WGU D345 NURS 6438
Psychopharmacology OA ACTUAL
EXAM 2026/2027 | Psychopharmacology
Final | Verified Q&A | Pass Guaranteed -
A+ Graded
Section 1: Neurotransmitters & Mechanisms of Action
Q1: A 45-year-old patient with major depressive disorder (MDD) and hypertension presents for
medication review. The APRN explains that selective serotonin reuptake inhibitors (SSRIs) work primarily
by which mechanism?
A. Blocking dopamine D2 receptors in the mesolimbic pathway
B. Inhibiting monoamine oxidase to prevent neurotransmitter breakdown
C. Blocking the serotonin transporter (SERT) to increase synaptic serotonin availability [CORRECT]
D. Stimulating norepinephrine release from presynaptic neurons
Correct Answer: C
Rationale: SSRIs exert their therapeutic effect by competitively inhibiting the serotonin transporter
(SERT) at the presynaptic membrane, preventing serotonin reuptake and increasing 5-HT concentration
in the synaptic cleft. Option A describes antipsychotic mechanisms, not SSRIs. Option B describes MAOIs,
not SSRIs. Option D describes the mechanism of stimulants like amphetamines, not SSRIs.
Q2: A patient with bipolar disorder is prescribed lamotrigine. The APRN explains that this medication's
mood-stabilizing effects are primarily attributed to which mechanism?
A. Blocking voltage-gated sodium channels and inhibiting glutamate release [CORRECT]
B. Enhancing GABA-A receptor chloride channel opening
C. Inhibiting serotonin reuptake at the presynaptic neuron
D. Blocking dopamine D2 and serotonin 5-HT2A receptors
Correct Answer: A
,Rationale: Lamotrigine stabilizes mood by blocking voltage-gated sodium channels, which inhibits
presynaptic glutamate and aspartate release, reducing neuronal excitability. Option B describes
benzodiazepine mechanisms. Option C describes SSRI mechanisms. Option D describes atypical
antipsychotic mechanisms like risperidone.
Q3: A 28-year-old patient with ADHD is started on methylphenidate. The APRN explains that this
stimulant primarily works by which mechanism to improve attention?
A. Blocking the reuptake of dopamine and norepinephrine into presynaptic neurons [CORRECT]
B. Increasing serotonin synthesis through tryptophan hydroxylase activation
C. Blocking NMDA glutamate receptors to reduce excitotoxicity
D. Enhancing GABA-B receptor activity to reduce neuronal firing
Correct Answer: A
Rationale: Methylphenidate is a dopamine and norepinephrine reuptake inhibitor (DNRI) that blocks the
dopamine transporter (DAT) and norepinephrine transporter (NET), increasing catecholamine availability
in the prefrontal cortex and striatum. Option B describes a theoretical serotonin mechanism not used by
stimulants. Option C describes NMDA antagonists like ketamine. Option D describes GABAergic drugs
which would impair cognition.
Q4: A patient with schizophrenia is prescribed aripiprazole. The APRN explains that this medication's
unique mechanism involves which receptor activity?
A. Pure dopamine D2 receptor antagonism
B. Dopamine D2 partial agonism and serotonin 5-HT1A partial agonism [CORRECT]
C. Pure serotonin 5-HT2A receptor antagonism
D. Muscarinic acetylcholine receptor agonism
Correct Answer: B
Rationale: Aripiprazole is a third-generation atypical antipsychotic with D2 partial agonist activity
(stabilizing dopamine signaling) and 5-HT1A partial agonism (enhancing serotonergic transmission),
distinguishing it from full antagonists. Option A describes first-generation antipsychotics like haloperidol.
Option C describes the mechanism of pimavanserin alone. Option D would cause cholinergic side effects,
not antipsychotic effects.
Q5: A patient with treatment-resistant depression is prescribed ketamine. The APRN explains that its
rapid antidepressant effects are primarily mediated through which mechanism?
