NR-607 Final Exam Reviewer
Final Exam Questions and Correct Answers
Academic Cycle
Chamberlain University
Psychiatric Mental Health Nurse Practitioner (PMHNP)
100 Questions | Rated 100% | Guaranteed Pass
Verified Solutions | Graded A+
,Table of Contents
Section 1: Advanced Psychopharmacology – Antidepressants (Q1–Q10)
Section 2: Advanced Psychopharmacology – Antipsychotics & Mood Stabilizers (Q11–Q22)
Section 3: Advanced Psychopharmacology – Anxiolytics, Stimulants & Other Agents (Q23–Q32)
Section 4: DSM-5-TR Diagnostic Criteria – Mood & Anxiety Disorders (Q33–Q42)
Section 5: DSM-5-TR Diagnostic Criteria – Psychotic, Trauma & OCD Spectrum (Q43–Q50)
, Section 1: Advanced Psychopharmacology – Antidepressants (Q1–Q10)
1. What is the primary mechanism of action of selective serotonin reuptake inhibitors
(SSRIs)?
A) Block the serotonin transporter (SERT), increasing synaptic serotonin levels
B) Block the norepinephrine transporter, increasing synaptic norepinephrine levels
C) Inhibit monoamine oxidase enzyme, preventing serotonin degradation
D) Act as direct agonists at postsynaptic 5-HT1A receptors
Rationale: SSRIs selectively inhibit the serotonin transporter (SERT), increasing serotonin
availability in the synaptic cleft. This mechanism underlies their first-line status for MDD and GAD
per APA practice guidelines. Unlike MAOIs, SSRIs do not require dietary restrictions.
2. A 35-year-old patient with major depressive disorder is prescribed sertraline (Zoloft).
What is the recommended starting dose, and what FDA black box warning must the
PMHNP discuss?
A) Start 50 mg/day; warn about increased risk of suicidal thoughts and behaviors in
patients under age 25
B) Start 25 mg/day; warn about risk of serotonin syndrome
C) Start 100 mg/day; warn about QTc prolongation
D) Start 200 mg/day; warn about hepatic failure
Rationale: Sertraline is typically initiated at 50 mg/day. The FDA black box warning for all
antidepressants mandates counseling patients under 25 about increased suicidality risk.
Monitoring for clinical worsening in the first 1–2 months is a PMHNP standard of care.
3. Which of the following is a serotonin-norepinephrine reuptake inhibitor (SNRI)
indicated for both major depressive disorder and diabetic peripheral neuropathic pain?
A) Duloxetine (Cymbalta)
B) Fluoxetine (Prozac)
C) Mirtazapine (Remeron)
D) Bupropion (Wellbutrin)
Rationale: Duloxetine is an SNRI that inhibits both serotonin and norepinephrine reuptake. It is
FDA-approved for MDD, GAD, and diabetic peripheral neuropathic pain, making it versatile in
PMHNP practice. Venlafaxine is another SNRI but is not specifically indicated for neuropathic
pain.
4. A PMHNP is considering prescribing venlafaxine (Effexor XR). At what dose does
venlafaxine begin to significantly inhibit norepinephrine reuptake in addition to
serotonin?
A) Greater than 150 mg/day
B) Greater than 75 mg/day
C) Greater than 225 mg/day
D) At any dose including 37.5 mg/day
Rationale: Venlafaxine has dose-dependent neurotransmitter effects: it primarily inhibits serotonin
reuptake at low doses (< 150 mg/day) and gains significant norepinephrine reuptake inhibition
above 150 mg/day. At very high doses (> 300 mg/day), it also weakly inhibits dopamine reuptake.
This dose-response relationship is critical for PMHNP prescribing decisions.
5. Which tricyclic antidepressant (TCA) is considered the most lethal in overdose due to
sodium channel blockade, leading to cardiac arrhythmias?
