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NSG 552 PSYCHOPHARMACOLOGYEXAM 2 — 2026/2027
COMPLETE (150) CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED RATIONALES.
PSYCHOPHARMACOLOGY
Prepare effectively for the NSG 552 Psychopharmacology Exam 2 with this focused
study resource. It supports review of psychiatric medications, pharmacodynamics,
pharmacokinetics, therapeutic effects, adverse reactions, drug interactions, and
medication management principles. Use the material to reinforce your
psychopharmacology knowledge, review high-yield topics, and identify areas that may
require additional study. This resource is suited for nursing students, psychiatric-
mental health nursing learners, and candidates preparing for the NSG 552 Exam 2.
MULTIPLE CHOICE.
SECTION 1: ANTIDEPRESSANTS — SSRIs, SNRIs, & TCAs (Questions 1–25)
1. A patient with major depressive disorder is started on fluoxetine. Which
mechanism of action best describes how this medication increases
synaptic serotonin?
A. Direct stimulation of post-synaptic serotonin receptors
B. Inhibition of monoamine oxidase
C. Blockade of the serotonin transporter (SERT), inhibiting serotonin
reuptake
D. Stimulation of serotonin release from presynaptic neurons
Answer: C. Blockade of the serotonin transporter (SERT), inhibiting
serotonin reuptake
Rationale: SSRIs (fluoxetine, sertraline, escitalopram, paroxetine) block
the serotonin transporter, preventing the reuptake of serotonin into the
presynaptic neuron and increasing serotonin availability in the synaptic
cleft. This is the primary mechanism of action for all SSRIs. MAOIs inhibit
monoamine oxidase (B). TCAs block both serotonin and norepinephrine
reuptake.
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2. A patient prescribed sertraline reports sexual dysfunction, including
decreased libido and anorgasmia. The PMHNP's MOST appropriate
response is:
A. "This side effect is rare and will likely resolve on its own."
B. "Sexual dysfunction is a common side effect of SSRIs. We can discuss
switching to another medication like bupropion."
C. "You should stop the medication immediately."
D. "This means the medication is not working for you."
Answer: B. "Sexual dysfunction is a common side effect of SSRIs. We can
discuss switching to another medication like bupropion."
Rationale: Sexual dysfunction (decreased libido, erectile dysfunction,
anorgasmia) is a common side effect of SSRIs, occurring in 30–70% of
patients. Bupropion, mirtazapine, or vortioxetine have lower rates of
sexual dysfunction. Patients should not stop SSRIs abruptly due to
discontinuation syndrome.
3. A patient is being switched from paroxetine to fluoxetine. Which of the
following is the MOST important consideration?
A. Fluoxetine has a shorter half-life than paroxetine
B. Fluoxetine has a long half-life; a washout period may not be necessary,
but cross-tapering requires caution
C. No washout period is needed for any SSRI switch
D. Paroxetine is less likely to cause withdrawal symptoms
Answer: B. Fluoxetine has a long half-life; a washout period may not be
necessary, but cross-tapering requires caution
Rationale: Fluoxetine has a long half-life (approximately 4–6 days for the
parent drug and 7–15 days for its active metabolite, norfluoxetine). This
allows for a more rapid switch without a washout period, but caution is
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needed due to potential drug interactions and serotonin syndrome risk.
Paroxetine has a short half-life and can cause significant withdrawal
symptoms if discontinued abruptly.
4. A patient with major depressive disorder and chronic pain is started on
duloxetine. Which statement BEST describes the mechanism of action of
this medication?
A. Serotonin and norepinephrine reuptake inhibition (SNRI)
B. Selective serotonin reuptake inhibition only
C. Dopamine and norepinephrine reuptake inhibition
D. Serotonin receptor antagonism
Answer: A. Serotonin and norepinephrine reuptake inhibition (SNRI)
Rationale: Duloxetine is a serotonin-norepinephrine reuptake inhibitor
(SNRI) that blocks both serotonin and norepinephrine transporters. This
dual action makes it effective for both major depressive disorder and
neuropathic pain conditions such as diabetic peripheral neuropathy and
fibromyalgia. Venlafaxine and desvenlafaxine are also SNRIs.
5. A patient with depression and insomnia is started on mirtazapine.
Which side effect is MOST likely to be beneficial for this patient?
A. Weight loss
B. Sedation
C. Insomnia
D. Sexual dysfunction
Answer: B. Sedation
Rationale: Mirtazapine is a noradrenergic and specific serotonergic
antidepressant (NaSSA) with potent histamine H1 receptor antagonism,
causing significant sedation. This makes it particularly useful for patients
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with depression and insomnia. It also has a low risk of sexual dysfunction
and can cause weight gain.
6. A patient with treatment-resistant depression has been on an SSRI with
partial response. The PMHNP is considering augmentation with a second-
generation antipsychotic. Which of the following has FDA approval for
augmentation in major depressive disorder?
A. Haloperidol
B. Aripiprazole
C. Clozapine
D. Ziprasidone
Answer: B. Aripiprazole
Rationale: Aripiprazole, quetiapine, and olanzapine (in combination with
fluoxetine) have FDA approval for augmentation of antidepressants in
treatment-resistant depression. Aripiprazole is a partial dopamine D2
agonist and 5-HT1A partial agonist. Clozapine is used for treatment-
resistant schizophrenia; haloperidol and ziprasidone are not FDA-
approved for this indication.
7. A patient is prescribed venlafaxine XR for major depressive disorder.
Which of the following is an important consideration regarding its dosing?
A. Venlafaxine is only effective at low doses
B. At higher doses (>150 mg/day), venlafaxine also inhibits norepinephrine
reuptake
C. Venlafaxine should be taken only at bedtime
D. Venlafaxine has no withdrawal syndrome
Answer: B. At higher doses (>150 mg/day), venlafaxine also inhibits
norepinephrine reuptake
Rationale: Venlafaxine is a serotonin-norepinephrine reuptake inhibitor
NSG 552 PSYCHOPHARMACOLOGYEXAM 2 — 2026/2027
COMPLETE (150) CURRENT TESTING QUESTIONS AND
CORRECT ANSWERS WITH DETAILED RATIONALES.
PSYCHOPHARMACOLOGY
Prepare effectively for the NSG 552 Psychopharmacology Exam 2 with this focused
study resource. It supports review of psychiatric medications, pharmacodynamics,
pharmacokinetics, therapeutic effects, adverse reactions, drug interactions, and
medication management principles. Use the material to reinforce your
psychopharmacology knowledge, review high-yield topics, and identify areas that may
require additional study. This resource is suited for nursing students, psychiatric-
mental health nursing learners, and candidates preparing for the NSG 552 Exam 2.
MULTIPLE CHOICE.
SECTION 1: ANTIDEPRESSANTS — SSRIs, SNRIs, & TCAs (Questions 1–25)
1. A patient with major depressive disorder is started on fluoxetine. Which
mechanism of action best describes how this medication increases
synaptic serotonin?
A. Direct stimulation of post-synaptic serotonin receptors
B. Inhibition of monoamine oxidase
C. Blockade of the serotonin transporter (SERT), inhibiting serotonin
reuptake
D. Stimulation of serotonin release from presynaptic neurons
Answer: C. Blockade of the serotonin transporter (SERT), inhibiting
serotonin reuptake
Rationale: SSRIs (fluoxetine, sertraline, escitalopram, paroxetine) block
the serotonin transporter, preventing the reuptake of serotonin into the
presynaptic neuron and increasing serotonin availability in the synaptic
cleft. This is the primary mechanism of action for all SSRIs. MAOIs inhibit
monoamine oxidase (B). TCAs block both serotonin and norepinephrine
reuptake.
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2. A patient prescribed sertraline reports sexual dysfunction, including
decreased libido and anorgasmia. The PMHNP's MOST appropriate
response is:
A. "This side effect is rare and will likely resolve on its own."
B. "Sexual dysfunction is a common side effect of SSRIs. We can discuss
switching to another medication like bupropion."
C. "You should stop the medication immediately."
D. "This means the medication is not working for you."
Answer: B. "Sexual dysfunction is a common side effect of SSRIs. We can
discuss switching to another medication like bupropion."
Rationale: Sexual dysfunction (decreased libido, erectile dysfunction,
anorgasmia) is a common side effect of SSRIs, occurring in 30–70% of
patients. Bupropion, mirtazapine, or vortioxetine have lower rates of
sexual dysfunction. Patients should not stop SSRIs abruptly due to
discontinuation syndrome.
3. A patient is being switched from paroxetine to fluoxetine. Which of the
following is the MOST important consideration?
A. Fluoxetine has a shorter half-life than paroxetine
B. Fluoxetine has a long half-life; a washout period may not be necessary,
but cross-tapering requires caution
C. No washout period is needed for any SSRI switch
D. Paroxetine is less likely to cause withdrawal symptoms
Answer: B. Fluoxetine has a long half-life; a washout period may not be
necessary, but cross-tapering requires caution
Rationale: Fluoxetine has a long half-life (approximately 4–6 days for the
parent drug and 7–15 days for its active metabolite, norfluoxetine). This
allows for a more rapid switch without a washout period, but caution is
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needed due to potential drug interactions and serotonin syndrome risk.
Paroxetine has a short half-life and can cause significant withdrawal
symptoms if discontinued abruptly.
4. A patient with major depressive disorder and chronic pain is started on
duloxetine. Which statement BEST describes the mechanism of action of
this medication?
A. Serotonin and norepinephrine reuptake inhibition (SNRI)
B. Selective serotonin reuptake inhibition only
C. Dopamine and norepinephrine reuptake inhibition
D. Serotonin receptor antagonism
Answer: A. Serotonin and norepinephrine reuptake inhibition (SNRI)
Rationale: Duloxetine is a serotonin-norepinephrine reuptake inhibitor
(SNRI) that blocks both serotonin and norepinephrine transporters. This
dual action makes it effective for both major depressive disorder and
neuropathic pain conditions such as diabetic peripheral neuropathy and
fibromyalgia. Venlafaxine and desvenlafaxine are also SNRIs.
5. A patient with depression and insomnia is started on mirtazapine.
Which side effect is MOST likely to be beneficial for this patient?
A. Weight loss
B. Sedation
C. Insomnia
D. Sexual dysfunction
Answer: B. Sedation
Rationale: Mirtazapine is a noradrenergic and specific serotonergic
antidepressant (NaSSA) with potent histamine H1 receptor antagonism,
causing significant sedation. This makes it particularly useful for patients
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with depression and insomnia. It also has a low risk of sexual dysfunction
and can cause weight gain.
6. A patient with treatment-resistant depression has been on an SSRI with
partial response. The PMHNP is considering augmentation with a second-
generation antipsychotic. Which of the following has FDA approval for
augmentation in major depressive disorder?
A. Haloperidol
B. Aripiprazole
C. Clozapine
D. Ziprasidone
Answer: B. Aripiprazole
Rationale: Aripiprazole, quetiapine, and olanzapine (in combination with
fluoxetine) have FDA approval for augmentation of antidepressants in
treatment-resistant depression. Aripiprazole is a partial dopamine D2
agonist and 5-HT1A partial agonist. Clozapine is used for treatment-
resistant schizophrenia; haloperidol and ziprasidone are not FDA-
approved for this indication.
7. A patient is prescribed venlafaxine XR for major depressive disorder.
Which of the following is an important consideration regarding its dosing?
A. Venlafaxine is only effective at low doses
B. At higher doses (>150 mg/day), venlafaxine also inhibits norepinephrine
reuptake
C. Venlafaxine should be taken only at bedtime
D. Venlafaxine has no withdrawal syndrome
Answer: B. At higher doses (>150 mg/day), venlafaxine also inhibits
norepinephrine reuptake
Rationale: Venlafaxine is a serotonin-norepinephrine reuptake inhibitor
