NRNP 6675 Final Exam Questions and Answers |Fall
2025/2026 Update | 100% Correct
QUESTION 1:
Which of the following neurotransmitters primarily regulates mood, sleep, and appetite?
A. Dopamine
B. Serotonin
C. Acetylcholine
D. Glutamate
CORRECT ANSWER: B
RATIONALE: Serotonin plays a significant role in mood regulation, sleep cycles, and appetite
control. Dopamine is more related to reward and motivation, acetylcholine to memory and
muscle activation, and glutamate to excitatory signaling.
QUESTION 2:
A 35-year-old patient with major depressive disorder fails to respond to two SSRIs. Which would
be the next reasonable pharmacologic option?
A. Switch to a monoamine oxidase inhibitor (MAOI)
B. Try a serotonin-norepinephrine reuptake inhibitor (SNRI)
C. Add a benzodiazepine
D. Add a stimulant medication
CORRECT ANSWER: B
RATIONALE: SNRIs are appropriate after SSRI failure as they target both serotonin and
norepinephrine. MAOIs are reserved for treatment-resistant cases due to dietary restrictions.
Benzodiazepines and stimulants don’t address the core depressive symptoms.
QUESTION 3:
Which antidepressant is most likely to cause significant weight gain?
A. Bupropion
B. Fluoxetine
C. Mirtazapine
D. Venlafaxine
CORRECT ANSWER: C
RATIONALE: Mirtazapine commonly causes increased appetite and weight gain due to histamine
,receptor blockade. Bupropion often causes weight loss, while fluoxetine and venlafaxine are
weight-neutral or mildly increasing.
QUESTION 4:
A client presents with auditory hallucinations, flat affect, and poor hygiene. The most
appropriate diagnosis is:
A. Bipolar I disorder
B. Major depressive disorder with psychotic features
C. Schizophrenia
D. Schizoaffective disorder
CORRECT ANSWER: C
RATIONALE: Persistent psychotic symptoms with negative features such as flat affect and neglect
indicate schizophrenia. Schizoaffective disorder includes prominent mood components.
QUESTION 5:
First-line pharmacologic treatment for generalized anxiety disorder (GAD) typically includes:
A. SSRIs or SNRIs
B. Benzodiazepines only
C. Antipsychotics
D. Stimulants
CORRECT ANSWER: A
RATIONALE: SSRIs and SNRIs are gold standard first-line agents for GAD due to safety and
efficacy. Benzodiazepines are used short-term; antipsychotics and stimulants are not indicated.
QUESTION 6:
Overactivation of the HPA axis is most strongly associated with which condition?
A. Panic disorder
B. Major depressive disorder
C. Schizophrenia
D. Insomnia disorder
CORRECT ANSWER: B
RATIONALE: Depression involves dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis,
,resulting in excessive cortisol release. Panic and psychotic disorders have other neurochemical
abnormalities.
QUESTION 7:
Which drug requires dietary tyramine restriction to prevent hypertensive crisis?
A. Phenelzine
B. Paroxetine
C. Buspirone
D. Trazodone
CORRECT ANSWER: A
RATIONALE: Phenelzine is an MAOI, and MAOIs can interact with tyramine-rich foods causing
hypertensive crises.
QUESTION 8:
A major difference between bipolar I and bipolar II disorders is:
A. Presence of depressive episodes
B. Presence of manic episodes
C. Duration of symptoms
D. Severity of manic or hypomanic symptoms
CORRECT ANSWER: B
RATIONALE: Bipolar I includes at least one full manic episode; bipolar II includes hypomania but
no full mania.
QUESTION 9:
Lamotrigine is most effective in which phase of bipolar disorder management?
A. Acute mania
B. Bipolar depression
C. Rapid cycling
D. Mixed features
CORRECT ANSWER: B
RATIONALE: Lamotrigine is effective in bipolar depression prevention and maintenance, not
acute mania.
, QUESTION 10:
A black box warning for SSRIs includes the risk of:
A. Serotonin syndrome
B. Suicidal ideation in young patients
C. Cardiovascular toxicity
D. Hepatic failure
CORRECT ANSWER: B
RATIONALE: SSRIs carry an FDA black box warning for increased suicidal thinking in children,
adolescents, and young adults.
QUESTION 11:
Which laboratory test should be ordered before initiating valproic acid therapy?
A. Complete blood count (CBC)
B. Thyroid-stimulating hormone (TSH)
C. Serum creatinine
D. Fasting glucose
CORRECT ANSWER: A
RATIONALE: Valproic acid can cause thrombocytopenia and hepatotoxicity; a baseline CBC and
liver function tests are essential before initiation.
QUESTION 12:
Clozapine requires regular monitoring of which parameter?
A. White blood cell count
B. Electrolytes
C. Thyroid function
D. Serum glucose
CORRECT ANSWER: A
RATIONALE: Clozapine can cause agranulocytosis; weekly or biweekly WBC monitoring is
mandatory.
