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NR546 Final Exam 2025/2026 – Advanced Pathophysiology
and Pharmacology for Nurse Practitioners | 150 Verified
Questions and Correct Answers | Complete Exam
1. Which neurotransmitters are primarily increased by MAOIs?
A. GABA and glutamate
B. Serotonin, dopamine, norepinephrine
C. Acetylcholine only
D. Histamine and glycine
Answer: B
Rationale: MAOIs inhibit breakdown of monoamines, increasing serotonin, dopamine, and
norepinephrine.
2. First-line pharmacologic treatment for major depressive disorder is:
A. MAOIs
B. TCAs
C. SSRIs
D. Antipsychotics
Answer: C
Rationale: SSRIs are first-line due to safety and tolerability.
3. Which SSRI is safest in overdose?
A. Fluoxetine
B. Paroxetine
C. Sertraline
D. Citalopram
Answer: C
Rationale: Sertraline has a wide safety margin and fewer cardiac effects.
4. Which antidepressant is best for a patient with poor medication adherence?
A. Fluoxetine
B. Paroxetine
C. Trazodone
D. Venlafaxine
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Answer: A
Rationale: Fluoxetine has a long half-life, reducing withdrawal risk.
5. Lamotrigine carries a black box warning for:
A. Hepatic failure
B. Stevens-Johnson syndrome
C. Respiratory depression
D. Agranulocytosis
Answer: B
Rationale: Risk of life-threatening skin reactions.
6. Duloxetine acts on which neurotransmitters?
A. Serotonin and dopamine
B. Serotonin and norepinephrine
C. GABA and glutamate
D. Acetylcholine and histamine
Answer: B
Rationale: SNRI increases serotonin and norepinephrine.
7. Best antidepressant for elderly patient with weight loss and poor appetite:
A. Bupropion
B. Mirtazapine
C. Fluoxetine
D. Sertraline
Answer: B
Rationale: Mirtazapine increases appetite and weight gain.
8. Opioid acute adverse effect NOT expected:
A. Sedation
B. Respiratory depression
C. Immunosuppression
D. Constipation
Answer: C
Rationale: Immunosuppression is chronic, not acute.
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9. Citalopram dose is reduced in elderly due to risk of:
A. Seizures
B. QT prolongation
C. Liver toxicity
D. Weight gain
Answer: B
Rationale: Dose-dependent QT prolongation risk.
10. First-line medication class for OCD:
A. Benzodiazepines
B. SSRIs
C. Antipsychotics
D. Mood stabilizers
Answer: B
Rationale: SSRIs are first-line for OCD.
11. Which SSRI has sedating and antihistamine effects?
A. Fluoxetine
B. Sertraline
C. Paroxetine
D. Escitalopram
Answer: C
Rationale: Paroxetine is most sedating.
12. Preferred SSRI in polypharmacy patient:
A. Fluoxetine
B. Paroxetine
C. Escitalopram
D. Fluvoxamine
Answer: C
Rationale: Escitalopram has fewer drug interactions.
13. Best SSRI for anxiety + insomnia:
A. Fluoxetine
B. Paroxetine
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C. Bupropion
D. Venlafaxine
Answer: B
Rationale: Paroxetine is sedating and anxiolytic.
14. TCAs block reuptake of:
A. Dopamine and GABA
B. Serotonin and norepinephrine
C. Acetylcholine only
D. Histamine only
Answer: B
Rationale: TCAs inhibit serotonin and norepinephrine reuptake.
15. Tyramine diet restriction is required for:
A. SSRIs
B. MAOIs
C. TCAs
D. SNRIs
Answer: B
Rationale: Prevent hypertensive crisis.
16. Reward pathway neurotransmitter:
A. Serotonin
B. Dopamine
C. GABA
D. Acetylcholine
Answer: B
Rationale: Dopamine mediates reward and addiction.
