PSYCHOPHARMACOLOGY (NR-546) FINAL EXAM MCQ EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS AND RATIONALE | LATEST

PSYCHOPHARMACOLOGY (NR-546) FINAL EXAM MCQ EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS AND RATIONALE | LATEST 1. The monoamine hypothesis of depression suggests that depression is associated with: A. Excess serotonin and dopamine B. Deficiency of serotonin, norepinephrine, and dopamine C. Overstimulation of glutamate and GABA receptors D. Low acetylcholine and histamine: The monoamine hypothesis of depression suggests that depression is associated with: A. Excess serotonin and dopamine B. Deficiency of serotonin, norepinephrine, and dopamine C.Overstimulation of glutamate and GABA receptorsD. Low acetylcholine and histamine Rationale: The monoamine hypothesis states that depression results from a deficiency in the monoamine neurotransmitters: serotonin (5-HT), norepinephrine (NE), and dopamine (DA). 2. Before prescribing an SSRI, the most important screening includes: A. Cardiac arrhythmias and kidney function B. Bipolar disorder and suicidal ideation C. Blood pressure and electrolyte levels D. Alcohol use and smoking history: Before prescribing an SSRI, the most important screening includes: A. Cardiac arrhythmias and kidney function B. Bipolar disorder and suicidal ideation C.Blood pressure and electrolyte levelsD. Alcohol use and smoking history Rationale: SSRIs can precipitate mania in patients with bipolar disorder and may increase suicidal thoughts in patients 25. Screening prevents adverse outcomes. 3. Adolescents and young adults under 25 taking SSRIs are at increased risk for: A. QT prolongation B. Suicidal ideation C. Hypertensive crisis D. Manic episodes: Adolescents and young adults under 25 taking SSRIs are at increased risk for: A. QT prolongation B. Suicidal ideation C.Hypertensive crisisD. Manic episodes Rationale: The FDA black box warning highlights increased risk of suicidal thinking/behavior in children, adolescents, and young adults 25. 4. Which SSRI has the least CYP450 interactions and is considered safest in polypharmacy? A. Fluoxetine B. EscitalopramC. Paroxetine D. Fluvoxamine: Which SSRI has the least CYP450 interactions and is considered safest in polypharmacy? A. Fluoxetine B. Escitalopram C. Paroxetine D. Fluvoxamine Rationale: Escitalopram has minimal CYP450 inhibition, making it the SSRI with the fewest drug-drug interactions. 5. Which SSRI has the longest half-life, reducing discontinuation syndrome risk? A. Sertraline B. Fluoxetine C. Paroxetine D. Citalopram: Which SSRI has the longest half-life, reducing discontinuation syndrome risk? A. Sertraline B. Fluoxetine C. Paroxetine D. Citalopram Rationale: Fluoxetine has a half-life of 4-6 days and active metabolite norfluoxetine, making it long-acting and protective against discontinuation syndrome. 6. Which SSRI is most associated with discontinuation syndrome if stopped abruptly? A. Paroxetine B. Fluoxetine C. Escitalopram D. Sertraline: Which SSRI is most associated with discontinuation syndrome if stopped abruptly? A. Paroxetine B. Fluoxetine C. Escitalopram D. Sertraline Rationale: Paroxetine has a short half-life and no active metabolites abrupt discontinuation causes withdrawal (flu-like ’ symptoms, insomnia, irritability). 7. Which of the following increases lithium levels and risk of toxicity? A. Caffeine B. TheophyllineC. NSAIDs D. Sodium intake: Which of the following increases lithium levels and risk of toxicity? A. Caffeine B. Theophylline C. NSAIDs D. Sodium intake Rationale: NSAIDs, ACE inhibitors, and diuretics reduce renal clearance of lithium, increasing serum levels and toxicity risk. 8. Which of the following decreases lithium levels? A. ACE inhibitors B. DiureticsC. Caffeine D. Dehydration: Which of the following decreases lithium levels? A. ACE inhibitors B. Diuretics C. Caffeine D. Dehydration Rationale: Caffeine and theophylline increase renal clearance of lithium, lowering levels. Sodium restriction/dehydration increases levels. 9. A patient on multiple serotonergic medications develops hyperthermia, agitation, tremor, and clonus. This presentation is most consistent with: A. Anticholinergic toxicity B. Serotonin syndrome C. Neuroleptic malignant syndrome D. Hypertensive crisis: Serotonin Syndrome A patient on multiple serotonergic medications develops hyperthermia, agitation, tremor, and clonus. This presentation is most consistent with: A. Anticholinergic toxicity B. Serotonin syndrome C.Neuroleptic malignant syndromeD. Hypertensive crisis Rationale: Serotonin syndrome results from excess serotonergic activity (often SSRIs + MAOIs or other serotonergic agents). Key features: autonomic instability, neuromuscular hyperactivity (clonus, tremor), mental status changes