A. Inhibition of serotonin transporters
, B. NMDA receptor antagonism leading to increased glutamate and BDNF release [CORRECT]
C. Direct stimulation of dopamine D1 receptors
D. Enhancement of GABA-A receptor activity
Correct Answer: B
Rationale: Ketamine is an NMDA receptor antagonist that blocks glutamate's excitatory effects,
triggering compensatory glutamate burst release, AMPA receptor activation, and BDNF synthesis,
promoting synaptogenesis. Option A describes SSRIs. Option C is incorrect as ketamine does not directly
stimulate D1 receptors. Option D describes benzodiazepines.
Q6: A patient with generalized anxiety disorder (GAD) is prescribed buspirone. The APRN explains that
this medication's anxiolytic effects result from which mechanism?
A. Enhancement of GABA-A receptor chloride conductance
B. Partial agonism at serotonin 5-HT1A receptors [CORRECT]
C. Blockade of voltage-gated calcium channels
D. Inhibition of norepinephrine reuptake
Correct Answer: B
Rationale: Buspirone is a 5-HT1A partial agonist that desensitizes presynaptic autoreceptors and
enhances postsynaptic serotonergic transmission in the amygdala and hippocampus without GABA
involvement. Option A describes benzodiazepines. Option C describes gabapentinoids. Option D
describes SNRIs or NRIs.
Q7: A patient with Parkinson's disease develops psychosis and is prescribed pimavanserin. The APRN
explains that this medication works primarily through which mechanism?
A. Dopamine D2 receptor blockade
B. Serotonin 5-HT2A receptor inverse agonism with no dopamine binding [CORRECT]
C. Muscarinic acetylcholine receptor antagonism
D. NMDA receptor antagonism
Correct Answer: B
Rationale: Pimavanserin is a selective 5-HT2A inverse agonist that reduces psychosis without blocking
dopamine D2 receptors, avoiding worsening of parkinsonian motor symptoms. Option A would worsen
Parkinson's symptoms. Option C describes benztropine for extrapyramidal symptoms. Option D
describes ketamine.
Psychopharmacology OA ACTUAL
EXAM 2026/2027 | Psychopharmacology
Final | Verified Q&A | Pass Guaranteed -
A+ Graded
Section 1: Neurotransmitters & Mechanisms of Action
Q1: A 45-year-old patient with major depressive disorder (MDD) and hypertension presents for
medication review. The APRN explains that selective serotonin reuptake inhibitors (SSRIs) work primarily
by which mechanism?
A. Blocking dopamine D2 receptors in the mesolimbic pathway
B. Inhibiting monoamine oxidase to prevent neurotransmitter breakdown
C. Blocking the serotonin transporter (SERT) to increase synaptic serotonin availability [CORRECT]
D. Stimulating norepinephrine release from presynaptic neurons
Correct Answer: C
Rationale: SSRIs exert their therapeutic effect by competitively inhibiting the serotonin transporter
(SERT) at the presynaptic membrane, preventing serotonin reuptake and increasing 5-HT concentration
in the synaptic cleft. Option A describes antipsychotic mechanisms, not SSRIs. Option B describes MAOIs,
not SSRIs. Option D describes the mechanism of stimulants like amphetamines, not SSRIs.
Q2: A patient with bipolar disorder is prescribed lamotrigine. The APRN explains that this medication's
mood-stabilizing effects are primarily attributed to which mechanism?
A. Blocking voltage-gated sodium channels and inhibiting glutamate release [CORRECT]
B. Enhancing GABA-A receptor chloride channel opening
C. Inhibiting serotonin reuptake at the presynaptic neuron
D. Blocking dopamine D2 and serotonin 5-HT2A receptors
Correct Answer: A
,Rationale: Lamotrigine stabilizes mood by blocking voltage-gated sodium channels, which inhibits
presynaptic glutamate and aspartate release, reducing neuronal excitability. Option B describes
benzodiazepine mechanisms. Option C describes SSRI mechanisms. Option D describes atypical
antipsychotic mechanisms like risperidone.
