NR546: Final Comprehensive Exam
2026/2027 |Newly Released
Advanced Pharmacology for Psychiatric
Mental Health Nurse Practitioners
Chamberlain University
75 Questions with answers and detailled Rationale
Q1: Which neurobiological concept explains why the episodes of Bipolar Disorder often
increase in frequency and severity over time if left untreated?
A. The dopamine hypothesis
B. The kindling hypothesis
C. The glutamate surge theory
D. The serotonin depletion model
Correct Answer: B
Rationale: Correct because the kindling hypothesis suggests that repeated neuronal
firing (episodes of mood disturbance) lowers the threshold for future episodes, leading
to increased cycle frequency and severity, often necessitating mood stabilizer
maintenance.
Q2: A 25-year-old female presents with symptoms of GAD. She is concerned about
weight gain and sedation. Which medication is a non-benzodiazepine anxiolytic that
lacks these side effects?
A. Lorazepam
B. Hydroxyzine
C. Buspirone
D. Mirtazapine
,Correct Answer: C
Rationale: Correct because buspirone is a partial 5-HT1A agonist that treats anxiety
without causing significant sedation, weight gain, or physical dependence associated
with benzodiazepines or sedating antidepressants.
Q3: A patient with schizophrenia is currently on a high-potency first-generation
antipsychotic. He presents with pill-rolling tremor, shuffling gait, and mask-like facies.
The PMHNP recognizes these as symptoms of:
A. Acute dystonia
B. Drug-induced parkinsonism
C. Akathisia
D. Tardive dyskinesia
Correct Answer: B
Rationale: Correct because drug-induced parkinsonism results from nigrostriatal
dopamine blockade and mimics idiopathic Parkinson's disease with bradykinesia,
rigidity, and resting tremor.
Q4: A patient with depression wants to avoid sexual dysfunction but has a history of a
seizure disorder. Which antidepressant is contraindicated?
A. Sertraline
B. Mirtazapine
C. Bupropion
D. Duloxetine
Correct Answer: C
Rationale: Correct because bupropion lowers the seizure threshold and is
contraindicated in patients with a history of seizure disorders or eating disorders.
, Q5: What is the primary mechanism of action of carbamazepine in the treatment of
Bipolar Disorder?
A. Inhibition of GABA transaminase
B. Blockade of voltage-gated sodium channels
C. Potentiation of serotonin 5-HT1A receptors
D. Inhibition of phosphodiesterase
Correct Answer: B
Rationale: Correct because carbamazepine stabilizes neuronal membranes by blocking
voltage-gated sodium channels, which reduces the repetitive firing of neurons and helps
stabilize mood.
Q6: Which stimulant formulation is a prodrug that requires conversion in the gut to
active d-amphetamine, providing a long duration of effect and lower abuse potential?
A. Methylphenidate HCl
B. Lisdexamfetamine (Vyvanse)
C. Mixed amphetamine salts (Adderall)
D. Dexmethylphenidate (Focalin)
Correct Answer: B
Rationale: Correct because lisdexamfetamine is an inactive prodrug covalently linked
to the amino acid lysine; it is converted to active d-amphetamine only after enzymatic
cleavage in the gastrointestinal tract, reducing intravenous abuse potential.
Q7: A patient with Alcohol Use Disorder is prescribed disulfiram. The PMHNP must
warn the patient to avoid which product due to its alcohol content?
A. Soy sauce
B. Mouthwash
C. Aged cheeses
D. Caffeinated beverages
Correct Answer: B
2026/2027 |Newly Released
Advanced Pharmacology for Psychiatric
Mental Health Nurse Practitioners
Chamberlain University
75 Questions with answers and detailled Rationale
Q1: Which neurobiological concept explains why the episodes of Bipolar Disorder often
increase in frequency and severity over time if left untreated?
A. The dopamine hypothesis
B. The kindling hypothesis
C. The glutamate surge theory
D. The serotonin depletion model
Correct Answer: B
Rationale: Correct because the kindling hypothesis suggests that repeated neuronal
firing (episodes of mood disturbance) lowers the threshold for future episodes, leading
to increased cycle frequency and severity, often necessitating mood stabilizer
maintenance.
Q2: A 25-year-old female presents with symptoms of GAD. She is concerned about
weight gain and sedation. Which medication is a non-benzodiazepine anxiolytic that
lacks these side effects?
A. Lorazepam
B. Hydroxyzine
C. Buspirone
D. Mirtazapine
,Correct Answer: C
Rationale: Correct because buspirone is a partial 5-HT1A agonist that treats anxiety
without causing significant sedation, weight gain, or physical dependence associated
with benzodiazepines or sedating antidepressants.
Q3: A patient with schizophrenia is currently on a high-potency first-generation
antipsychotic. He presents with pill-rolling tremor, shuffling gait, and mask-like facies.
The PMHNP recognizes these as symptoms of:
A. Acute dystonia
B. Drug-induced parkinsonism
C. Akathisia
D. Tardive dyskinesia
Correct Answer: B
Rationale: Correct because drug-induced parkinsonism results from nigrostriatal
dopamine blockade and mimics idiopathic Parkinson's disease with bradykinesia,
rigidity, and resting tremor.
Q4: A patient with depression wants to avoid sexual dysfunction but has a history of a
seizure disorder. Which antidepressant is contraindicated?
A. Sertraline
B. Mirtazapine
C. Bupropion
D. Duloxetine
Correct Answer: C
Rationale: Correct because bupropion lowers the seizure threshold and is
contraindicated in patients with a history of seizure disorders or eating disorders.
, Q5: What is the primary mechanism of action of carbamazepine in the treatment of
Bipolar Disorder?
A. Inhibition of GABA transaminase
B. Blockade of voltage-gated sodium channels
C. Potentiation of serotonin 5-HT1A receptors
D. Inhibition of phosphodiesterase
Correct Answer: B
Rationale: Correct because carbamazepine stabilizes neuronal membranes by blocking
voltage-gated sodium channels, which reduces the repetitive firing of neurons and helps
stabilize mood.
Q6: Which stimulant formulation is a prodrug that requires conversion in the gut to
active d-amphetamine, providing a long duration of effect and lower abuse potential?
A. Methylphenidate HCl
B. Lisdexamfetamine (Vyvanse)
C. Mixed amphetamine salts (Adderall)
D. Dexmethylphenidate (Focalin)
Correct Answer: B
Rationale: Correct because lisdexamfetamine is an inactive prodrug covalently linked
to the amino acid lysine; it is converted to active d-amphetamine only after enzymatic
cleavage in the gastrointestinal tract, reducing intravenous abuse potential.
Q7: A patient with Alcohol Use Disorder is prescribed disulfiram. The PMHNP must
warn the patient to avoid which product due to its alcohol content?
A. Soy sauce
B. Mouthwash
C. Aged cheeses
D. Caffeinated beverages
Correct Answer: B
