PSYCHOPHARMACOLOGY EXAM ACTUAL EXAM 2026/2027 | MOST TESTED |
200-QUESTION FOCUSED REVIEW & PMHNP CORE CURRICULUM | VERIFIED
ANSWERS & RATIONALES | PASS GUARANTEED - GRADED A+
INSTRUCTIONS:
This exam contains 200 multiple-choice questions focused on Psychopharmacology
Select the best answer for each question
Answers and rationales are provided after each question
Time suggested: 3 hours (180 minutes)
Q1. A patient with major depressive disorder is started on sertraline. The most common initial side effect is:
A) Weight gain
B) Sexual dysfunction
C) Nausea
D) Insomnia
Answer: C
Rationale: Nausea is the most common initial side effect of SSRIs (20-30%), usually resolving within 1-2
weeks. Weight gain and sexual dysfunction are later-onset side effects.
Q2. The therapeutic serum level range for lithium in acute mania is:
A) 0.4-0.6 mEq/L
B) 0.6-0.8 mEq/L
C) 0.8-1.2 mEq/L
, PSYCHOPHARMACOLOGY EXAM ACTUAL EXAM 2026/2027 | MOST TESTED |
200-QUESTION FOCUSED REVIEW & PMHNP CORE CURRICULUM | VERIFIED
ANSWERS & RATIONALES | PASS GUARANTEED - GRADED A+
D) 1.2-1.5 mEq/L
Answer: C
Rationale: Lithium level for acute mania is 0.8-1.2 mEq/L. For maintenance, the range is 0.6-0.8 mEq/L.
Q3. Which SSRI has the highest risk of drug-drug interactions due to CYP450 inhibition?
A) Sertraline
B) Escitalopram
C) Fluoxetine
D) Citalopram
Answer: C
Rationale: Fluoxetine (and paroxetine) are strong CYP2D6 inhibitors, causing many drug interactions.
Sertraline and citalopram/escitalopram have fewer interactions.
Q4. A patient on phenelzine (MAOI) must avoid which of the following foods to prevent hypertensive crisis?
A) Grapefruit
B) Aged cheese, cured meats, red wine
C) Bananas
D) Chocolate
Answer: B
, PSYCHOPHARMACOLOGY EXAM ACTUAL EXAM 2026/2027 | MOST TESTED |
200-QUESTION FOCUSED REVIEW & PMHNP CORE CURRICULUM | VERIFIED
ANSWERS & RATIONALES | PASS GUARANTEED - GRADED A+
Rationale: Tyramine-rich foods (aged cheese, cured meats, fermented foods, red wine, fava beans, yeast
extracts) can cause hypertensive crisis with MAOIs.
Q5. The starting dose of donepezil for Alzheimer's disease is:
A) 2.5 mg daily
B) 5 mg daily
C) 10 mg daily
D) 5 mg BID
Answer: B
Rationale: Donepezil is started at 5 mg daily, increased to 10 mg after 4-6 weeks.
Q6. A patient on clozapine develops fever, muscle rigidity, and elevated creatine kinase. What is the most
likely diagnosis?
A) Serotonin syndrome
B) Neuroleptic malignant syndrome (NMS)
C) Tardive dyskinesia
D) EPS
Answer: B
Rationale: NMS triad: fever, rigidity, autonomic instability + elevated CK. Stop antipsychotic immediately.
Q7. Which antipsychotic is most likely to cause significant weight gain and metabolic syndrome?
, PSYCHOPHARMACOLOGY EXAM ACTUAL EXAM 2026/2027 | MOST TESTED |
200-QUESTION FOCUSED REVIEW & PMHNP CORE CURRICULUM | VERIFIED
ANSWERS & RATIONALES | PASS GUARANTEED - GRADED A+
A) Aripiprazole
B) Ziprasidone
C) Olanzapine
D) Lurasidone
Answer: C
Rationale: Olanzapine (and clozapine) have the highest metabolic side effects (weight gain, diabetes,
dyslipidemia).
Q8. A patient with generalized anxiety disorder is started on buspirone. How long does buspirone take to
reach therapeutic effect?
A) 1-3 days
B) 1-2 weeks
C) 2-4 weeks
D) 6-8 weeks
Answer: C
Rationale: Buspirone takes 2-4 weeks to reach therapeutic effect. It is not effective for acute anxiety.
