NR 546 / NR546 Final Exam: Psychopharmacology for
PMHNP – 100% Verified Questions & ANSs (Latest
2025–2026 Edition)
Most Comprehensive Review Guide to Pass on the First
Attempt
Intro
Ace your NR 546 Final Exam with confidence!
This comprehensive Psychopharmacology for PMHNP Study Guide is expertly curated for
nursing students and psychiatric-mental health nurse practitioner candidates preparing for the NR
546 / NR546 Final Exam.
Covering the latest 2025–2026 curriculum, this all-in-one guide includes real, verified exam
questions, detailed rationales, and essential pharmacology concepts tested on the NR 546
final. Whether you're reviewing antidepressants, antipsychotics, mood stabilizers, anxiolytics, or
neurobiological mechanisms—this resource delivers everything you need to master
psychopharmacology and pass with excellence.
1. MAOIs (monoamine oxidase inhibitors) affect which neurotransmitters?
ANS: A. Serotonin, Dopamine, Norepinephrine
EXPLANATION
MAOIs inhibit the enzyme monoamine oxidase, which breaks down serotonin, dopamine, and
norepinephrine. By preventing their breakdown, MAOIs increase the levels of these
neurotransmitters in the brain, improving mood and reducing depression symptoms.
2. Which of the following is considered first-line treatment for depression?
ANS: A. SSRI
EXPLANATION
,Selective Serotonin Reuptake Inhibitors (SSRIs) are first-line because they are effective,
welltolerated, and have a safer side effect profile compared to older antidepressants like MAOIs
or TCAs.
3. When treating a patient for major depressive disorder, which medication
would the PMHNP consider first?
ANS: C. Escitalopram
EXPLANATION
Escitalopram (Lexapro) is a well-tolerated SSRI with few drug interactions and minimal side
effects, making it an excellent first choice for MDD.
4. Which medication should be considered for a patient diagnosed with major
depressive disorder who reports “always forgetting to take my pills”?
ANS: C. Fluoxetine
EXPLANATION
Fluoxetine (Prozac) has a long half-life (up to several days), providing a “forgiveness factor” if
doses are missed. This makes it suitable for patients who are nonadherent with daily dosing.
5. Which medication has a black box warning of a life-threatening skin rash?
ANS: B. Lamotrigine
EXPLANATION
Lamotrigine (Lamictal) can cause Stevens-Johnson Syndrome, a potentially fatal rash. Titration
must be slow to reduce this risk.
6. Which medication is considered the best tolerated SSRI?
ANS: D. Escitalopram
EXPLANATION
Escitalopram causes fewer side effects and drug interactions than many other SSRIs. It is often
preferred for patients who are sensitive to adverse effects.
, 7. During a 4-week follow-up appointment, Rashida (on Sertraline 25 mg qAM)
reports slight improvement and tolerating medication well. What should the
PMHNP do?
ANS: A. Increase Sertraline dose
EXPLANATION
Sertraline (Zoloft) often starts at a low dose and is titrated up. If tolerated and showing minimal
improvement, dose increase is appropriate after 4 weeks.
8. Which medication should be avoided for a 66-year-old patient with
depression, anxiety, and a history of falls?
ANS: C. Paroxetine
EXPLANATION
Paroxetine (Paxil) has strong anticholinergic and sedative effects that can cause confusion,
orthostatic hypotension, and increase fall risk in older adults.
9. A patient reports upset stomach and diarrhea 3 days after starting Sertraline.
What should the PMHNP say?
ANS: B. “Most side effects subside after 4–5 days. Your body is getting adjusted to the
increased serotonin levels.” EXPLANATION
GI upset is a common early SSRI side effect due to increased serotonin in the gut. It typically
improves within a week as the body adjusts.
10. During a 2-week follow-up, the patient reports no improvement with
Escitalopram. What is the correct statement by the PMHNP?
ANS: B. “It can take up to 6 weeks before you notice improvements of depressive
symptoms.” EXPLANATION
Antidepressants take 4–6 weeks for full therapeutic effect. Early discontinuation is avoided
unless side effects are intolerable.
