics, antidepressants, antipsychotics, mood stabilizers, anxiolytics,
and ADHD medications. Each question includes four answer choices, the correct answer in
RED, and a detailed rationale based on psychopharmacology principles. Questions are separated
by horizontal lines for clarity.



Question 1
What is the primary neurotransmitter implicated in schizophrenia?
A. Serotonin
B. Dopamine
C. GABA
D. Acetylcholine
Correct Answer: B. Dopamine
Rationale: Dopamine hypothesis: excess in mesolimbic pathway causes positive symptoms;
deficit in mesocortical causes negative. Serotonin (A) modulates, GABA (C) inhibitory, ACh (D)
cognitive.



Question 2
Which receptor does serotonin primarily act on in antidepressants?
A. 5-HT1A
B. 5-HT2A
C. 5-HT3
D. All
Correct Answer: A. 5-HT1A
Rationale: SSRIs increase serotonin, desensitizing autoreceptors like 5-HT1A for therapeutic
effect. 5-HT2A (B) antipsychotics, 5-HT3 (C) nausea.



Question 3
What is the mechanism first-pass effect in pharmacokinetics?
A. Absorption

,B. Liver metabolism before systemic circulation
C. Distribution
D. Excretion
Correct Answer: B. Liver metabolism before systemic circulation
Rationale: Oral drugs metabolized by CYP enzymes, reducing bioavailability. IV bypasses.



Question 4
Which CYP enzyme is inhibited by fluoxetine?
A. CYP2D6
B. CYP3A4
C. CYP1A2
D. All
Correct Answer: A. CYP2D6
Rationale: Fluoxetine strong 2D6 inhibitor, increasing levels of substrates like TCAs,
antipsychotics.



Question 5
What is the half-life consideration for drug steady state?
A. 1-2 half-lives
B. 4-5 half-lives
C. 10 half-lives
D. Immediate
Correct Answer: B. 4-5 half-lives
Rationale: Steady state reached after 4-5 half-lives for dosing intervals.



Question 6
In ionotropic receptors, what happens?
A. Slow modulation
B. Ion channel opening
C. G-protein coupling
D. Gene transcription
Correct Answer: B. Ion channel opening
Rationale: Ligand-gated like NMDA, GABA-A. Metabotropic (C) slower.



Question 7
What is epigenetics in psychiatry?
A. Gene sequence change
B. Expression modification without sequence

, C. Mutation
D. Deletion
Correct Answer: B. Expression modification without sequence
Rationale: Methylation affects stress response, antidepressant action.



Question 8
The blood-brain barrier is formed by:
A. Astrocytes
B. Tight junctions of endothelial cells
C. Microglia
D. Oligodendrocytes
Correct Answer: B. Tight junctions of endothelial cells
Rationale: Prevents hydrophilic drugs entry; lipophilic pass.



Question 9
Which is a second-generation antidepressant mechanism?
A. MAO inhibition
B. Serotonin reuptake inhibition
C. Dopamine blockade
D. GABA agonism
Correct Answer: B. Serotonin reuptake inhibition
Rationale: SSRIs like fluoxetine block SERT.



Question 10
Black box warning for antidepressants?
A. Suicidality in youth
B. Hypertension
C. Seizures
D. Liver failure
Correct Answer: A. Suicidality in youth
Rationale: Increased risk <24 years; monitor closely.



Question 11
Which SSRI has longest half-life?
A. Sertraline
B. Paroxetine
C. Fluoxetine
D. Citalopram