Q9. The primary mechanism of action of memantine is:
A) Acetylcholinesterase inhibition
B) NMDA receptor antagonism
200-QUESTION FOCUSED REVIEW & PMHNP CORE CURRICULUM | VERIFIED
ANSWERS & RATIONALES | PASS GUARANTEED - GRADED A+
INSTRUCTIONS:
This exam contains 200 multiple-choice questions focused on Psychopharmacology
Select the best answer for each question
Answers and rationales are provided after each question
Time suggested: 3 hours (180 minutes)
Q1. A patient with major depressive disorder is started on sertraline. The most common initial side effect is:
A) Weight gain
B) Sexual dysfunction
C) Nausea
D) Insomnia
Answer: C
Rationale: Nausea is the most common initial side effect of SSRIs (20-30%), usually resolving within 1-2
weeks. Weight gain and sexual dysfunction are later-onset side effects.
Q2. The therapeutic serum level range for lithium in acute mania is:
A) 0.4-0.6 mEq/L
B) 0.6-0.8 mEq/L
C) 0.8-1.2 mEq/L
, PSYCHOPHARMACOLOGY EXAM ACTUAL EXAM 2026/2027 | MOST TESTED |
200-QUESTION FOCUSED REVIEW & PMHNP CORE CURRICULUM | VERIFIED
ANSWERS & RATIONALES | PASS GUARANTEED - GRADED A+
D) 1.2-1.5 mEq/L
Answer: C
Rationale: Lithium level for acute mania is 0.8-1.2 mEq/L. For maintenance, the range is 0.6-0.8 mEq/L.
Q3. Which SSRI has the highest risk of drug-drug interactions due to CYP450 inhibition?
A) Sertraline
B) Escitalopram
C) Fluoxetine
D) Citalopram
Answer: C
Rationale: Fluoxetine (and paroxetine) are strong CYP2D6 inhibitors, causing many drug interactions.
Sertraline and citalopram/escitalopram have fewer interactions.
Q4. A patient on phenelzine (MAOI) must avoid which of the following foods to prevent hypertensive crisis?
A) Grapefruit
B) Aged cheese, cured meats, red wine
C) Bananas
D) Chocolate
Answer: B
, PSYCHOPHARMACOLOGY EXAM ACTUAL EXAM 2026/2027 | MOST TESTED |
200-QUESTION FOCUSED REVIEW & PMHNP CORE CURRICULUM | VERIFIED
ANSWERS & RATIONALES | PASS GUARANTEED - GRADED A+
Rationale: Tyramine-rich foods (aged cheese, cured meats, fermented foods, red wine, fava beans, yeast
extracts) can cause hypertensive crisis with MAOIs.
Q5. The starting dose of donepezil for Alzheimer's disease is:
A) 2.5 mg daily
B) 5 mg daily
C) 10 mg daily
D) 5 mg BID
Answer: B
Rationale: Donepezil is started at 5 mg daily, increased to 10 mg after 4-6 weeks.
Q6. A patient on clozapine develops fever, muscle rigidity, and elevated creatine kinase. What is the most
likely diagnosis?
A) Serotonin syndrome
B) Neuroleptic malignant syndrome (NMS)
C) Tardive dyskinesia
D) EPS
Answer: B
Rationale: NMS triad: fever, rigidity, autonomic instability + elevated CK. Stop antipsychotic immediately.
Q7. Which antipsychotic is most likely to cause significant weight gain and metabolic syndrome?
, PSYCHOPHARMACOLOGY EXAM ACTUAL EXAM 2026/2027 | MOST TESTED |
200-QUESTION FOCUSED REVIEW & PMHNP CORE CURRICULUM | VERIFIED
ANSWERS & RATIONALES | PASS GUARANTEED - GRADED A+
A) Aripiprazole
B) Ziprasidone
C) Olanzapine
D) Lurasidone
Answer: C
Rationale: Olanzapine (and clozapine) have the highest metabolic side effects (weight gain, diabetes,
dyslipidemia).
Q8. A patient with generalized anxiety disorder is started on buspirone. How long does buspirone take to
reach therapeutic effect?
A) 1-3 days
B) 1-2 weeks
C) 2-4 weeks
D) 6-8 weeks
Answer: C
Rationale: Buspirone takes 2-4 weeks to reach therapeutic effect. It is not effective for acute anxiety.
Q9. The primary mechanism of action of memantine is:
A) Acetylcholinesterase inhibition
B) NMDA receptor antagonism
