NR 546 / NR546 Final Exam Psychopharmacology for PMHNP: Most
Comprehensive Qs & Ans - to Pass the Exam, 100% Verified (Latest
)
1. Which neurotransmitter is most directly involved in the therapeutic effect of SSRIs?
ANS Serotonin
EXPLANATION SSRIs selectively block the reuptake of serotonin at the presynaptic neuron, increasing its
availability in the synaptic cleft and improving mood and anxiety symptoms.
2. Which antidepressant is most likely to cause hypertension at high doses?
ANS Venlafaxine
EXPLANATION Venlafaxine, an SNRI, increases both serotonin and norepinephrine. At higher doses,
norepinephrine reuptake inhibition can elevate blood pressure.
3. A patient on clozapine develops fever, sore throat, and malaise. What is the priority lab?
ANS Complete blood count (CBC) with absolute neutrophil count (ANC)
EXPLANATION Clozapine may cause agranulocytosis; prompt ANC evaluation is essential when infection-
like symptoms appear.
4. The therapeutic plasma range for lithium is:
ANS 0.6–1.2 mEq/L
EXPLANATION Levels above 1.5 mEq/L may cause toxicity; levels below 0.6 mEq/L are often
subtherapeutic.
5. Which benzodiazepine has the shortest half-life?
ANS Alprazolam
EXPLANATION Alprazolam’s short half-life (≈ 6–12 hours) contributes to rapid relief but increases
withdrawal risk.
6. Which medication can cause Stevens–Johnson syndrome?
, ANS Lamotrigine
EXPLANATION A rapid titration of lamotrigine can cause severe rash and Stevens–Johnson syndrome;
dose must be increased slowly.
7. Which antidepressant is contraindicated in patients with a seizure disorder?
ANS Bupropion
EXPLANATION Bupropion lowers the seizure threshold, particularly in eating disorders or seizure
history.
8. The mechanism of action of buspirone involves partial agonism at which receptor?
ANS 5-HT₁A receptor
EXPLANATION Buspirone is a serotonin 5-HT₁A partial agonist that reduces anxiety without sedation or
dependence.
9. Which SSRI has the longest half-life?
ANS Fluoxetine
EXPLANATION Fluoxetine’s long half-life (1–4 days; metabolite up to 16 days) means fewer withdrawal
symptoms.
10. Which antipsychotic has the highest risk for metabolic syndrome?
ANS Olanzapine
EXPLANATION Olanzapine strongly blocks histamine and serotonin receptors, causing weight gain,
dyslipidemia, and insulin resistance.
11. Which drug is an NMDA receptor antagonist used for dementia?
ANS Memantine
EXPLANATION Memantine blocks NMDA glutamate receptors, reducing excitotoxicity in moderate–
severe Alzheimer’s disease.
12. Which antidepressant is safest in cardiac disease?
ANS Sertraline
EXPLANATION Sertraline has minimal cardiac conduction effects and few drug–drug interactions.
Comprehensive Qs & Ans - to Pass the Exam, 100% Verified (Latest
)
1. Which neurotransmitter is most directly involved in the therapeutic effect of SSRIs?
ANS Serotonin
EXPLANATION SSRIs selectively block the reuptake of serotonin at the presynaptic neuron, increasing its
availability in the synaptic cleft and improving mood and anxiety symptoms.
2. Which antidepressant is most likely to cause hypertension at high doses?
ANS Venlafaxine
EXPLANATION Venlafaxine, an SNRI, increases both serotonin and norepinephrine. At higher doses,
norepinephrine reuptake inhibition can elevate blood pressure.
3. A patient on clozapine develops fever, sore throat, and malaise. What is the priority lab?
ANS Complete blood count (CBC) with absolute neutrophil count (ANC)
EXPLANATION Clozapine may cause agranulocytosis; prompt ANC evaluation is essential when infection-
like symptoms appear.
4. The therapeutic plasma range for lithium is:
ANS 0.6–1.2 mEq/L
EXPLANATION Levels above 1.5 mEq/L may cause toxicity; levels below 0.6 mEq/L are often
subtherapeutic.
5. Which benzodiazepine has the shortest half-life?
ANS Alprazolam
EXPLANATION Alprazolam’s short half-life (≈ 6–12 hours) contributes to rapid relief but increases
withdrawal risk.
6. Which medication can cause Stevens–Johnson syndrome?
, ANS Lamotrigine
EXPLANATION A rapid titration of lamotrigine can cause severe rash and Stevens–Johnson syndrome;
dose must be increased slowly.
7. Which antidepressant is contraindicated in patients with a seizure disorder?
ANS Bupropion
EXPLANATION Bupropion lowers the seizure threshold, particularly in eating disorders or seizure
history.
8. The mechanism of action of buspirone involves partial agonism at which receptor?
ANS 5-HT₁A receptor
EXPLANATION Buspirone is a serotonin 5-HT₁A partial agonist that reduces anxiety without sedation or
dependence.
9. Which SSRI has the longest half-life?
ANS Fluoxetine
EXPLANATION Fluoxetine’s long half-life (1–4 days; metabolite up to 16 days) means fewer withdrawal
symptoms.
10. Which antipsychotic has the highest risk for metabolic syndrome?
ANS Olanzapine
EXPLANATION Olanzapine strongly blocks histamine and serotonin receptors, causing weight gain,
dyslipidemia, and insulin resistance.
11. Which drug is an NMDA receptor antagonist used for dementia?
ANS Memantine
EXPLANATION Memantine blocks NMDA glutamate receptors, reducing excitotoxicity in moderate–
severe Alzheimer’s disease.
12. Which antidepressant is safest in cardiac disease?
ANS Sertraline
EXPLANATION Sertraline has minimal cardiac conduction effects and few drug–drug interactions.
