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NSG552 / NSG 552 (Latest 2025/2026)
Psychopharmacology Exam | Grade A
Questions and Verified Answers |
100% Correct
1. Which mechanism of action is primarily responsible for the
antidepressant effects of selective serotonin reuptake inhibitors
(SSRIs) like fluoxetine? A. Inhibition of serotonin reuptake at the
presynaptic neuron B. Blockade of dopamine D2 receptors C.
Enhancement of GABA activity D. Inhibition of norepinephrine
reuptake only
A Rationale: SSRIs exert their therapeutic effects by selectively
blocking the serotonin transporter (SERT), increasing synaptic serotonin
levels, which is the cornerstone of their efficacy in major depressive
disorder per APA guidelines.
2. A patient on sertraline develops a fine tremor and diaphoresis after
starting treatment. What is the most likely cause? A. Serotonin
syndrome B. Extrapyramidal symptoms C. Orthostatic hypotension
D. Anticholinergic toxicity
A Rationale: Early signs of serotonin syndrome, such as tremor and
diaphoresis, can occur with SSRIs alone or in combination, necessitating
immediate dose adjustment or discontinuation as per clinical monitoring
protocols.
3. What is a key contraindication for initiating paroxetine in a 65-
year-old patient? A. History of glaucoma B. Concurrent use of
tamoxifen C. Renal impairment (CrCl <30 mL/min) D. All of the
above
, 2
D Rationale: Paroxetine's anticholinergic effects worsen glaucoma, it
inhibits CYP2D6 reducing tamoxifen efficacy, and dose adjustments are
needed in renal failure, aligning with Beers Criteria for older adults.
4. In treating OCD, which SSRI is FDA-approved for pediatric use
starting at age 6? A. Escitalopram B. Fluoxetine C. Citalopram D.
Sertraline
B Rationale: Fluoxetine has the broadest pediatric approval for OCD
due to its established safety profile and efficacy in serotonin modulation
for obsessive-compulsive symptoms.
5. A patient with MDD switches from venlafaxine to duloxetine.
What shared mechanism justifies this? A. Dual reuptake inhibition
of serotonin and norepinephrine B. Monoamine oxidase inhibition
C. NMDA receptor antagonism D. Sigma-1 receptor agonism
A Rationale: Both are SNRIs that inhibit reuptake of both serotonin and
norepinephrine, providing efficacy in treatment-resistant depression as
supported by STAR*D trial insights.
6. What is the primary side effect concern with long-term SNRI use
like desvenlafaxine? A. Sexual dysfunction B. Sustained
hypertension C. Weight gain D. Sedation
B Rationale: SNRIs can elevate blood pressure via norepinephrine
effects, requiring regular monitoring, especially in patients with
cardiovascular risk factors per AHA guidelines.
7. Which TCA, amitriptyline, is contraindicated in patients with a
history of seizures? A. Due to lowered seizure threshold B. Due to
QT prolongation C. Due to hyperprolactinemia D. Due to
metabolic syndrome
A Rationale: TCAs like amitriptyline lower the seizure threshold
through sodium channel blockade, making them unsuitable for epilepsy
patients as per epilepsy management guidelines.
NSG552 / NSG 552 (Latest 2025/2026)
Psychopharmacology Exam | Grade A
Questions and Verified Answers |
100% Correct
1. Which mechanism of action is primarily responsible for the
antidepressant effects of selective serotonin reuptake inhibitors
(SSRIs) like fluoxetine? A. Inhibition of serotonin reuptake at the
presynaptic neuron B. Blockade of dopamine D2 receptors C.
Enhancement of GABA activity D. Inhibition of norepinephrine
reuptake only
A Rationale: SSRIs exert their therapeutic effects by selectively
blocking the serotonin transporter (SERT), increasing synaptic serotonin
levels, which is the cornerstone of their efficacy in major depressive
disorder per APA guidelines.
2. A patient on sertraline develops a fine tremor and diaphoresis after
starting treatment. What is the most likely cause? A. Serotonin
syndrome B. Extrapyramidal symptoms C. Orthostatic hypotension
D. Anticholinergic toxicity
A Rationale: Early signs of serotonin syndrome, such as tremor and
diaphoresis, can occur with SSRIs alone or in combination, necessitating
immediate dose adjustment or discontinuation as per clinical monitoring
protocols.
3. What is a key contraindication for initiating paroxetine in a 65-
year-old patient? A. History of glaucoma B. Concurrent use of
tamoxifen C. Renal impairment (CrCl <30 mL/min) D. All of the
above
, 2
D Rationale: Paroxetine's anticholinergic effects worsen glaucoma, it
inhibits CYP2D6 reducing tamoxifen efficacy, and dose adjustments are
needed in renal failure, aligning with Beers Criteria for older adults.
4. In treating OCD, which SSRI is FDA-approved for pediatric use
starting at age 6? A. Escitalopram B. Fluoxetine C. Citalopram D.
Sertraline
B Rationale: Fluoxetine has the broadest pediatric approval for OCD
due to its established safety profile and efficacy in serotonin modulation
for obsessive-compulsive symptoms.
5. A patient with MDD switches from venlafaxine to duloxetine.
What shared mechanism justifies this? A. Dual reuptake inhibition
of serotonin and norepinephrine B. Monoamine oxidase inhibition
C. NMDA receptor antagonism D. Sigma-1 receptor agonism
A Rationale: Both are SNRIs that inhibit reuptake of both serotonin and
norepinephrine, providing efficacy in treatment-resistant depression as
supported by STAR*D trial insights.
6. What is the primary side effect concern with long-term SNRI use
like desvenlafaxine? A. Sexual dysfunction B. Sustained
hypertension C. Weight gain D. Sedation
B Rationale: SNRIs can elevate blood pressure via norepinephrine
effects, requiring regular monitoring, especially in patients with
cardiovascular risk factors per AHA guidelines.
7. Which TCA, amitriptyline, is contraindicated in patients with a
history of seizures? A. Due to lowered seizure threshold B. Due to
QT prolongation C. Due to hyperprolactinemia D. Due to
metabolic syndrome
A Rationale: TCAs like amitriptyline lower the seizure threshold
through sodium channel blockade, making them unsuitable for epilepsy
patients as per epilepsy management guidelines.
