NR 546 / NR546 Final Exam – Psychopharmacology for PMHNP:
Complete 2025–2026 Study Guide with Real Exam Questions,
Verified Answers & Expert Rationales
Get fully prepared to ace your NR 546 / NR546 Psychopharmacology for PMHNP Final
Exam with this most comprehensive, up-to-date 2025–2026 exam review.
This expertly designed guide brings together real verified exam questions, accurate answers,
and in-depth rationales that mirror the current NR 546 test blueprint. Developed for
Psychiatric-Mental Health Nurse Practitioner (PMHNP) students, it covers every key topic—
from antidepressants and antipsychotics to neurotransmitter systems, mood stabilizers,
anxiolytics, and clinical psychopharmacology principle
1. Which neurotransmitter is most directly involved in the therapeutic effect of SSRIs?
A. Dopamine
B. Serotonin
C. Norepinephrine
D. Acetylcholine
✅ Answer: B. Serotonin
Explanation: SSRIs block serotonin reuptake transporters, increasing serotonin availability in the
synaptic cleft.
2. Which antidepressant is most likely to cause hypertension at high doses?
A. Bupropion
B. Paroxetine
C. Venlafaxine
D. Sertraline
✅ Answer: C. Venlafaxine
Explanation: Venlafaxine inhibits norepinephrine reuptake at higher doses, increasing BP.
3. A patient on clozapine develops fever, sore throat, and malaise. What is the priority lab?
,A. Serum lithium
B. CBC with differential
C. LFTs
D. Renal panel
✅ Answer: B. CBC with differential
Explanation: Agranulocytosis is a life-threatening side effect of clozapine; WBC and ANC must be
monitored.
4. The therapeutic plasma range for lithium is:
A. 0.2–0.6 mEq/L
B. 0.6–1.2 mEq/L
C. 1.5–2.0 mEq/L
D. 2.0–3.0 mEq/L
✅ Answer: B. 0.6–1.2 mEq/L
Explanation: Levels >1.5 mEq/L risk toxicity (tremor, confusion, seizures).
5. Which benzodiazepine has the shortest half-life?
A. Lorazepam
B. Alprazolam
C. Diazepam
D. Clonazepam
✅ Answer: B. Alprazolam
Explanation: Alprazolam’s short half-life contributes to rebound anxiety between doses.
6. Which medication can cause Stevens–Johnson syndrome?
A. Lamotrigine
B. Lithium
C. Valproate
D. Gabapentin
✅ Answer: A. Lamotrigine
Explanation: Rapid titration increases SJS risk; start low and titrate slowly.
7. Which antidepressant is contraindicated in patients with a seizure disorder?
A. Fluoxetine
B. Bupropion
C. Mirtazapine
D. Duloxetine
, ✅ Answer: B. Bupropion
Explanation: Bupropion lowers the seizure threshold.
8. The mechanism of action of buspirone involves partial agonism at which receptor?
A. 5-HT₁A
B. D₂
C. GABA-A
D. NMDA
✅ Answer: A. 5-HT₁A
Explanation: Buspirone is a serotonin 1A partial agonist used for generalized anxiety.
9. Which SSRI has the longest half-life?
A. Sertraline
B. Citalopram
C. Paroxetine
D. Fluoxetine
✅ Answer: D. Fluoxetine
Explanation: Fluoxetine’s long half-life (and active metabolite norfluoxetine) allows weekly dosing in
some cases.
10. Which of the following antipsychotics has the highest risk for metabolic syndrome?
A. Risperidone
B. Haloperidol
C. Aripiprazole
D. Olanzapine
✅ Answer: D. Olanzapine
Explanation: Olanzapine and clozapine are most strongly linked to weight gain and insulin resistance.
11. Which of the following drugs is an NMDA receptor antagonist used for dementia?
A. Donepezil
B. Rivastigmine
C. Memantine
D. Galantamine
✅ Answer: C. Memantine
Explanation: Memantine blocks NMDA glutamate receptors to prevent excitotoxicity in Alzheimer’s
disease.
