NURS 752 Clinical Psychopharmacology Exam Practice – 130 Questions with Answers 2026\2027, Exams of Nursing

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NURS 752 Exam 3 – Clinical

Psychopharmacology

Practice Questions & CORRECT ANSWER s

2026 \ 2027

This comprehensive practice exam for NURS 752 – Clinical Psychopharmacology at includes 130 high-yield multiple choice, true/false, and case-based questions with detailed CORRECT ANSWER s and rationales. Designed for PMHNP and advanced nursing students preparing for exams or board certification. Topics include antidepressants, antipsychotics, mood stabilizers, anxiolytics, stimulants, lifespan considerations, and psychopharmacological clinical reasoning.

1. Which antidepressant is least likely to cause sexual dysfunction? A. Fluoxetine B. Sertraline C. Bupropion D. Paroxetine CORRECT ANSWER : C Explanation: Bupropion is a norepinephrine-dopamine reuptake inhibitor (NDRI) and has minimal sexual side effects compared to SSRIs. 2. Which mood stabilizer is most associated with thyroid abnormalities? A. Lithium B. Lamotrigine C. Valproate D. Carbamazepine CORRECT ANSWER : A Explanation: Lithium is known to cause hypothyroidism and requires regular TSH monitoring. 3. Risperidone is more likely to cause which side effect? A. Agranulocytosis B. Extrapyramidal symptoms (EPS) C. Weight loss D. Hypercalcemia

CORRECT ANSWER : B

Explanation: At higher doses, risperidone can cause EPS due to D2 receptor antagonism.

4. Benzodiazepines act primarily on which neurotransmitter? A. Dopamine B. Serotonin C. GABA D. Norepinephrine CORRECT ANSWER : C Explanation: Benzodiazepines enhance the effect of GABA at GABA-A receptors. 5. A 68-year-old with depression is started on nortriptyline. What is the primary concern? A. Hepatic toxicity B. Cardiotoxicity C. Visual disturbances D. Diarrhea CORRECT ANSWER : B Explanation: TCAs can lead to cardiotoxic effects, especially in elderly patients. 6. Which medication is a dopamine partial agonist? A. Olanzapine B. Risperidone C. Aripiprazole D. Quetiapine CORRECT ANSWER : C Explanation: Aripiprazole is a dopamine D2 partial agonist used in schizophrenia and bipolar disorder. 7. Which antipsychotic has the highest risk of agranulocytosis? A. Clozapine B. Olanzapine C. Ziprasidone D. Lurasidone CORRECT ANSWER : A Explanation: Clozapine requires regular ANC monitoring due to agranulocytosis risk.

B. Phenelzine C. Bupropion D. Mirtazapine CORRECT ANSWER : B Explanation: Phenelzine is an MAOI and must not be taken with tyramine-rich foods.

13. First-line treatment for acute mania is: A. Fluoxetine B. Lithium C. Bupropion D. Buspirone CORRECT ANSWER : B Explanation: Lithium is a first-line agent for acute mania. 14. Neurotransmitter most involved in schizophrenia pathophysiology? A. Serotonin B. Dopamine C. Acetylcholine D. Norepinephrine CORRECT ANSWER : B Explanation: Dopamine dysregulation is central to schizophrenia, especially excess in mesolimbic pathway. 15. Which antipsychotic causes hyperprolactinemia? A. Clozapine B. Risperidone C. Aripiprazole D. Olanzapine CORRECT ANSWER : B Explanation: Risperidone strongly antagonizes dopamine in the tuberoinfundibular pathway. 16. Safest mood stabilizer in pregnancy? A. Valproic acid B. Lithium C. Lamotrigine D. Carbamazepine CORRECT ANSWER : C Explanation: Lamotrigine is preferred in pregnancy due to its lower teratogenic risk.