A) Amitriptyline
B) Nortriptyline
C) Desipramine
D) Imipramine
Final Exam Questions and Correct Answers
Academic Cycle
Chamberlain University
Psychiatric Mental Health Nurse Practitioner (PMHNP)
100 Questions | Rated 100% | Guaranteed Pass
Verified Solutions | Graded A+
,Table of Contents
Section 1: Advanced Psychopharmacology – Antidepressants (Q1–Q10)
Section 2: Advanced Psychopharmacology – Antipsychotics & Mood Stabilizers (Q11–Q22)
Section 3: Advanced Psychopharmacology – Anxiolytics, Stimulants & Other Agents (Q23–Q32)
Section 4: DSM-5-TR Diagnostic Criteria – Mood & Anxiety Disorders (Q33–Q42)
Section 5: DSM-5-TR Diagnostic Criteria – Psychotic, Trauma & OCD Spectrum (Q43–Q50)
, Section 1: Advanced Psychopharmacology – Antidepressants (Q1–Q10)
1. What is the primary mechanism of action of selective serotonin reuptake inhibitors
(SSRIs)?
A) Block the serotonin transporter (SERT), increasing synaptic serotonin levels
B) Block the norepinephrine transporter, increasing synaptic norepinephrine levels
C) Inhibit monoamine oxidase enzyme, preventing serotonin degradation
D) Act as direct agonists at postsynaptic 5-HT1A receptors
Rationale: SSRIs selectively inhibit the serotonin transporter (SERT), increasing serotonin
availability in the synaptic cleft. This mechanism underlies their first-line status for MDD and GAD
per APA practice guidelines. Unlike MAOIs, SSRIs do not require dietary restrictions.
2. A 35-year-old patient with major depressive disorder is prescribed sertraline (Zoloft).
What is the recommended starting dose, and what FDA black box warning must the
PMHNP discuss?
A) Start 50 mg/day; warn about increased risk of suicidal thoughts and behaviors in
patients under age 25
B) Start 25 mg/day; warn about risk of serotonin syndrome
C) Start 100 mg/day; warn about QTc prolongation
D) Start 200 mg/day; warn about hepatic failure
Rationale: Sertraline is typically initiated at 50 mg/day. The FDA black box warning for all
antidepressants mandates counseling patients under 25 about increased suicidality risk.
Monitoring for clinical worsening in the first 1–2 months is a PMHNP standard of care.
3. Which of the following is a serotonin-norepinephrine reuptake inhibitor (SNRI)
indicated for both major depressive disorder and diabetic peripheral neuropathic pain?
A) Duloxetine (Cymbalta)
B) Fluoxetine (Prozac)
C) Mirtazapine (Remeron)
D) Bupropion (Wellbutrin)
Rationale: Duloxetine is an SNRI that inhibits both serotonin and norepinephrine reuptake. It is
FDA-approved for MDD, GAD, and diabetic peripheral neuropathic pain, making it versatile in
PMHNP practice. Venlafaxine is another SNRI but is not specifically indicated for neuropathic
pain.
4. A PMHNP is considering prescribing venlafaxine (Effexor XR). At what dose does
venlafaxine begin to significantly inhibit norepinephrine reuptake in addition to
serotonin?
A) Greater than 150 mg/day
B) Greater than 75 mg/day
C) Greater than 225 mg/day
D) At any dose including 37.5 mg/day
Rationale: Venlafaxine has dose-dependent neurotransmitter effects: it primarily inhibits serotonin
reuptake at low doses (< 150 mg/day) and gains significant norepinephrine reuptake inhibition
above 150 mg/day. At very high doses (> 300 mg/day), it also weakly inhibits dopamine reuptake.
This dose-response relationship is critical for PMHNP prescribing decisions.
5. Which tricyclic antidepressant (TCA) is considered the most lethal in overdose due to
sodium channel blockade, leading to cardiac arrhythmias?
A) Amitriptyline
B) Nortriptyline
C) Desipramine
D) Imipramine
