NURSING 7350 PSYCHOPHARMACOLOGY
ACROSS THE LIFESPAN EXAM Q & A,
2026 Questions with Correct Answers
1. A nurse is caring for an elderly patient who has been recently diagnosed with
depression. Which of the following psychotropic medications would the nurse
anticipate being prescribed due to its efficacy and reduced risk of adverse effects in
older adults?
a) Fluoxetine (Prozac)
b) Venlafaxine (Effexor)
c) Paroxetine (Paxil)
d) Sertraline (Zoloft)
Answer: d
Rationale: Sertraline is a selective serotonin reuptake inhibitor (SSRI) commonly
prescribed for depression. It is often preferred in older adults due to its reduced
side effect profile and lower drug-drug interaction potential compared to other
SSRIs.
2. A 30-year-old female patient with bipolar disorder presents with manic
symptoms. Considering this patient's gender and reproductive stage, which mood
stabilizer would be most appropriate to avoid negative effects on fertility and
pregnancy?
a) Lithium
b) Carbamazepine (Tegretol)
c) Valproate (Depakote)
d) Lamotrigine (Lamictal)
Answer: d
Rationale: Lamotrigine has demonstrated a lower risk of reproductive adverse
effects and is considered a safe option during pregnancy compared to valproate
and carbamazepine, which have higher teratogenic risks.
,3. A 72-year-old patient with Parkinson's disease develops psychotic symptoms.
Which antipsychotic is safest for this patient?
a) Haloperidol (Haldol)
b) Quetiapine (Seroquel)
c) Risperidone (Risperdal)
d) Olanzapine (Zyprexa)
Answer: b
Rationale: Quetiapine has a lower risk of extrapyramidal symptoms (EPS) and is
often preferred in Parkinson's disease psychosis. Pimavanserin is also used, but
among the options, quetiapine is safest.
4. A 16-year-old adolescent with major depressive disorder has failed treatment
with fluoxetine. The nurse practitioner considers adding a second medication.
Which augmentation strategy has the strongest evidence in adolescents?
a) Aripiprazole (Abilify)
b) Lithium
c) Bupropion (Wellbutrin)
d) Methylphenidate (Ritalin)
Answer: a
Rationale: Aripiprazole is FDA-approved for adjunctive treatment of major
depressive disorder in adolescents. Lithium and bupropion have less evidence in
this population.
5. A 45-year-old male with bipolar I disorder is stabilized on lithium but develops
a fine tremor that interferes with his job as a dentist. Which medication can be
added to reduce the tremor?
a) Propranolol (Inderal)
b) Benztropine (Cogentin)
c) Clonazepam (Klonopin)
d) Amantadine (Symmetrel)
Answer: a
Rationale: Propranolol, a beta-blocker, is effective for lithium-induced tremor.
Benztropine is for extrapyramidal symptoms, not lithium tremor.
,6. A pregnant woman at 28 weeks gestation with bipolar I disorder is being treated
with valproate. What is the most appropriate action?
a) Continue valproate at the same dose
b) Increase the valproate dose due to increased metabolism in pregnancy
c) Switch to lamotrigine or lithium
d) Add folic acid 0.4 mg daily
Answer: c
Rationale: Valproate is associated with neural tube defects and developmental
delay; it should be avoided in pregnancy. Lamotrigine or lithium are safer
alternatives.
7. A 55-year-old patient with generalized anxiety disorder (GAD) also has a
history of alcohol use disorder. Which medication is preferred due to lower abuse
potential?
a) Alprazolam (Xanax)
b) Lorazepam (Ativan)
c) Buspirone (Buspar)
d) Clonazepam (Klonopin)
Answer: c
Rationale: Buspirone has no abuse potential and is not a controlled substance,
making it ideal for patients with substance use history.
8. A 10-year-old child with attention-deficit/hyperactivity disorder (ADHD)
experiences significant appetite suppression and weight loss on methylphenidate.
Which alternative medication is least likely to cause appetite suppression?
a) Amphetamine salts (Adderall)
b) Dexmethylphenidate (Focalin)
c) Guanfacine (Intuniv)
d) Lisdexamfetamine (Vyvanse)
Answer: c
Rationale: Guanfacine is a non-stimulant; it does not suppress appetite. Stimulants
commonly cause decreased appetite and weight loss.
, 9. A 68-year-old patient with insomnia is prescribed a hypnotic. Which agent is
most appropriate to minimize fall risk?
a) Zolpidem (Ambien)
b) Temazepam (Restoril)
c) Ramelteon (Rozerem)
d) Eszopiclone (Lunesta)
Answer: c
Rationale: Ramelteon is a melatonin receptor agonist with no abuse potential and
minimal risk of falls, sedation, or next-day impairment, making it safer for older
adults.
10. A 32-year-old female with panic disorder is prescribed a selective serotonin
reuptake inhibitor (SSRI). She is also taking oral contraceptives. Which SSRI is
least likely to interact with her birth control?
a) Fluoxetine (Prozac)
b) Paroxetine (Paxil)
c) Sertraline (Zoloft)
d) Fluvoxamine (Luvox)
Answer: c
Rationale: Sertraline has minimal effect on CYP enzymes; fluoxetine and
paroxetine inhibit CYP2D6 and can affect metabolism of other drugs, but oral
contraceptives are primarily affected by CYP3A4 inducers. However, among
SSRIs, sertraline is generally the safest choice with minimal interactions.