17. SNRI most likely to cause dose-related hypertension? A. Duloxetine B. Venlafaxine C. Desvenlafaxine D. Milnacipran CORRECT ANSWER : B Explanation: Venlafaxine increases blood pressure, especially at doses >150 mg. 18. Treatment-resistant schizophrenia best treated with: A. Risperidone B. Aripiprazole C. Clozapine D. Ziprasidone CORRECT ANSWER : C Explanation: Clozapine is the gold standard for treatment-resistant cases. 19. Buspirone's mechanism of action: A. GABA agonist B. Dopamine antagonist C. 5HT1A partial agonist D. Norepinephrine reuptake inhibitor CORRECT ANSWER : C Explanation: Buspirone is a serotonin 5HT1A receptor partial agonist used in GAD. 20. Antipsychotic most associated with QT prolongation: A. Ziprasidone B. Aripiprazole C. Lurasidone D. Risperidone CORRECT ANSWER : A Explanation: Ziprasidone prolongs QTc interval and requires ECG monitoring. 21. Mirtazapine’s most common side effect is: A. Anxiety B. Weight gain C. Sexual dysfunction

CORRECT ANSWER : C

Explanation: Valproate inhibits lamotrigine metabolism, increasing the risk of StevensJohnson Syndrome.

26. All antidepressants carry a black box warning for: A. Liver failure B. Mania induction C. Suicide risk in young adults D. QT prolongation CORRECT ANSWER : C Explanation: All antidepressants have a black box warning for increased suicidality in children, teens, and young adults. 27. Which medication is often used to treat antipsychotic-induced akathisia? A. Diphenhydramine B. Propranolol C. Sertraline D. Diazepam CORRECT ANSWER : B Explanation: Beta-blockers like propranolol are first-line treatments for akathisia. 28. What are hallmark signs of neuroleptic malignant syndrome (NMS)? A. Hyperactivity, tremor, diarrhea B. Fever, rigidity, autonomic instability C. Euphoria, insomnia, sweating D. Tardive dyskinesia, bradykinesia CORRECT ANSWER : B Explanation: NMS is a life-threatening reaction to antipsychotics with hyperthermia, muscle rigidity, and unstable vitals. 29. SNRIs primarily block reuptake of: A. GABA B. Serotonin and dopamine C. Serotonin and norepinephrine D. Norepinephrine and acetylcholine CORRECT ANSWER : C Explanation: SNRIs inhibit both serotonin and norepinephrine reuptake.

30. What labs are necessary for lithium monitoring? A. Liver enzymes and platelet count B. TSH, creatinine, and lithium level C. Glucose, HbA1c, and calcium D. Electrolytes only CORRECT ANSWER : B Explanation: Lithium can cause hypothyroidism and renal impairment; levels must be monitored closely. 31. Abrupt discontinuation of benzodiazepines can lead to: A. Weight gain B. Rash C. Seizures D. QT prolongation CORRECT ANSWER : C Explanation: Benzodiazepine withdrawal can cause life-threatening seizures. 32. Bupropion should be avoided in patients with: A. Depression B. ADHD C. Seizure disorder D. Obesity CORRECT ANSWER : C Explanation: Bupropion lowers seizure threshold and should be avoided in at-risk patients. 33. Which SSRI is known to be more activating and may cause insomnia? A. Paroxetine B. Escitalopram C. Fluoxetine D. Sertraline CORRECT ANSWER : C Explanation: Fluoxetine is stimulating and often causes sleep disturbances, especially early in treatment.

Explanation: Quetiapine blocks histamine receptors, causing sedation.

39. What is the therapeutic serum range for lithium? A. 2 – 3 mEq/L B. 0.3–0.5 mEq/L C. 0.6–1.2 mEq/L D. 1.5–2.0 mEq/L CORRECT ANSWER : C Explanation: This is the safe and effective therapeutic range. 40. Aripiprazole differs from other antipsychotics because it: A. Is a D2 receptor antagonist B. Is a partial dopamine agonist C. Causes EPS in all patients D. Inhibits norepinephrine reuptake CORRECT ANSWER : B Explanation: Aripiprazole’s partial agonism at D2 leads to reduced side effects and mood stabilization. 41. Which antipsychotic causes the most metabolic side effects? A. Aripiprazole B. Lurasidone C. Olanzapine D. Ziprasidone CORRECT ANSWER : C Explanation: Olanzapine is highly associated with weight gain and metabolic syndrome. 42. Which antidepressant is safest in seizure-prone patients? A. Bupropion B. Sertraline C. Trazodone D. Maprotiline CORRECT ANSWER : B Explanation: SSRIs like sertraline are generally safe in seizure disorders. 43. Atypical antipsychotics differ from typicals because they: A. Do not cause sedation B. Only block serotonin

C. Block both D2 and 5HT2A receptors D. Have no side effects CORRECT ANSWER : C Explanation: This dual mechanism improves efficacy and reduces EPS.