11. Duloxetine affects which two neurotransmitters?
PMHNP – 100% Verified Questions & ANSs (Latest
2025–2026 Edition)
Most Comprehensive Review Guide to Pass on the First
Attempt
Intro
Ace your NR 546 Final Exam with confidence!
This comprehensive Psychopharmacology for PMHNP Study Guide is expertly curated for
nursing students and psychiatric-mental health nurse practitioner candidates preparing for the NR
546 / NR546 Final Exam.
Covering the latest 2025–2026 curriculum, this all-in-one guide includes real, verified exam
questions, detailed rationales, and essential pharmacology concepts tested on the NR 546
final. Whether you're reviewing antidepressants, antipsychotics, mood stabilizers, anxiolytics, or
neurobiological mechanisms—this resource delivers everything you need to master
psychopharmacology and pass with excellence.
1. MAOIs (monoamine oxidase inhibitors) affect which neurotransmitters?
ANS: A. Serotonin, Dopamine, Norepinephrine
EXPLANATION
MAOIs inhibit the enzyme monoamine oxidase, which breaks down serotonin, dopamine, and
norepinephrine. By preventing their breakdown, MAOIs increase the levels of these
neurotransmitters in the brain, improving mood and reducing depression symptoms.
2. Which of the following is considered first-line treatment for depression?
ANS: A. SSRI
EXPLANATION
,Selective Serotonin Reuptake Inhibitors (SSRIs) are first-line because they are effective,
welltolerated, and have a safer side effect profile compared to older antidepressants like MAOIs
or TCAs.
3. When treating a patient for major depressive disorder, which medication
would the PMHNP consider first?
ANS: C. Escitalopram
EXPLANATION
Escitalopram (Lexapro) is a well-tolerated SSRI with few drug interactions and minimal side
effects, making it an excellent first choice for MDD.
4. Which medication should be considered for a patient diagnosed with major
depressive disorder who reports “always forgetting to take my pills”?
ANS: C. Fluoxetine
EXPLANATION
Fluoxetine (Prozac) has a long half-life (up to several days), providing a “forgiveness factor” if
doses are missed. This makes it suitable for patients who are nonadherent with daily dosing.
5. Which medication has a black box warning of a life-threatening skin rash?
ANS: B. Lamotrigine
EXPLANATION
Lamotrigine (Lamictal) can cause Stevens-Johnson Syndrome, a potentially fatal rash. Titration
must be slow to reduce this risk.
6. Which medication is considered the best tolerated SSRI?
ANS: D. Escitalopram
EXPLANATION
Escitalopram causes fewer side effects and drug interactions than many other SSRIs. It is often
preferred for patients who are sensitive to adverse effects.
, 7. During a 4-week follow-up appointment, Rashida (on Sertraline 25 mg qAM)
reports slight improvement and tolerating medication well. What should the
PMHNP do?
ANS: A. Increase Sertraline dose
EXPLANATION
Sertraline (Zoloft) often starts at a low dose and is titrated up. If tolerated and showing minimal
improvement, dose increase is appropriate after 4 weeks.
8. Which medication should be avoided for a 66-year-old patient with
depression, anxiety, and a history of falls?
ANS: C. Paroxetine
EXPLANATION
Paroxetine (Paxil) has strong anticholinergic and sedative effects that can cause confusion,
orthostatic hypotension, and increase fall risk in older adults.
9. A patient reports upset stomach and diarrhea 3 days after starting Sertraline.
What should the PMHNP say?
ANS: B. “Most side effects subside after 4–5 days. Your body is getting adjusted to the
increased serotonin levels.” EXPLANATION
GI upset is a common early SSRI side effect due to increased serotonin in the gut. It typically
improves within a week as the body adjusts.
10. During a 2-week follow-up, the patient reports no improvement with
Escitalopram. What is the correct statement by the PMHNP?
ANS: B. “It can take up to 6 weeks before you notice improvements of depressive
symptoms.” EXPLANATION
Antidepressants take 4–6 weeks for full therapeutic effect. Early discontinuation is avoided
unless side effects are intolerable.
11. Duloxetine affects which two neurotransmitters?
