NRNP 6675 Final Exam 2026 PMHNP Questions & Verified Answers
Psychiatric Nursing Review.
1–10: Basic Neurobiology & Neurotransmitters
Which neurotransmitter is primarily implicated in the rewarding effects of
substances like cocaine and amphetamines?
a) Serotonin
b) Norepinephrine
c) Dopamine
d) GABA
Answer: c) Dopamine
Rationale: Dopamine release in the mesolimbic pathway mediates reward and
reinforcement.
The therapeutic action of SSRIs is most directly related to:
a) Blocking dopamine receptors
b) Increasing synaptic availability of serotonin
c) Enhancing GABA activity
d) Inhibiting norepinephrine reuptake
Answer: b) Increasing synaptic availability of serotonin
,Rationale: SSRIs selectively block the serotonin transporter, raising extracellular
serotonin.
A patient on long‑term benzodiazepines develops tolerance. This is primarily due
to:
a) Upregulation of GABA receptors
b) Downregulation of GABA receptors and altered subunit composition
c) Increased serotonin synthesis
d) Dopamine supersensitivity
Answer: b) Downregulation of GABA receptors and altered subunit composition
Rationale: Chronic benzodiazepine use leads to receptor desensitization, reducing
efficacy.
Which receptor is the primary target of typical antipsychotics for treating positive
symptoms?
a) 5‑HT2A
b) D2
c) D1
d) H1
Answer: b) D2
,Rationale: Typical antipsychotics are potent D2 antagonists; this correlates with
their antipsychotic effect.
Which medication is an antagonist at the NMDA receptor and may cause
dissociative symptoms?
a) Ketamine
b) Fluoxetine
c) Naltrexone
d) Donepezil
Answer: a) Ketamine
Rationale: Ketamine blocks NMDA receptors, leading to rapid antidepressant
effects but also dissociation.
The "kindling" model helps explain:
a) Antidepressant response delay
b) Seizure threshold reduction with repeated subthreshold stimuli
c) Tolerance to opioids
d) Lithium’s mechanism in bipolar disorder
Answer: b) Seizure threshold reduction with repeated subthreshold stimuli
, Rationale: Kindling is used to model seizure disorders and bipolar mood episode
recurrence.
Which neuropeptide is strongly associated with the stress response and anxiety
regulation?
a) Oxytocin
b) Corticotropin‑releasing factor (CRF)
c) Neuropeptide Y
d) Substance P
Answer: b) Corticotropin‑releasing factor (CRF)
Rationale: CRF activates the HPA axis and is involved in anxiety and mood
disorders.
The enzyme monoamine oxidase (MAO) is responsible for:
a) Breaking down catecholamines and serotonin
b) Synthesizing dopamine
c) Transporting GABA into vesicles
d) Metabolizing acetylcholine
Answer: a) Breaking down catecholamines and serotonin
Psychiatric Nursing Review.
1–10: Basic Neurobiology & Neurotransmitters
Which neurotransmitter is primarily implicated in the rewarding effects of
substances like cocaine and amphetamines?
a) Serotonin
b) Norepinephrine
c) Dopamine
d) GABA
Answer: c) Dopamine
Rationale: Dopamine release in the mesolimbic pathway mediates reward and
reinforcement.
The therapeutic action of SSRIs is most directly related to:
a) Blocking dopamine receptors
b) Increasing synaptic availability of serotonin
c) Enhancing GABA activity
d) Inhibiting norepinephrine reuptake
Answer: b) Increasing synaptic availability of serotonin
,Rationale: SSRIs selectively block the serotonin transporter, raising extracellular
serotonin.
A patient on long‑term benzodiazepines develops tolerance. This is primarily due
to:
a) Upregulation of GABA receptors
b) Downregulation of GABA receptors and altered subunit composition
c) Increased serotonin synthesis
d) Dopamine supersensitivity
Answer: b) Downregulation of GABA receptors and altered subunit composition
Rationale: Chronic benzodiazepine use leads to receptor desensitization, reducing
efficacy.
Which receptor is the primary target of typical antipsychotics for treating positive
symptoms?
a) 5‑HT2A
b) D2
c) D1
d) H1
Answer: b) D2
,Rationale: Typical antipsychotics are potent D2 antagonists; this correlates with
their antipsychotic effect.
Which medication is an antagonist at the NMDA receptor and may cause
dissociative symptoms?
a) Ketamine
b) Fluoxetine
c) Naltrexone
d) Donepezil
Answer: a) Ketamine
Rationale: Ketamine blocks NMDA receptors, leading to rapid antidepressant
effects but also dissociation.
The "kindling" model helps explain:
a) Antidepressant response delay
b) Seizure threshold reduction with repeated subthreshold stimuli
c) Tolerance to opioids
d) Lithium’s mechanism in bipolar disorder
Answer: b) Seizure threshold reduction with repeated subthreshold stimuli
, Rationale: Kindling is used to model seizure disorders and bipolar mood episode
recurrence.
Which neuropeptide is strongly associated with the stress response and anxiety
regulation?
a) Oxytocin
b) Corticotropin‑releasing factor (CRF)
c) Neuropeptide Y
d) Substance P
Answer: b) Corticotropin‑releasing factor (CRF)
Rationale: CRF activates the HPA axis and is involved in anxiety and mood
disorders.
The enzyme monoamine oxidase (MAO) is responsible for:
a) Breaking down catecholamines and serotonin
b) Synthesizing dopamine
c) Transporting GABA into vesicles
d) Metabolizing acetylcholine
Answer: a) Breaking down catecholamines and serotonin