44. What condition is a contraindication for stimulant use in ADHD? A. Obesity B. Anxiety C. Cardiac disease D. Headache CORRECT ANSWER : C Explanation: Stimulants increase heart rate and blood pressure, contraindicated in serious cardiac conditions. 45. Lamotrigine is most effective for which phase of bipolar disorder? A. Acute mania B. Bipolar depression C. Mixed episodes D. Psychosis CORRECT ANSWER : B Explanation: Lamotrigine is best for depressive episodes and not effective in mania. 46. What symptom can antidepressants worsen in bipolar patients? A. Depression B. Mania C. Anxiety D. Sleep CORRECT ANSWER : B Explanation: Antidepressants can trigger manic episodes in bipolar disorder if not stabilized. 47. Which antidepressant is known for its sedative effects and is often used as a sleep aid? A. Sertraline B. Trazodone C. Bupropion D. Fluoxetine CORRECT ANSWER : B Explanation: Trazodone has antihistaminic effects and is commonly used for insomnia.

B. GABA-A receptor agonism C. Dopamine D2 antagonism D. Serotonin reuptake inhibition CORRECT ANSWER : B Explanation: Benzodiazepines enhance GABA-A receptor activity, producing sedative effects.

53. Which mood stabilizer can cause polycystic ovarian syndrome (PCOS) in females? A. Lithium B. Valproic acid C. Carbamazepine D. Lamotrigine CORRECT ANSWER : B Explanation: Valproic acid can lead to endocrine disturbances, including PCOS. 54. Which medication requires a slow titration to prevent rash and Stevens-Johnson Syndrome? A. Valproate B. Lamotrigine C. Lithium D. Carbamazepine CORRECT ANSWER : B Explanation: Rapid titration of lamotrigine increases the risk of SJS. 55. A black box warning for clozapine includes: A. Liver failure B. Renal impairment C. Agranulocytosis D. Diabetes CORRECT ANSWER : C Explanation: Clozapine can cause life-threatening agranulocytosis; requires ANC monitoring. 56. Which drug may lead to hyponatremia via SIADH? A. Lithium B. Venlafaxine C. Bupropion

D. Aripiprazole CORRECT ANSWER : B Explanation: SSRIs and SNRIs, including venlafaxine, may induce SIADH and hyponatremia.

57. Which antipsychotic is considered most effective in treatment-resistant schizophrenia? A. Aripiprazole B. Risperidone C. Clozapine D. Lurasidone CORRECT ANSWER : C Explanation: Clozapine is reserved for treatment-resistant cases due to risk of severe side effects. 58. The therapeutic effect of SSRIs may take: A. 1 – 2 days B. 1 – 2 weeks C. 4 – 6 weeks D. 8 – 10 weeks CORRECT ANSWER : C Explanation: Most SSRIs take 4–6 weeks for full therapeutic effects. 59. Which of the following medications carries the highest risk for QTc prolongation? A. Fluoxetine B. Bupropion C. Citalopram D. Sertraline CORRECT ANSWER : C Explanation: Citalopram is known to prolong the QT interval, especially at higher doses. 60. What’s the appropriate first step in serotonin syndrome management? A. Increase SSRI dose B. Administer lithium C. Discontinue serotonergic agents D. Administer clozapine CORRECT ANSWER : C Explanation: Immediate cessation of all serotonergic drugs is the priority.