Complete 2025–2026 Study Guide with Real Exam Questions,
Verified Answers & Expert Rationales
Get fully prepared to ace your NR 546 / NR546 Psychopharmacology for PMHNP Final
Exam with this most comprehensive, up-to-date 2025–2026 exam review.
This expertly designed guide brings together real verified exam questions, accurate answers,
and in-depth rationales that mirror the current NR 546 test blueprint. Developed for
Psychiatric-Mental Health Nurse Practitioner (PMHNP) students, it covers every key topic—
from antidepressants and antipsychotics to neurotransmitter systems, mood stabilizers,
anxiolytics, and clinical psychopharmacology principle
1. Which neurotransmitter is most directly involved in the therapeutic effect of SSRIs?
A. Dopamine
B. Serotonin
C. Norepinephrine
D. Acetylcholine
✅ Answer: B. Serotonin
Explanation: SSRIs block serotonin reuptake transporters, increasing serotonin availability in the
synaptic cleft.
2. Which antidepressant is most likely to cause hypertension at high doses?
A. Bupropion
B. Paroxetine
C. Venlafaxine
D. Sertraline
✅ Answer: C. Venlafaxine
Explanation: Venlafaxine inhibits norepinephrine reuptake at higher doses, increasing BP.
3. A patient on clozapine develops fever, sore throat, and malaise. What is the priority lab?
,A. Serum lithium
B. CBC with differential
C. LFTs
D. Renal panel
✅ Answer: B. CBC with differential
Explanation: Agranulocytosis is a life-threatening side effect of clozapine; WBC and ANC must be
monitored.
4. The therapeutic plasma range for lithium is:
A. 0.2–0.6 mEq/L
B. 0.6–1.2 mEq/L
C. 1.5–2.0 mEq/L
D. 2.0–3.0 mEq/L
✅ Answer: B. 0.6–1.2 mEq/L
Explanation: Levels >1.5 mEq/L risk toxicity (tremor, confusion, seizures).
5. Which benzodiazepine has the shortest half-life?
A. Lorazepam
B. Alprazolam
C. Diazepam
D. Clonazepam
✅ Answer: B. Alprazolam
Explanation: Alprazolam’s short half-life contributes to rebound anxiety between doses.
6. Which medication can cause Stevens–Johnson syndrome?
A. Lamotrigine
B. Lithium
C. Valproate
D. Gabapentin
✅ Answer: A. Lamotrigine
Explanation: Rapid titration increases SJS risk; start low and titrate slowly.
7. Which antidepressant is contraindicated in patients with a seizure disorder?
A. Fluoxetine
B. Bupropion
C. Mirtazapine
D. Duloxetine
, ✅ Answer: B. Bupropion
Explanation: Bupropion lowers the seizure threshold.
8. The mechanism of action of buspirone involves partial agonism at which receptor?
A. 5-HT₁A
B. D₂
C. GABA-A
D. NMDA
✅ Answer: A. 5-HT₁A
Explanation: Buspirone is a serotonin 1A partial agonist used for generalized anxiety.
9. Which SSRI has the longest half-life?
A. Sertraline
B. Citalopram
C. Paroxetine
D. Fluoxetine
✅ Answer: D. Fluoxetine
Explanation: Fluoxetine’s long half-life (and active metabolite norfluoxetine) allows weekly dosing in
some cases.
10. Which of the following antipsychotics has the highest risk for metabolic syndrome?
A. Risperidone
B. Haloperidol
C. Aripiprazole
D. Olanzapine
✅ Answer: D. Olanzapine
Explanation: Olanzapine and clozapine are most strongly linked to weight gain and insulin resistance.
11. Which of the following drugs is an NMDA receptor antagonist used for dementia?
A. Donepezil
B. Rivastigmine
C. Memantine
D. Galantamine
✅ Answer: C. Memantine
Explanation: Memantine blocks NMDA glutamate receptors to prevent excitotoxicity in Alzheimer’s
disease.