17. First-line medication for opioid overdose:
A. Naltrexone
B. Methadone
C. Naloxone
D. Buprenorphine
NR546 Final Exam 2025/2026 – Advanced Pathophysiology
and Pharmacology for Nurse Practitioners | 150 Verified
Questions and Correct Answers | Complete Exam
1. Which neurotransmitters are primarily increased by MAOIs?
A. GABA and glutamate
B. Serotonin, dopamine, norepinephrine
C. Acetylcholine only
D. Histamine and glycine
Answer: B
Rationale: MAOIs inhibit breakdown of monoamines, increasing serotonin, dopamine, and
norepinephrine.
2. First-line pharmacologic treatment for major depressive disorder is:
A. MAOIs
B. TCAs
C. SSRIs
D. Antipsychotics
Answer: C
Rationale: SSRIs are first-line due to safety and tolerability.
3. Which SSRI is safest in overdose?
A. Fluoxetine
B. Paroxetine
C. Sertraline
D. Citalopram
Answer: C
Rationale: Sertraline has a wide safety margin and fewer cardiac effects.
4. Which antidepressant is best for a patient with poor medication adherence?
A. Fluoxetine
B. Paroxetine
C. Trazodone
D. Venlafaxine
,2|Page
Answer: A
Rationale: Fluoxetine has a long half-life, reducing withdrawal risk.
5. Lamotrigine carries a black box warning for:
A. Hepatic failure
B. Stevens-Johnson syndrome
C. Respiratory depression
D. Agranulocytosis
Answer: B
Rationale: Risk of life-threatening skin reactions.
6. Duloxetine acts on which neurotransmitters?
A. Serotonin and dopamine
B. Serotonin and norepinephrine
C. GABA and glutamate
D. Acetylcholine and histamine
Answer: B
Rationale: SNRI increases serotonin and norepinephrine.
7. Best antidepressant for elderly patient with weight loss and poor appetite:
A. Bupropion
B. Mirtazapine
C. Fluoxetine
D. Sertraline
Answer: B
Rationale: Mirtazapine increases appetite and weight gain.
8. Opioid acute adverse effect NOT expected:
A. Sedation
B. Respiratory depression
C. Immunosuppression
D. Constipation
Answer: C
Rationale: Immunosuppression is chronic, not acute.
,3|Page
9. Citalopram dose is reduced in elderly due to risk of:
A. Seizures
B. QT prolongation
C. Liver toxicity
D. Weight gain
Answer: B
Rationale: Dose-dependent QT prolongation risk.
10. First-line medication class for OCD:
A. Benzodiazepines
B. SSRIs
C. Antipsychotics
D. Mood stabilizers
Answer: B
Rationale: SSRIs are first-line for OCD.
11. Which SSRI has sedating and antihistamine effects?
A. Fluoxetine
B. Sertraline
C. Paroxetine
D. Escitalopram
Answer: C
Rationale: Paroxetine is most sedating.
12. Preferred SSRI in polypharmacy patient:
A. Fluoxetine
B. Paroxetine
C. Escitalopram
D. Fluvoxamine
Answer: C
Rationale: Escitalopram has fewer drug interactions.
13. Best SSRI for anxiety + insomnia:
A. Fluoxetine
B. Paroxetine
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C. Bupropion
D. Venlafaxine
Answer: B
Rationale: Paroxetine is sedating and anxiolytic.
14. TCAs block reuptake of:
A. Dopamine and GABA
B. Serotonin and norepinephrine
C. Acetylcholine only
D. Histamine only
Answer: B
Rationale: TCAs inhibit serotonin and norepinephrine reuptake.
15. Tyramine diet restriction is required for:
A. SSRIs
B. MAOIs
C. TCAs
D. SNRIs
Answer: B
Rationale: Prevent hypertensive crisis.
16. Reward pathway neurotransmitter:
A. Serotonin
B. Dopamine
C. GABA
D. Acetylcholine
Answer: B
Rationale: Dopamine mediates reward and addiction.
17. First-line medication for opioid overdose:
A. Naltrexone
B. Methadone
C. Naloxone
D. Buprenorphine
