NR546 PSYCHOPHARMACOLOGY FOR
PMHNP PRACTICE EXAM QUESTIONS
AND ANSWERS
1. Which neurotransmitter is primarily synthesized from the amino acid glutamine in the
presynaptic terminal?
A. GABA
B. Glutamate
C. Dopamine
D. Serotonin
Answer: B
Conceptual Explanation: Glutamate is synthesized from glutamine by the enzyme
glutaminase. While GABA is synthesized from glutamate, the direct precursor for glutamate
in the cycle is glutamine.
2. Blockade of dopamine in the Nigrostriatal pathway is most likely to result in which of the
following side effects?
A. Hyperprolactinemia
,B. Reduction of positive symptoms
C. Worsening of negative symptoms
D. Extrapyramidal symptoms (EPS)
Answer: D
Conceptual Explanation: The Nigrostriatal pathway controls motor function.
Antipsychotics that block D2 receptors in this pathway can lead to EPS and tardive
dyskinesia.
3. A patient who smokes 1 pack of cigarettes a day is prescribed Clozapine. If the patient
suddenly stops smoking, what is the most likely pharmacological outcome?
A. Clozapine levels will decrease significantly.
B. No change in Clozapine levels is expected.
C. Nicotine will inhibit the absorption of Clozapine.
D. Clozapine levels will increase, raising toxicity risk.
Answer: D
Conceptual Explanation: Cigarette smoke (hydrocarbons) induces the CYP1A2 enzyme.
When a patient stops smoking, the induction ceases, leading to higher serum levels of drugs
metabolized by 1A2, such as Clozapine.
, 4. Which mechanism of action is responsible for the unique properties of Atypical
Antipsychotics compared to Typical Antipsychotics?
A. Serotonin-Dopamine Antagonism (5HT2A blockade)
B. Pure D2 receptor antagonism
C. GABAergic modulation
D. NMDA receptor activation
Answer: A
Conceptual Explanation: Atypical antipsychotics (SDAs) are defined by their ability to
block both D2 receptors and 5HT2A receptors, which helps mitigate EPS and treat negative
symptoms.
5. A patient with a history of Bipolar Disorder and Bulimia Nervosa requires an
antidepressant. Which medication is strictly contraindicated in this patient?
A. Fluoxetine
B. Venlafaxine
C. Bupropion
D. Sertraline
Answer: C
Conceptual Explanation: Bupropion is contraindicated in patients with seizure disorders
and eating disorders (Bulimia or Anorexia) due to a significantly increased risk of seizures.
PMHNP PRACTICE EXAM QUESTIONS
AND ANSWERS
1. Which neurotransmitter is primarily synthesized from the amino acid glutamine in the
presynaptic terminal?
A. GABA
B. Glutamate
C. Dopamine
D. Serotonin
Answer: B
Conceptual Explanation: Glutamate is synthesized from glutamine by the enzyme
glutaminase. While GABA is synthesized from glutamate, the direct precursor for glutamate
in the cycle is glutamine.
2. Blockade of dopamine in the Nigrostriatal pathway is most likely to result in which of the
following side effects?
A. Hyperprolactinemia
,B. Reduction of positive symptoms
C. Worsening of negative symptoms
D. Extrapyramidal symptoms (EPS)
Answer: D
Conceptual Explanation: The Nigrostriatal pathway controls motor function.
Antipsychotics that block D2 receptors in this pathway can lead to EPS and tardive
dyskinesia.
3. A patient who smokes 1 pack of cigarettes a day is prescribed Clozapine. If the patient
suddenly stops smoking, what is the most likely pharmacological outcome?
A. Clozapine levels will decrease significantly.
B. No change in Clozapine levels is expected.
C. Nicotine will inhibit the absorption of Clozapine.
D. Clozapine levels will increase, raising toxicity risk.
Answer: D
Conceptual Explanation: Cigarette smoke (hydrocarbons) induces the CYP1A2 enzyme.
When a patient stops smoking, the induction ceases, leading to higher serum levels of drugs
metabolized by 1A2, such as Clozapine.
, 4. Which mechanism of action is responsible for the unique properties of Atypical
Antipsychotics compared to Typical Antipsychotics?
A. Serotonin-Dopamine Antagonism (5HT2A blockade)
B. Pure D2 receptor antagonism
C. GABAergic modulation
D. NMDA receptor activation
Answer: A
Conceptual Explanation: Atypical antipsychotics (SDAs) are defined by their ability to
block both D2 receptors and 5HT2A receptors, which helps mitigate EPS and treat negative
symptoms.
5. A patient with a history of Bipolar Disorder and Bulimia Nervosa requires an
antidepressant. Which medication is strictly contraindicated in this patient?
A. Fluoxetine
B. Venlafaxine
C. Bupropion
D. Sertraline
Answer: C
Conceptual Explanation: Bupropion is contraindicated in patients with seizure disorders
and eating disorders (Bulimia or Anorexia) due to a significantly increased risk of seizures.
