ESTUDYR
NSG 552 – Psychopharmacology Exam 2
Intensive Multiple-Choice Questions with Rationales
1. A patient develops emotional and behavioral symptoms after losing employment.
Symptoms resolve within 4 months and do not meet criteria for bereavement. Which
diagnosis best fits this presentation?
A. Major depressive disorder
B. Acute stress disorder
C. Adjustment disorder
D. PTSD
✅Correct Answer: C
Rationale:
Adjustment disorder occurs in response to an identifiable stressor, begins within 3 months, and
resolves within 6 months after the stressor ends.
2. Which medication class is considered FIRST-LINE pharmacologic treatment for PTSD?
A. Benzodiazepines
B. Tricyclic antidepressants
C. SSRIs
D. Antipsychotics
✅Correct Answer: C
Rationale:
SSRIs (sertraline, paroxetine) are first-line due to efficacy, tolerability, and FDA approval.
3. A patient with PTSD is prescribed prazosin for nightmares. What parameter requires close
monitoring?
A. Heart rate
B. Blood glucose
C. Blood pressure
D. Liver enzymes
,ESTUDYR
✅Correct Answer: C
Rationale:
Prazosin is an α-1 blocker and can cause orthostatic hypotension, especially during initiation.
4. Why are benzodiazepines contraindicated in PTSD treatment?
A. They worsen nightmares
B. Increase serotonin syndrome risk
C. They impair trauma processing and have high addiction risk
D. They are ineffective anxiolytics
✅Correct Answer: C
Rationale:
Benzodiazepines interfere with CBT, worsen outcomes, and pose high SUD risk, which is
common in PTSD.
5. Which medications are FDA-approved for PTSD?
A. Sertraline and fluoxetine
B. Venlafaxine and duloxetine
C. Sertraline and paroxetine
D. Escitalopram and citalopram
✅Correct Answer: C
Rationale:
Only sertraline and paroxetine carry FDA approval for PTSD.
6. When should atypical antipsychotics be used in PTSD management?
A. First-line therapy
B. Moderate PTSD
C. PTSD with insomnia only
D. Severe, treatment-resistant cases only
✅Correct Answer: D
Rationale:
Antipsychotics are augmentation agents reserved for severe, refractory symptoms.
,ESTUDYR
7. Dissociative Identity Disorder (DID) most commonly co-occurs with which condition?
A. Bipolar disorder
B. Schizophrenia
C. PTSD
D. Panic disorder
✅Correct Answer: C
Rationale:
DID is strongly associated with chronic childhood trauma, making PTSD highly prevalent.
8. In patients with DID, SSRIs are primarily used to treat which symptoms?
A. Identity fragmentation
B. Dissociation
C. Comorbid depression and PTSD symptoms
D. Psychosis
✅Correct Answer: C
Rationale:
No medication treats dissociation itself; SSRIs target associated mood and PTSD symptoms.
9. Which is the most appropriate treatment approach for adjustment disorder?
A. Antipsychotic monotherapy
B. Long-term benzodiazepines
C. Psychotherapy ± symptom-targeted pharmacology
D. Mood stabilizers
✅Correct Answer: C
Rationale:
Psychotherapy is first-line, with medications used short-term for anxiety, depression, or
insomnia.
, ESTUDYR
10. Which medication reduces self-injurious behaviors in patients with DID?
A. Clozapine
B. Lithium
C. Naltrexone
D. Buspirone
✅Correct Answer: C
Rationale:
Naltrexone reduces impulsive and self-harm behaviors via opioid receptor blockade.
11. Is ECT contraindicated in Dissociative Identity Disorder?
A. Yes, always
B. Yes, unless psychotic
C. No, especially if comorbid depression is severe
D. Only if PTSD is absent
✅Correct Answer: C
Rationale:
ECT may be effective for treatment-resistant depression or anxiety in DID patients.
12. Which treatment plan is most appropriate for excoriation (skin-picking) disorder?
A. Benzodiazepines only
B. Psychotherapy ± SSRIs; antipsychotics if severe
C. Mood stabilizers only
D. No pharmacologic options
✅Correct Answer: B
Rationale:
CBT is first-line; SSRIs address comorbid anxiety/depression.
