NURS 751 FINAL EXAM QUESTIONS WITH
COMPLETE SOLUTIONS
2 Major risks of Monoamine Oxidase Inhibitors (MAOIs)
Correct Answers Hypertensive crisis with tyramine-containing
foods ("cheese effect")
Serotonin syndrome if combined with serotonergic agents —
requires 2-week (or
longer) washout when switching
Best pharmacological treatment for Aggression / Explosive
Anger in PTSD Correct Answers • Clozapine or low-dose
antipsychotics (in rare cases with comorbid psychosis)
• Valproate - mood stabilizer with anti-aggression properties
• Propranolol - blunts autonomic arousal
• Clonidine - if persistent autonomic overactivation
Best pharmacological treatment for Dissociation / Detachment /
Emotional Numbing in PTSD Correct Answers Sertraline or
Paroxetine - may reduce emotional numbing
• Oxytocin (nasal spray) - experimental, enhances prosocial
connection
• MDMA-assisted therapy - enhances fear extinction and social
engagement
,Best pharmacological treatment for dysphoria/anhedonia in
PTSD Correct Answers • SSRIs/SNRIs - core treatment
• Bupropion - adjunct if fatigue and anhedonia dominate
• N-acetylcysteine (NAC) - experimental adjunct for affective
instability
Best pharmacological treatment for
hyperarousal/irritability/anxiety in PTSD Correct Answers
SSRIs (Sertraline)-first-line
Clonidine- alpha-2 agonist for acute hyperarousal
• Guanfacine - if sedation is a concern (selective alpha-2A)
• Propranolol - adjunct for somatic anxiety or early memory
modulation (within 24 hrs of trauma)
Best pharmacological treatment for Intrusion symptoms
(flashbacks, nightmares) in PTSD Correct Answers • Prazosin
- if nightmares dominate (especially in veterans)
• SSRIs (Sertraline, Paroxetine) - first-line for broad symptom
coverage
• Trazodone - if insomnia coexists and SSRIs insufficient
• Consider MDMA-assisted psychotherapy (if treatment-
resistant and available)
Best Treatment for rapid cycling Correct Answers o Valproate
o Lamotrigine
o Lithium (less effective than valproate in rapid cycling)
, Black box warning for SSRIs Correct Answers Increased
suicidality in children and young adults.
Cannabidiol for PTSD Correct Answers Used as an adjunct;
experimental
Modulates CB1/CB2, 5HT1A and TRPV1
Reduces fear memory reconsolidation
Mild sedation, rare interactions
Clinical Presentation of Bipolar Depression Correct Answers
Similar to unipolar depression, but often with:
§ Hypersomnia
§ Psychomotor retardation
§ Mood lability
§ Atypical features (e.g., mood reactivity)
Clinical relevance of Acetylcholine (ACh) imbalance Correct
Answers Imbalance implicated in delirium, insomnia, and
cognitive dysfunction
Clinical Significance of Resilience Correct Answers Lowers
risk of:
Depression
Anxiety
PTSD
o Moderates response to treatment
COMPLETE SOLUTIONS
2 Major risks of Monoamine Oxidase Inhibitors (MAOIs)
Correct Answers Hypertensive crisis with tyramine-containing
foods ("cheese effect")
Serotonin syndrome if combined with serotonergic agents —
requires 2-week (or
longer) washout when switching
Best pharmacological treatment for Aggression / Explosive
Anger in PTSD Correct Answers • Clozapine or low-dose
antipsychotics (in rare cases with comorbid psychosis)
• Valproate - mood stabilizer with anti-aggression properties
• Propranolol - blunts autonomic arousal
• Clonidine - if persistent autonomic overactivation
Best pharmacological treatment for Dissociation / Detachment /
Emotional Numbing in PTSD Correct Answers Sertraline or
Paroxetine - may reduce emotional numbing
• Oxytocin (nasal spray) - experimental, enhances prosocial
connection
• MDMA-assisted therapy - enhances fear extinction and social
engagement
,Best pharmacological treatment for dysphoria/anhedonia in
PTSD Correct Answers • SSRIs/SNRIs - core treatment
• Bupropion - adjunct if fatigue and anhedonia dominate
• N-acetylcysteine (NAC) - experimental adjunct for affective
instability
Best pharmacological treatment for
hyperarousal/irritability/anxiety in PTSD Correct Answers
SSRIs (Sertraline)-first-line
Clonidine- alpha-2 agonist for acute hyperarousal
• Guanfacine - if sedation is a concern (selective alpha-2A)
• Propranolol - adjunct for somatic anxiety or early memory
modulation (within 24 hrs of trauma)
Best pharmacological treatment for Intrusion symptoms
(flashbacks, nightmares) in PTSD Correct Answers • Prazosin
- if nightmares dominate (especially in veterans)
• SSRIs (Sertraline, Paroxetine) - first-line for broad symptom
coverage
• Trazodone - if insomnia coexists and SSRIs insufficient
• Consider MDMA-assisted psychotherapy (if treatment-
resistant and available)
Best Treatment for rapid cycling Correct Answers o Valproate
o Lamotrigine
o Lithium (less effective than valproate in rapid cycling)
, Black box warning for SSRIs Correct Answers Increased
suicidality in children and young adults.
Cannabidiol for PTSD Correct Answers Used as an adjunct;
experimental
Modulates CB1/CB2, 5HT1A and TRPV1
Reduces fear memory reconsolidation
Mild sedation, rare interactions
Clinical Presentation of Bipolar Depression Correct Answers
Similar to unipolar depression, but often with:
§ Hypersomnia
§ Psychomotor retardation
§ Mood lability
§ Atypical features (e.g., mood reactivity)
Clinical relevance of Acetylcholine (ACh) imbalance Correct
Answers Imbalance implicated in delirium, insomnia, and
cognitive dysfunction
Clinical Significance of Resilience Correct Answers Lowers
risk of:
Depression
Anxiety
PTSD
o Moderates response to treatment
