1|Page
NSG 533| NSG533 Advanced
Pharmacology Final Exam (Module 2, 5,
6, 7 ,8) Questions and Answers Graded A+
| Latest 2025
RATED
Which of the following SSRIs requires up to a 5-week washout period because of the
long half-life of its potent active metabolite?
A. Escitalopram
B. Fluvoxamine
C. Fluoxetine
D. Sertraline - ANS ✓✓ C
Which of the following symptoms is most likely to improve within approximately 1 week
of starting treatment?
A. Depressed mood
B. Suicidal thoughts
C. Anhedonia
D. Sleep - ANS ✓✓ D
Of the following combinations of medications, which one would you want to avoid?
A. Fluoxetine-lithium
B. Fluoxetine-phenelzine
C. Citalopram-valproic acid
,2|Page
D. Citalopram-aripiprazole - ANS ✓✓ B
A 26-year-old man with a history of depression has been taking sertraline 200 mg/day for 12 weeks with no
response. The patient has no other complications. The physician asks for your recommendation. The most
reasonable recommendation would be to:
A. Increase sertraline
B. Add fluoxetine
C. Switch to amitriptyline
D. Change to venlafaxine
E. Decrease sertraline - ANS ✓✓ D
Which of the following is a dangerous combination?
A. MAOI-lorazepam
B. MAOI-acetaminophen
C. MAOI-meperidine
D. MAOI-ziprasidone - ANS ✓✓ C
A 23-year-old married white woman comes to the outpatient psychiatric clinic
complaining of decreased sleep, decreased appetite, decreased concentration, depressed
mood, thoughts of death, and lack of interest in activities for 6 weeks' duration. She has
no history of psychiatric illness and takes no medications except for Ortho-Tri Cyclen Lo
daily. Based upon the patients symptoms, choose the best medication to treat this patient.
A. Nefazodone 100 mg po twice daily
B. Paroxetine 20 mg po daily
C. St. John's wort 300 mg po three times daily
D. Amitriptyline 25 mg at bedtime - ANS ✓✓ B
A 36-year-old man is admitted to the hospital for a severe methicillin-resistant Staphylococcus aureus diabetic
foot infection and is started on linezolid 600 mg IV every 12 hours. His medication profile includes paroxetine
40 mg every morning, trazodone 100 mg at bedtime as needed for sleep, and metformin 1000 mg po twice daily.
After 3
days on these medications, the patient becomes agitated, confused, and diaphoretic and develops myoclonic
jerks. Which of the following is the most likely diagnosis?
,3|Page
A. Overdose of metformin
B. Bacterial meningitis
C. Neuroleptic malignant syndrome
D. Serotonin syndrome - ANS ✓✓ D
A 46-year-old woman presents to the psychiatric outpatient clinic for follow-up treatment of major depression.
She is currently on paroxetine 10 mg at bedtime, which she started taking 2 months ago when admitted to the
psychiatric hospital for suicidal ideation. During the interview, she says that she does not think the medication is
working because she is just as depressed as she was before taking the medication and has recently started
drinking eight to 10 beers daily to alleviate the depression. Before this episode, she was
sober for 4 years. Which of the following treatment strategies would be the appropriate choice for this patient?
A. Stop the paroxetine and start nefazodone 100 mg po twice daily
B. Increase the dose of paroxetine to 20 mg po at bedtime
C. Stop the paroxetine and start duloxetine 20 mg/day
D. Continue the paroxetine at them same dose for a longer period of time to evaluate
whether she will res - ANS ✓✓ B
Which of the following is a flaw in the monoamine hypothesis of depression?
A. Concentrations of neurotransmitters are reduced in the synaptic cleft
B. A switch to a different class of antidepressants does not improve response
C. Antidepressant response is associated with a therapeutic level of the medication
D. Antidepressant effects on neurotransmitters do not temporally correspond to response. - ANS ✓✓ D
A 26-year-old patient with a first episode of depression has been treated with duloxetine 60 mg twice daily for
the past 4 months. The patient would like to discontinue treatment. The patient should be told that they need at
least _____full months of antidepressant
therapy after reaching full remission.
A. 3
B. 6
C. 9
D. 12 - ANS ✓✓ B
, 4|Page
Which of the side effects of trazodone for the treatment of depression is most frequently
observed?
A. Hematuria
B. Delayed orgasm
C. Priapism
D. Orthostasis - ANS ✓✓ D
An antidepressant that may be dangerous in overdose is
A. Mirtazapine
B. Amitriptyline
C. Fluoxetine
D. Escitalopram - ANS ✓✓ B
A 28-year-old man with a history of depression has been taking sertraline 200 mg daily for 12 weeks with no
response. The patient has no other complaints. The physician asks for your recommendation. The most
reasonable recommendation would be to:
A. Increase sertraline
B. Add fluoxetine
C. Switch to amitriptyline
D. Change to venlafaxine - ANS ✓✓ D
AS is an 18-year-old woman hospitalized for the fourth time for major depressive disorder. On this occasion, AS
was admitted for suicidal ideation. Her other symptoms include loss of appetite, insomnia, decreased energy,
increased agitation, and anhedonia for the past 2 months. Although she did well her first semester of college, AS
"partied: a lot and broke up with a new boyfriend. Two months ago, AS refused to go back to college after the
winter holidays. She does not have any other medical problems. AS's mother and grandfather have a history of
bipolar illness, and her father has a history of
substance abuse. AS's symptoms meet the criteria for major depressive disorder based upon the fact that she has:
A. A history of mania
B. A history of substance abuse
C. Felt suicidal and had four target symptoms for more than 10 days
D. Had a loss of pleasure and four target symptoms for more than 2 weeks. - ANS ✓✓ D
NSG 533| NSG533 Advanced
Pharmacology Final Exam (Module 2, 5,
6, 7 ,8) Questions and Answers Graded A+
| Latest 2025
RATED
Which of the following SSRIs requires up to a 5-week washout period because of the
long half-life of its potent active metabolite?