Q3: A 28-year-old patient with ADHD is started on methylphenidate. The APRN explains that this
stimulant primarily works by which mechanism to improve attention?
A. Blocking the reuptake of dopamine and norepinephrine into presynaptic neurons [CORRECT]
B. Increasing serotonin synthesis through tryptophan hydroxylase activation
C. Blocking NMDA glutamate receptors to reduce excitotoxicity
D. Enhancing GABA-B receptor activity to reduce neuronal firing
Correct Answer: A
Rationale: Methylphenidate is a dopamine and norepinephrine reuptake inhibitor (DNRI) that blocks the
dopamine transporter (DAT) and norepinephrine transporter (NET), increasing catecholamine availability
in the prefrontal cortex and striatum. Option B describes a theoretical serotonin mechanism not used by
stimulants. Option C describes NMDA antagonists like ketamine. Option D describes GABAergic drugs
which would impair cognition.
Q4: A patient with schizophrenia is prescribed aripiprazole. The APRN explains that this medication's
unique mechanism involves which receptor activity?
A. Pure dopamine D2 receptor antagonism
B. Dopamine D2 partial agonism and serotonin 5-HT1A partial agonism [CORRECT]
C. Pure serotonin 5-HT2A receptor antagonism
D. Muscarinic acetylcholine receptor agonism
Correct Answer: B
Rationale: Aripiprazole is a third-generation atypical antipsychotic with D2 partial agonist activity
(stabilizing dopamine signaling) and 5-HT1A partial agonism (enhancing serotonergic transmission),
distinguishing it from full antagonists. Option A describes first-generation antipsychotics like haloperidol.
Option C describes the mechanism of pimavanserin alone. Option D would cause cholinergic side effects,
not antipsychotic effects.
Q5: A patient with treatment-resistant depression is prescribed ketamine. The APRN explains that its
rapid antidepressant effects are primarily mediated through which mechanism?
A. Inhibition of serotonin transporters
, B. NMDA receptor antagonism leading to increased glutamate and BDNF release [CORRECT]
C. Direct stimulation of dopamine D1 receptors
D. Enhancement of GABA-A receptor activity
Correct Answer: B
Rationale: Ketamine is an NMDA receptor antagonist that blocks glutamate's excitatory effects,
triggering compensatory glutamate burst release, AMPA receptor activation, and BDNF synthesis,
promoting synaptogenesis. Option A describes SSRIs. Option C is incorrect as ketamine does not directly
stimulate D1 receptors. Option D describes benzodiazepines.
Q6: A patient with generalized anxiety disorder (GAD) is prescribed buspirone. The APRN explains that
this medication's anxiolytic effects result from which mechanism?
A. Enhancement of GABA-A receptor chloride conductance
B. Partial agonism at serotonin 5-HT1A receptors [CORRECT]
C. Blockade of voltage-gated calcium channels
D. Inhibition of norepinephrine reuptake
Correct Answer: B
Rationale: Buspirone is a 5-HT1A partial agonist that desensitizes presynaptic autoreceptors and
enhances postsynaptic serotonergic transmission in the amygdala and hippocampus without GABA
involvement. Option A describes benzodiazepines. Option C describes gabapentinoids. Option D
describes SNRIs or NRIs.
Q7: A patient with Parkinson's disease develops psychosis and is prescribed pimavanserin. The APRN
explains that this medication works primarily through which mechanism?
A. Dopamine D2 receptor blockade
B. Serotonin 5-HT2A receptor inverse agonism with no dopamine binding [CORRECT]
C. Muscarinic acetylcholine receptor antagonism
D. NMDA receptor antagonism
Correct Answer: B
Rationale: Pimavanserin is a selective 5-HT2A inverse agonist that reduces psychosis without blocking
dopamine D2 receptors, avoiding worsening of parkinsonian motor symptoms. Option A would worsen
Parkinson's symptoms. Option C describes benztropine for extrapyramidal symptoms. Option D
describes ketamine.