NSG 552 – Psychopharmacology Exam 2
Intensive Multiple-Choice Questions with Rationales
1. A patient develops emotional and behavioral symptoms after losing employment.
Symptoms resolve within 4 months and do not meet criteria for bereavement. Which
diagnosis best fits this presentation?
A. Major depressive disorder
B. Acute stress disorder
C. Adjustment disorder
D. PTSD
✅Correct Answer: C
Rationale:
Adjustment disorder occurs in response to an identifiable stressor, begins within 3 months, and
resolves within 6 months after the stressor ends.
2. Which medication class is considered FIRST-LINE pharmacologic treatment for PTSD?
A. Benzodiazepines
B. Tricyclic antidepressants
C. SSRIs
D. Antipsychotics
✅Correct Answer: C
Rationale:
SSRIs (sertraline, paroxetine) are first-line due to efficacy, tolerability, and FDA approval.
3. A patient with PTSD is prescribed prazosin for nightmares. What parameter requires close
monitoring?
A. Heart rate
B. Blood glucose
C. Blood pressure
D. Liver enzymes
,ESTUDYR
✅Correct Answer: C
Rationale:
Prazosin is an α-1 blocker and can cause orthostatic hypotension, especially during initiation.
4. Why are benzodiazepines contraindicated in PTSD treatment?
A. They worsen nightmares
B. Increase serotonin syndrome risk
C. They impair trauma processing and have high addiction risk
D. They are ineffective anxiolytics
✅Correct Answer: C
Rationale:
Benzodiazepines interfere with CBT, worsen outcomes, and pose high SUD risk, which is
common in PTSD.
5. Which medications are FDA-approved for PTSD?
A. Sertraline and fluoxetine
B. Venlafaxine and duloxetine
C. Sertraline and paroxetine
D. Escitalopram and citalopram
✅Correct Answer: C
Rationale:
Only sertraline and paroxetine carry FDA approval for PTSD.
6. When should atypical antipsychotics be used in PTSD management?
A. First-line therapy
B. Moderate PTSD
C. PTSD with insomnia only
D. Severe, treatment-resistant cases only
✅Correct Answer: D
Rationale:
Antipsychotics are augmentation agents reserved for severe, refractory symptoms.
,ESTUDYR
7. Dissociative Identity Disorder (DID) most commonly co-occurs with which condition?
A. Bipolar disorder
B. Schizophrenia
C. PTSD
D. Panic disorder
✅Correct Answer: C
Rationale:
DID is strongly associated with chronic childhood trauma, making PTSD highly prevalent.
8. In patients with DID, SSRIs are primarily used to treat which symptoms?
A. Identity fragmentation
B. Dissociation
C. Comorbid depression and PTSD symptoms
D. Psychosis
✅Correct Answer: C
Rationale:
No medication treats dissociation itself; SSRIs target associated mood and PTSD symptoms.
9. Which is the most appropriate treatment approach for adjustment disorder?
A. Antipsychotic monotherapy
B. Long-term benzodiazepines
C. Psychotherapy ± symptom-targeted pharmacology
D. Mood stabilizers
✅Correct Answer: C
Rationale:
Psychotherapy is first-line, with medications used short-term for anxiety, depression, or
insomnia.
, ESTUDYR
10. Which medication reduces self-injurious behaviors in patients with DID?
A. Clozapine
B. Lithium
C. Naltrexone
D. Buspirone
✅Correct Answer: C
Rationale:
Naltrexone reduces impulsive and self-harm behaviors via opioid receptor blockade.
11. Is ECT contraindicated in Dissociative Identity Disorder?
A. Yes, always
B. Yes, unless psychotic
C. No, especially if comorbid depression is severe
D. Only if PTSD is absent
✅Correct Answer: C
Rationale:
ECT may be effective for treatment-resistant depression or anxiety in DID patients.
12. Which treatment plan is most appropriate for excoriation (skin-picking) disorder?
A. Benzodiazepines only
B. Psychotherapy ± SSRIs; antipsychotics if severe
C. Mood stabilizers only
D. No pharmacologic options
✅Correct Answer: B
Rationale:
CBT is first-line; SSRIs address comorbid anxiety/depression.
