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NSG552 / NSG 552 Psychopharmacology Exam 2
Actual Exam 2026/2027 – Complete Exam-Style
Questions with Detailed Rationales | 100% Verified –
Pass Guaranteed – A+ Graded
Section 1: Antidepressants (SSRIs, SNRIs, TCAs, MAOIs, Atypicals) (Questions 1-20)
Q1: A patient with major depressive disorder is started on fluoxetine. The nurse practitioner
educates the patient that if they need to switch to a Monoamine Oxidase Inhibitor (MAOI), they
must wait a specific amount of time after stopping fluoxetine to prevent serotonin syndrome.
How long must the patient wait?
A. 2 weeks
B. 5 weeks
C. 48 hours
D. 3 days
B. 5 weeks [CORRECT]
Correct Answer: B
Rationale: Fluoxetine and its active metabolite norfluoxetine have very long half-lives (up to 15
days). To prevent serotonin syndrome when switching to an MAOI, a washout period of 5 weeks
is required compared to the standard 2 weeks for other antidepressants.
Q2: Which of the following antidepressants is most associated with dose-dependent hypertension
due to its effects on norepinephrine reuptake inhibition at higher doses?
A. Sertraline
B. Venlafaxine
C. Mirtazapine
D. Escitalopram
B. Venlafaxine [CORRECT]
Correct Answer: B
,2
Rationale: Venlafaxine acts as an SSRI at lower doses (<150 mg/day) but gains significant
norepinephrine reuptake inhibition (SNRI properties) at higher doses (>150 mg/day), which can
lead to dose-dependent hypertension.
Q3: A patient presents with complaints of dry mouth, constipation, urinary retention, and blurred
vision. The nurse practitioner recognizes these are classic anticholinergic side effects associated
with which class of antidepressants?
A. Selective Serotonin Reuptake Inhibitors (SSRIs)
B. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
C. Tricyclic Antidepressants (TCAs)
D. Atypical Antipsychotics
C. Tricyclic Antidepressants (TCAs) [CORRECT]
Correct Answer: C
Rationale: TCAs block histamine H1, alpha-1 adrenergic, and muscarinic acetylcholine
receptors. Anticholinergic side effects (dry mouth, constipation, urinary retention, blurred vision)
are hallmark adverse effects of this class.
Q4: A patient with treatment-resistant depression is prescribed phenelzine, an MAOI. The nurse
practitioner provides critical dietary education to avoid hypertensive crisis. Which food
combination should the patient strictly avoid?
A. Fresh leafy green vegetables and citrus fruits
B. Aged cheese and red wine
C. Grilled chicken and white rice
D. Whole grain bread and oatmeal
B. Aged cheese and red wine [CORRECT]
Correct Answer: B
Rationale: Aged cheeses, cured meats, fermented foods, and red/beer wine contain high levels of
tyramine. In patients taking MAOIs, tyramine cannot be metabolized, leading to a hypertensive
crisis characterized by severe headache, hypertension, and risk of intracranial hemorrhage.
,3
Q5: Which antidepressant is contraindicated in patients with a history of seizure disorders or
bulimia nervosa due to a lowered seizure threshold?
A. Paroxetine
B. Bupropion
C. Duloxetine
D. Mirtazapine
B. Bupropion [CORRECT]
Correct Answer: B
Rationale: Bupropion (an NDRI) lowers the seizure threshold in a dose-dependent manner. It is
contraindicated in patients with a history of seizures or eating disorders (bulimia/anorexia) which
may predispose them to electrolyte imbalances and seizures.
Q6: A patient with depression complains of significant insomnia and weight loss. The nurse
practitioner considers which antidepressant that has sedative and appetite-stimulating properties
due to potent histamine H1 blockade?
A. Bupropion
B. Mirtazapine
C. Venlafaxine
D. Fluoxetine
B. Mirtazapine [CORRECT]
Correct Answer: B
Rationale: Mirtazapine is a potent antagonist of histamine H1 receptors, causing sedation and
increased appetite. It is often chosen for patients with depression who suffer from insomnia and
weight loss.
Q7: A patient taking an SSRI reports sexual dysfunction, including delayed ejaculation and
anorgasmia. The nurse practitioner explains that this is caused by increased serotonin stimulation
at which receptor subtype?
A. 5-HT1A
B. 5-HT2A
, 4
C. 5-HT2C
D. 5-HT3
C. 5-HT2C [CORRECT]
Correct Answer: C
Rationale: While the exact mechanism is complex, increased serotonin stimulation, particularly
at 5-HT2C receptors, is strongly implicated in SSRI-induced sexual dysfunction. Bupropion is
often added or switched because it lacks significant serotonergic activity.
Q8: Which TCA is primarily FDA-approved for the treatment of Obsessive-Compulsive Disorder
(OCD) rather than depression?
A. Amitriptyline
B. Nortriptyline
C. Clomipramine
D. Imipramine
C. Clomipramine [CORRECT]
Correct Answer: C
Rationale: Clomipramine is a TCA that is highly serotonergic and is FDA-approved specifically
for OCD. It is often used when SSRIs fail, though it carries a higher burden of anticholinergic
side effects.
Q9: The nurse practitioner is treating a patient with depression who also has chronic diabetic
neuropathy. Which SNRI is FDA-approved for both conditions?