QUESTION 13:
2025/2026 Update | 100% Correct
QUESTION 1:
Which of the following neurotransmitters primarily regulates mood, sleep, and appetite?
A. Dopamine
B. Serotonin
C. Acetylcholine
D. Glutamate
CORRECT ANSWER: B
RATIONALE: Serotonin plays a significant role in mood regulation, sleep cycles, and appetite
control. Dopamine is more related to reward and motivation, acetylcholine to memory and
muscle activation, and glutamate to excitatory signaling.
QUESTION 2:
A 35-year-old patient with major depressive disorder fails to respond to two SSRIs. Which would
be the next reasonable pharmacologic option?
A. Switch to a monoamine oxidase inhibitor (MAOI)
B. Try a serotonin-norepinephrine reuptake inhibitor (SNRI)
C. Add a benzodiazepine
D. Add a stimulant medication
CORRECT ANSWER: B
RATIONALE: SNRIs are appropriate after SSRI failure as they target both serotonin and
norepinephrine. MAOIs are reserved for treatment-resistant cases due to dietary restrictions.
Benzodiazepines and stimulants don’t address the core depressive symptoms.
QUESTION 3:
Which antidepressant is most likely to cause significant weight gain?
A. Bupropion
B. Fluoxetine
C. Mirtazapine
D. Venlafaxine
CORRECT ANSWER: C
RATIONALE: Mirtazapine commonly causes increased appetite and weight gain due to histamine
,receptor blockade. Bupropion often causes weight loss, while fluoxetine and venlafaxine are
weight-neutral or mildly increasing.
QUESTION 4:
A client presents with auditory hallucinations, flat affect, and poor hygiene. The most
appropriate diagnosis is:
A. Bipolar I disorder
B. Major depressive disorder with psychotic features
C. Schizophrenia
D. Schizoaffective disorder
CORRECT ANSWER: C
RATIONALE: Persistent psychotic symptoms with negative features such as flat affect and neglect
indicate schizophrenia. Schizoaffective disorder includes prominent mood components.
QUESTION 5:
First-line pharmacologic treatment for generalized anxiety disorder (GAD) typically includes:
A. SSRIs or SNRIs
B. Benzodiazepines only
C. Antipsychotics
D. Stimulants
CORRECT ANSWER: A
RATIONALE: SSRIs and SNRIs are gold standard first-line agents for GAD due to safety and
efficacy. Benzodiazepines are used short-term; antipsychotics and stimulants are not indicated.
QUESTION 6:
Overactivation of the HPA axis is most strongly associated with which condition?
A. Panic disorder
B. Major depressive disorder
C. Schizophrenia
D. Insomnia disorder
CORRECT ANSWER: B
RATIONALE: Depression involves dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis,
,resulting in excessive cortisol release. Panic and psychotic disorders have other neurochemical
abnormalities.
QUESTION 7:
Which drug requires dietary tyramine restriction to prevent hypertensive crisis?
A. Phenelzine
B. Paroxetine
C. Buspirone
D. Trazodone
CORRECT ANSWER: A
RATIONALE: Phenelzine is an MAOI, and MAOIs can interact with tyramine-rich foods causing
hypertensive crises.
QUESTION 8:
A major difference between bipolar I and bipolar II disorders is:
A. Presence of depressive episodes
B. Presence of manic episodes
C. Duration of symptoms
D. Severity of manic or hypomanic symptoms
CORRECT ANSWER: B
RATIONALE: Bipolar I includes at least one full manic episode; bipolar II includes hypomania but
no full mania.
QUESTION 9:
Lamotrigine is most effective in which phase of bipolar disorder management?
A. Acute mania
B. Bipolar depression
C. Rapid cycling
D. Mixed features
CORRECT ANSWER: B
RATIONALE: Lamotrigine is effective in bipolar depression prevention and maintenance, not
acute mania.
, QUESTION 10:
A black box warning for SSRIs includes the risk of:
A. Serotonin syndrome
B. Suicidal ideation in young patients
C. Cardiovascular toxicity
D. Hepatic failure
CORRECT ANSWER: B
RATIONALE: SSRIs carry an FDA black box warning for increased suicidal thinking in children,
adolescents, and young adults.
QUESTION 11:
Which laboratory test should be ordered before initiating valproic acid therapy?
A. Complete blood count (CBC)
B. Thyroid-stimulating hormone (TSH)
C. Serum creatinine
D. Fasting glucose
CORRECT ANSWER: A
RATIONALE: Valproic acid can cause thrombocytopenia and hepatotoxicity; a baseline CBC and
liver function tests are essential before initiation.
QUESTION 12:
Clozapine requires regular monitoring of which parameter?
A. White blood cell count
B. Electrolytes
C. Thyroid function
D. Serum glucose
CORRECT ANSWER: A
RATIONALE: Clozapine can cause agranulocytosis; weekly or biweekly WBC monitoring is
mandatory.
QUESTION 13:
