NR547 / NR 547 PMHNP MIDTERM & FINAL
EXAM Questions and Correct Answers with
Rationales | Reliable for A+ Grade
1. Which neurotransmitter is primarily implicated in depression?
A. Dopamine
B. Serotonin
C. Acetylcholine
D. Glutamate
Rationale: Serotonin regulates mood, appetite, and sleep; deficiency is strongly
linked to major depressive disorder. SSRIs increase serotonin availability.
2. First-line pharmacologic treatment for generalized anxiety disorder (GAD)?
A. Benzodiazepine
B. SSRI
C. MAOI
D. TCA
Rationale: SSRIs (e.g., sertraline, escitalopram) provide long-term symptom
control with a favorable side effect profile and are safer than benzodiazepines,
which have dependence risk.
3. Which symptom is considered a positive symptom in schizophrenia?
A. Flat affect
B. Hallucinations
C. Social withdrawal
D. Anhedonia
Rationale: Positive symptoms represent an excess or distortion of normal
functions (hallucinations, delusions, disorganized speech). Negative symptoms
include flat affect, anhedonia, and social withdrawal.
,4. Preferred treatment for acute mania in bipolar disorder?
A. Lithium
B. SSRI
C. TCA
D. Benzodiazepine
Rationale: Lithium is first-line for acute mania and maintenance in bipolar
disorder. It reduces manic episodes and suicide risk.
5. Which assessment tool is used to screen for dementia?
A. PHQ-9
B. MMSE (Mini-Mental State Exam)
C. GAD-7
D. CAGE
Rationale: MMSE assesses orientation, registration, attention, recall, and
language. It is widely used to screen for cognitive impairment and dementia.
6. Most common side effect of SSRIs?
A. Weight loss
B. Nausea
C. Hypertension
D. Bradycardia
Rationale: Nausea and gastrointestinal upset are the most common initial side
effects of SSRIs, usually resolving within 1-2 weeks.
7. First-line treatment for acute PTSD symptoms?
A. Benzodiazepine
B. SSRI
C. Antipsychotic
D. Lithium
,Rationale: SSRIs (sertraline, paroxetine) are FDA-approved for PTSD and reduce
re-experiencing, hyperarousal, and avoidance symptoms. Benzodiazepines are not
recommended.
8. Which lab value is critical to monitor in a patient taking lithium?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Rationale: Low sodium levels increase lithium reabsorption in the kidneys, raising
risk of toxicity. Monitor serum sodium and lithium levels regularly.
9. Preferred therapy for opioid use disorder?
A. Methadone
B. Diazepam
C. Haloperidol
D. Bupropion
Rationale: Methadone, buprenorphine, and naltrexone are first-line. Methadone
reduces cravings and withdrawal symptoms safely when administered in OTPs.
10. Which therapy is most effective for borderline personality disorder?
A. Cognitive behavioral therapy
B. Dialectical behavior therapy (DBT)
C. Psychoanalysis
D. Electroconvulsive therapy
Rationale: DBT, developed by Linehan, specifically targets emotional
dysregulation, interpersonal conflicts, and self-harm behaviors in BPD.
11. Which neurotransmitter is primarily implicated in schizophrenia?
, A. Serotonin
B. Dopamine
C. Acetylcholine
D. GABA
Rationale: The dopamine hypothesis suggests that overactivity of dopamine in
mesolimbic pathways contributes to positive symptoms of schizophrenia.
12. First-line pharmacologic treatment for OCD?
A. SSRI
B. MAOI
C. Benzodiazepine
D. Lithium
Rationale: High-dose SSRIs (fluoxetine, fluvoxamine, sertraline) are first-line for
OCD, often in combination with exposure and response prevention (ERP) therapy.
13. Which medication is associated with risk of agranulocytosis?
A. Lithium
B. Valproate
C. Clozapine
D. Quetiapine
Rationale: Clozapine carries a 0.5-2% risk of agranulocytosis, requiring regular
absolute neutrophil count (ANC) monitoring through the REMS program.
14. First-line treatment for panic disorder?
A. Benzodiazepine as monotherapy
B. SSRI or SNRI
C. Antipsychotic
D. Mood stabilizer
Rationale: SSRIs (escitalopram, paroxetine) and SNRIs (venlafaxine) are first-line
for panic disorder with or without agoraphobia.
EXAM Questions and Correct Answers with
Rationales | Reliable for A+ Grade
1. Which neurotransmitter is primarily implicated in depression?
A. Dopamine
B. Serotonin
C. Acetylcholine
D. Glutamate
Rationale: Serotonin regulates mood, appetite, and sleep; deficiency is strongly
linked to major depressive disorder. SSRIs increase serotonin availability.
2. First-line pharmacologic treatment for generalized anxiety disorder (GAD)?
A. Benzodiazepine
B. SSRI
C. MAOI
D. TCA
Rationale: SSRIs (e.g., sertraline, escitalopram) provide long-term symptom
control with a favorable side effect profile and are safer than benzodiazepines,
which have dependence risk.
3. Which symptom is considered a positive symptom in schizophrenia?
A. Flat affect
B. Hallucinations
C. Social withdrawal
D. Anhedonia
Rationale: Positive symptoms represent an excess or distortion of normal
functions (hallucinations, delusions, disorganized speech). Negative symptoms
include flat affect, anhedonia, and social withdrawal.
,4. Preferred treatment for acute mania in bipolar disorder?
A. Lithium
B. SSRI
C. TCA
D. Benzodiazepine
Rationale: Lithium is first-line for acute mania and maintenance in bipolar
disorder. It reduces manic episodes and suicide risk.
5. Which assessment tool is used to screen for dementia?
A. PHQ-9
B. MMSE (Mini-Mental State Exam)
C. GAD-7
D. CAGE
Rationale: MMSE assesses orientation, registration, attention, recall, and
language. It is widely used to screen for cognitive impairment and dementia.
6. Most common side effect of SSRIs?
A. Weight loss
B. Nausea
C. Hypertension
D. Bradycardia
Rationale: Nausea and gastrointestinal upset are the most common initial side
effects of SSRIs, usually resolving within 1-2 weeks.
7. First-line treatment for acute PTSD symptoms?
A. Benzodiazepine
B. SSRI
C. Antipsychotic
D. Lithium
,Rationale: SSRIs (sertraline, paroxetine) are FDA-approved for PTSD and reduce
re-experiencing, hyperarousal, and avoidance symptoms. Benzodiazepines are not
recommended.
8. Which lab value is critical to monitor in a patient taking lithium?
A. Sodium
B. Potassium
C. Calcium
D. Magnesium
Rationale: Low sodium levels increase lithium reabsorption in the kidneys, raising
risk of toxicity. Monitor serum sodium and lithium levels regularly.
9. Preferred therapy for opioid use disorder?
A. Methadone
B. Diazepam
C. Haloperidol
D. Bupropion
Rationale: Methadone, buprenorphine, and naltrexone are first-line. Methadone
reduces cravings and withdrawal symptoms safely when administered in OTPs.
10. Which therapy is most effective for borderline personality disorder?
A. Cognitive behavioral therapy
B. Dialectical behavior therapy (DBT)
C. Psychoanalysis
D. Electroconvulsive therapy
Rationale: DBT, developed by Linehan, specifically targets emotional
dysregulation, interpersonal conflicts, and self-harm behaviors in BPD.
11. Which neurotransmitter is primarily implicated in schizophrenia?
, A. Serotonin
B. Dopamine
C. Acetylcholine
D. GABA
Rationale: The dopamine hypothesis suggests that overactivity of dopamine in
mesolimbic pathways contributes to positive symptoms of schizophrenia.
12. First-line pharmacologic treatment for OCD?
A. SSRI
B. MAOI
C. Benzodiazepine
D. Lithium
Rationale: High-dose SSRIs (fluoxetine, fluvoxamine, sertraline) are first-line for
OCD, often in combination with exposure and response prevention (ERP) therapy.
13. Which medication is associated with risk of agranulocytosis?
A. Lithium
B. Valproate
C. Clozapine
D. Quetiapine
Rationale: Clozapine carries a 0.5-2% risk of agranulocytosis, requiring regular
absolute neutrophil count (ANC) monitoring through the REMS program.
14. First-line treatment for panic disorder?
A. Benzodiazepine as monotherapy
B. SSRI or SNRI
C. Antipsychotic
D. Mood stabilizer
Rationale: SSRIs (escitalopram, paroxetine) and SNRIs (venlafaxine) are first-line
for panic disorder with or without agoraphobia.