A. Desvenlafaxine
B. Levomilnacipran
C. Duloxetine
D. Venlafaxine
C. Duloxetine [CORRECT]
Correct Answer: C
NSG552 / NSG 552 Psychopharmacology Exam 2
Actual Exam 2026/2027 – Complete Exam-Style
Questions with Detailed Rationales | 100% Verified –
Pass Guaranteed – A+ Graded
Section 1: Antidepressants (SSRIs, SNRIs, TCAs, MAOIs, Atypicals) (Questions 1-20)
Q1: A patient with major depressive disorder is started on fluoxetine. The nurse practitioner
educates the patient that if they need to switch to a Monoamine Oxidase Inhibitor (MAOI), they
must wait a specific amount of time after stopping fluoxetine to prevent serotonin syndrome.
How long must the patient wait?
A. 2 weeks
B. 5 weeks
C. 48 hours
D. 3 days
B. 5 weeks [CORRECT]
Correct Answer: B
Rationale: Fluoxetine and its active metabolite norfluoxetine have very long half-lives (up to 15
days). To prevent serotonin syndrome when switching to an MAOI, a washout period of 5 weeks
is required compared to the standard 2 weeks for other antidepressants.
Q2: Which of the following antidepressants is most associated with dose-dependent hypertension
due to its effects on norepinephrine reuptake inhibition at higher doses?
A. Sertraline
B. Venlafaxine
C. Mirtazapine
D. Escitalopram
B. Venlafaxine [CORRECT]
Correct Answer: B
,2
Rationale: Venlafaxine acts as an SSRI at lower doses (<150 mg/day) but gains significant
norepinephrine reuptake inhibition (SNRI properties) at higher doses (>150 mg/day), which can
lead to dose-dependent hypertension.
Q3: A patient presents with complaints of dry mouth, constipation, urinary retention, and blurred
vision. The nurse practitioner recognizes these are classic anticholinergic side effects associated
with which class of antidepressants?
A. Selective Serotonin Reuptake Inhibitors (SSRIs)
B. Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
C. Tricyclic Antidepressants (TCAs)
D. Atypical Antipsychotics
C. Tricyclic Antidepressants (TCAs) [CORRECT]
Correct Answer: C
Rationale: TCAs block histamine H1, alpha-1 adrenergic, and muscarinic acetylcholine
receptors. Anticholinergic side effects (dry mouth, constipation, urinary retention, blurred vision)
are hallmark adverse effects of this class.
Q4: A patient with treatment-resistant depression is prescribed phenelzine, an MAOI. The nurse
practitioner provides critical dietary education to avoid hypertensive crisis. Which food
combination should the patient strictly avoid?
A. Fresh leafy green vegetables and citrus fruits
B. Aged cheese and red wine
C. Grilled chicken and white rice
D. Whole grain bread and oatmeal
B. Aged cheese and red wine [CORRECT]
Correct Answer: B
Rationale: Aged cheeses, cured meats, fermented foods, and red/beer wine contain high levels of
tyramine. In patients taking MAOIs, tyramine cannot be metabolized, leading to a hypertensive
crisis characterized by severe headache, hypertension, and risk of intracranial hemorrhage.
,3
Q5: Which antidepressant is contraindicated in patients with a history of seizure disorders or
bulimia nervosa due to a lowered seizure threshold?
A. Paroxetine
B. Bupropion
C. Duloxetine
D. Mirtazapine
B. Bupropion [CORRECT]
Correct Answer: B
Rationale: Bupropion (an NDRI) lowers the seizure threshold in a dose-dependent manner. It is
contraindicated in patients with a history of seizures or eating disorders (bulimia/anorexia) which
may predispose them to electrolyte imbalances and seizures.
Q6: A patient with depression complains of significant insomnia and weight loss. The nurse
practitioner considers which antidepressant that has sedative and appetite-stimulating properties
due to potent histamine H1 blockade?
A. Bupropion
B. Mirtazapine
C. Venlafaxine
D. Fluoxetine
B. Mirtazapine [CORRECT]
Correct Answer: B
Rationale: Mirtazapine is a potent antagonist of histamine H1 receptors, causing sedation and
increased appetite. It is often chosen for patients with depression who suffer from insomnia and
weight loss.
Q7: A patient taking an SSRI reports sexual dysfunction, including delayed ejaculation and
anorgasmia. The nurse practitioner explains that this is caused by increased serotonin stimulation
at which receptor subtype?
A. 5-HT1A
B. 5-HT2A
, 4
C. 5-HT2C
D. 5-HT3
C. 5-HT2C [CORRECT]
Correct Answer: C
Rationale: While the exact mechanism is complex, increased serotonin stimulation, particularly
at 5-HT2C receptors, is strongly implicated in SSRI-induced sexual dysfunction. Bupropion is
often added or switched because it lacks significant serotonergic activity.
Q8: Which TCA is primarily FDA-approved for the treatment of Obsessive-Compulsive Disorder
(OCD) rather than depression?
A. Amitriptyline
B. Nortriptyline
C. Clomipramine
D. Imipramine
C. Clomipramine [CORRECT]
Correct Answer: C
Rationale: Clomipramine is a TCA that is highly serotonergic and is FDA-approved specifically
for OCD. It is often used when SSRIs fail, though it carries a higher burden of anticholinergic
side effects.
Q9: The nurse practitioner is treating a patient with depression who also has chronic diabetic
neuropathy. Which SNRI is FDA-approved for both conditions?
A. Desvenlafaxine
B. Levomilnacipran
C. Duloxetine
D. Venlafaxine
C. Duloxetine [CORRECT]
Correct Answer: C