11. A 75-year-old patient with dementia is exhibiting agitation and aggression.
Which antipsychotic carries the highest risk of stroke and mortality in this
population?
a) Quetiapine (Seroquel)
b) Risperidone (Risperdal)
c) Aripiprazole (Abilify)
d) Olanzapine (Zyprexa)
ACROSS THE LIFESPAN EXAM Q & A,
2026 Questions with Correct Answers
1. A nurse is caring for an elderly patient who has been recently diagnosed with
depression. Which of the following psychotropic medications would the nurse
anticipate being prescribed due to its efficacy and reduced risk of adverse effects in
older adults?
a) Fluoxetine (Prozac)
b) Venlafaxine (Effexor)
c) Paroxetine (Paxil)
d) Sertraline (Zoloft)
Answer: d
Rationale: Sertraline is a selective serotonin reuptake inhibitor (SSRI) commonly
prescribed for depression. It is often preferred in older adults due to its reduced
side effect profile and lower drug-drug interaction potential compared to other
SSRIs.
2. A 30-year-old female patient with bipolar disorder presents with manic
symptoms. Considering this patient's gender and reproductive stage, which mood
stabilizer would be most appropriate to avoid negative effects on fertility and
pregnancy?
a) Lithium
b) Carbamazepine (Tegretol)
c) Valproate (Depakote)
d) Lamotrigine (Lamictal)
Answer: d
Rationale: Lamotrigine has demonstrated a lower risk of reproductive adverse
effects and is considered a safe option during pregnancy compared to valproate
and carbamazepine, which have higher teratogenic risks.
,3. A 72-year-old patient with Parkinson's disease develops psychotic symptoms.
Which antipsychotic is safest for this patient?
a) Haloperidol (Haldol)
b) Quetiapine (Seroquel)
c) Risperidone (Risperdal)
d) Olanzapine (Zyprexa)
Answer: b
Rationale: Quetiapine has a lower risk of extrapyramidal symptoms (EPS) and is
often preferred in Parkinson's disease psychosis. Pimavanserin is also used, but
among the options, quetiapine is safest.
4. A 16-year-old adolescent with major depressive disorder has failed treatment
with fluoxetine. The nurse practitioner considers adding a second medication.
Which augmentation strategy has the strongest evidence in adolescents?
a) Aripiprazole (Abilify)
b) Lithium
c) Bupropion (Wellbutrin)
d) Methylphenidate (Ritalin)
Answer: a
Rationale: Aripiprazole is FDA-approved for adjunctive treatment of major
depressive disorder in adolescents. Lithium and bupropion have less evidence in
this population.
5. A 45-year-old male with bipolar I disorder is stabilized on lithium but develops
a fine tremor that interferes with his job as a dentist. Which medication can be
added to reduce the tremor?
a) Propranolol (Inderal)
b) Benztropine (Cogentin)
c) Clonazepam (Klonopin)
d) Amantadine (Symmetrel)
Answer: a
Rationale: Propranolol, a beta-blocker, is effective for lithium-induced tremor.
Benztropine is for extrapyramidal symptoms, not lithium tremor.
,6. A pregnant woman at 28 weeks gestation with bipolar I disorder is being treated
with valproate. What is the most appropriate action?
a) Continue valproate at the same dose
b) Increase the valproate dose due to increased metabolism in pregnancy
c) Switch to lamotrigine or lithium
d) Add folic acid 0.4 mg daily
Answer: c
Rationale: Valproate is associated with neural tube defects and developmental
delay; it should be avoided in pregnancy. Lamotrigine or lithium are safer
alternatives.
7. A 55-year-old patient with generalized anxiety disorder (GAD) also has a
history of alcohol use disorder. Which medication is preferred due to lower abuse
potential?
a) Alprazolam (Xanax)
b) Lorazepam (Ativan)
c) Buspirone (Buspar)
d) Clonazepam (Klonopin)
Answer: c
Rationale: Buspirone has no abuse potential and is not a controlled substance,
making it ideal for patients with substance use history.
8. A 10-year-old child with attention-deficit/hyperactivity disorder (ADHD)
experiences significant appetite suppression and weight loss on methylphenidate.
Which alternative medication is least likely to cause appetite suppression?
a) Amphetamine salts (Adderall)
b) Dexmethylphenidate (Focalin)
c) Guanfacine (Intuniv)
d) Lisdexamfetamine (Vyvanse)
Answer: c
Rationale: Guanfacine is a non-stimulant; it does not suppress appetite. Stimulants
commonly cause decreased appetite and weight loss.
, 9. A 68-year-old patient with insomnia is prescribed a hypnotic. Which agent is
most appropriate to minimize fall risk?
a) Zolpidem (Ambien)
b) Temazepam (Restoril)
c) Ramelteon (Rozerem)
d) Eszopiclone (Lunesta)
Answer: c
Rationale: Ramelteon is a melatonin receptor agonist with no abuse potential and
minimal risk of falls, sedation, or next-day impairment, making it safer for older
adults.
10. A 32-year-old female with panic disorder is prescribed a selective serotonin
reuptake inhibitor (SSRI). She is also taking oral contraceptives. Which SSRI is
least likely to interact with her birth control?
a) Fluoxetine (Prozac)
b) Paroxetine (Paxil)
c) Sertraline (Zoloft)
d) Fluvoxamine (Luvox)
Answer: c
Rationale: Sertraline has minimal effect on CYP enzymes; fluoxetine and
paroxetine inhibit CYP2D6 and can affect metabolism of other drugs, but oral
contraceptives are primarily affected by CYP3A4 inducers. However, among
SSRIs, sertraline is generally the safest choice with minimal interactions.
11. A 75-year-old patient with dementia is exhibiting agitation and aggression.
Which antipsychotic carries the highest risk of stroke and mortality in this
population?
a) Quetiapine (Seroquel)
b) Risperidone (Risperdal)
c) Aripiprazole (Abilify)
d) Olanzapine (Zyprexa)