A. Escitalopram
B. Fluvoxamine
C. Fluoxetine
D. Sertraline - ANS ✓✓ C
Which of the following symptoms is most likely to improve within approximately 1 week
of starting treatment?
A. Depressed mood
B. Suicidal thoughts
C. Anhedonia
D. Sleep - ANS ✓✓ D
Of the following combinations of medications, which one would you want to avoid?
A. Fluoxetine-lithium
B. Fluoxetine-phenelzine
C. Citalopram-valproic acid
,2|Page
D. Citalopram-aripiprazole - ANS ✓✓ B
A 26-year-old man with a history of depression has been taking sertraline 200 mg/day for 12 weeks with no
response. The patient has no other complications. The physician asks for your recommendation. The most
reasonable recommendation would be to:
A. Increase sertraline
B. Add fluoxetine
C. Switch to amitriptyline
D. Change to venlafaxine
E. Decrease sertraline - ANS ✓✓ D
Which of the following is a dangerous combination?
A. MAOI-lorazepam
B. MAOI-acetaminophen
C. MAOI-meperidine
D. MAOI-ziprasidone - ANS ✓✓ C
A 23-year-old married white woman comes to the outpatient psychiatric clinic
complaining of decreased sleep, decreased appetite, decreased concentration, depressed
mood, thoughts of death, and lack of interest in activities for 6 weeks' duration. She has
no history of psychiatric illness and takes no medications except for Ortho-Tri Cyclen Lo
daily. Based upon the patients symptoms, choose the best medication to treat this patient.
A. Nefazodone 100 mg po twice daily
B. Paroxetine 20 mg po daily
C. St. John's wort 300 mg po three times daily
D. Amitriptyline 25 mg at bedtime - ANS ✓✓ B
A 36-year-old man is admitted to the hospital for a severe methicillin-resistant Staphylococcus aureus diabetic
foot infection and is started on linezolid 600 mg IV every 12 hours. His medication profile includes paroxetine
40 mg every morning, trazodone 100 mg at bedtime as needed for sleep, and metformin 1000 mg po twice daily.
After 3
days on these medications, the patient becomes agitated, confused, and diaphoretic and develops myoclonic
jerks. Which of the following is the most likely diagnosis?
,3|Page
A. Overdose of metformin
B. Bacterial meningitis
C. Neuroleptic malignant syndrome
D. Serotonin syndrome - ANS ✓✓ D
A 46-year-old woman presents to the psychiatric outpatient clinic for follow-up treatment of major depression.
She is currently on paroxetine 10 mg at bedtime, which she started taking 2 months ago when admitted to the
psychiatric hospital for suicidal ideation. During the interview, she says that she does not think the medication is
working because she is just as depressed as she was before taking the medication and has recently started
drinking eight to 10 beers daily to alleviate the depression. Before this episode, she was
sober for 4 years. Which of the following treatment strategies would be the appropriate choice for this patient?
A. Stop the paroxetine and start nefazodone 100 mg po twice daily
B. Increase the dose of paroxetine to 20 mg po at bedtime
C. Stop the paroxetine and start duloxetine 20 mg/day
D. Continue the paroxetine at them same dose for a longer period of time to evaluate
whether she will res - ANS ✓✓ B
Which of the following is a flaw in the monoamine hypothesis of depression?
A. Concentrations of neurotransmitters are reduced in the synaptic cleft
B. A switch to a different class of antidepressants does not improve response
C. Antidepressant response is associated with a therapeutic level of the medication
D. Antidepressant effects on neurotransmitters do not temporally correspond to response. - ANS ✓✓ D
A 26-year-old patient with a first episode of depression has been treated with duloxetine 60 mg twice daily for
the past 4 months. The patient would like to discontinue treatment. The patient should be told that they need at
least _____full months of antidepressant
therapy after reaching full remission.
A. 3
B. 6
C. 9
D. 12 - ANS ✓✓ B
, 4|Page
Which of the side effects of trazodone for the treatment of depression is most frequently
observed?
A. Hematuria
B. Delayed orgasm
C. Priapism
D. Orthostasis - ANS ✓✓ D
An antidepressant that may be dangerous in overdose is
A. Mirtazapine
B. Amitriptyline
C. Fluoxetine
D. Escitalopram - ANS ✓✓ B
A 28-year-old man with a history of depression has been taking sertraline 200 mg daily for 12 weeks with no
response. The patient has no other complaints. The physician asks for your recommendation. The most
reasonable recommendation would be to:
A. Increase sertraline
B. Add fluoxetine
C. Switch to amitriptyline
D. Change to venlafaxine - ANS ✓✓ D
AS is an 18-year-old woman hospitalized for the fourth time for major depressive disorder. On this occasion, AS
was admitted for suicidal ideation. Her other symptoms include loss of appetite, insomnia, decreased energy,
increased agitation, and anhedonia for the past 2 months. Although she did well her first semester of college, AS
"partied: a lot and broke up with a new boyfriend. Two months ago, AS refused to go back to college after the
winter holidays. She does not have any other medical problems. AS's mother and grandfather have a history of
bipolar illness, and her father has a history of
substance abuse. AS's symptoms meet the criteria for major depressive disorder based upon the fact that she has:
A. A history of mania
B. A history of substance abuse
C. Felt suicidal and had four target symptoms for more than 10 days
D. Had a loss of pleasure and four target symptoms for more than 2 weeks. - ANS ✓✓ D