D. Acetylcholine CORRECT ANSWER : B Explanation: Psychotic symptoms are largely attributed to dopamine dysregulation.

66. Long-acting injectable risperidone is administered: A. Daily B. Weekly C. Biweekly D. Monthly CORRECT ANSWER : C Explanation: Injectable risperidone is typically administered every two weeks. 67. Which antidepressant is considered safest in cardiac patients? A. Bupropion B. Citalopram C. Sertraline D. Amitriptyline CORRECT ANSWER : C Explanation: Sertraline is often preferred due to minimal cardiac side effects. 68. Which is a sign of lithium toxicity? A. Euphoria B. Fine tremor C. Ataxia and confusion D. Nausea only CORRECT ANSWER : C Explanation: Severe lithium toxicity presents with neurological symptoms like confusion and ataxia. 69. Buspirone is used primarily to treat: A. Panic disorder B. Generalized anxiety disorder C. OCD D. Bipolar disorder CORRECT ANSWER : B Explanation: Buspirone is a non-benzodiazepine anxiolytic for GAD.

70. Which lab must be monitored frequently with valproate? A. BUN B. CBC and LFTs C. Creatinine D. Vitamin D CORRECT ANSWER : B Explanation: Valproate may cause hepatotoxicity and thrombocytopenia, requiring CBC and LFT monitoring. 71. A serious side effect of antipsychotics that presents with fever and rigidity is: A. Tardive dyskinesia B. Dystonia C. Neuroleptic malignant syndrome D. Serotonin syndrome CORRECT ANSWER : C Explanation: NMS is a medical emergency requiring immediate discontinuation and supportive care. 72. The half-life of fluoxetine is approximately: A. 4 hours B. 24 hours C. 3 – 4 days D. 12 hours CORRECT ANSWER : C Explanation: Fluoxetine has a long half-life, making discontinuation symptoms less common. 73. Atypical antipsychotics have lower EPS risk due to: A. Dopamine blockade B. Serotonin antagonism C. GABA agonism D. NMDA activity CORRECT ANSWER : B Explanation: 5HT2A antagonism reduces the need for D2 blockade, lowering EPS risk. 74. First-line treatment for panic disorder is: A. Alprazolam B. Paroxetine

79. What is the best strategy to reduce lithium side effects? A. Give it once at bedtime B. Crush the tablets C. Increase fluid intake and monitor levels D. Discontinue abruptly CORRECT ANSWER : C Explanation: Adequate hydration and close monitoring help avoid lithium toxicity. 80. A patient taking an SSRI reports restlessness and muscle twitching. What is your concern? A. Withdrawal B. Serotonin syndrome C. NMS D. EPS CORRECT ANSWER : B Explanation: These are classic early signs of serotonin syndrome, especially with multiple serotonergic agents. 81. Which medication is most associated with metabolic syndrome? A. Lurasidone B. Ziprasidone C. Olanzapine D. Aripiprazole CORRECT ANSWER : C Explanation: Olanzapine carries a high risk for weight gain, hyperlipidemia, and insulin resistance. 82. Which of the following should be avoided in patients with a seizure disorder? A. Lamotrigine B. Bupropion C. Valproate D. Gabapentin CORRECT ANSWER : B Explanation: Bupropion lowers the seizure threshold and is contraindicated in seizureprone patients.

83. The most appropriate mood stabilizer for a pregnant patient is: A. Valproic acid B. Carbamazepine C. Lithium D. Lamotrigine CORRECT ANSWER : D Explanation: Lamotrigine is considered safer than lithium, valproate, or carbamazepine in pregnancy. 84. What is the mechanism of action of aripiprazole? A. Full dopamine D2 antagonist B. Partial dopamine D2 agonist C. Serotonin reuptake inhibitor D. GABA-A receptor agonist CORRECT ANSWER : B Explanation: Aripiprazole is a partial agonist at D2 receptors, which helps balance dopamine levels. 85. Which antipsychotic is known for causing hypersalivation? A. Risperidone B. Olanzapine C. Clozapine D. Ziprasidone CORRECT ANSWER : C Explanation: Clozapine paradoxically causes excessive salivation (sialorrhea). 86. What’s the target serum level range for lithium in maintenance therapy? A. 0.2–0.5 mEq/L B. 0.4–0.6 mEq/L C. 0.6–1.2 mEq/L D. 1.5–2.0 mEq/L CORRECT ANSWER : C Explanation: The therapeutic range is 0.6–1.2 mEq/L; levels above this may be toxic. 87. Which of the following can reduce the efficacy of oral contraceptives? A. Lamotrigine B. Lithium C. Carbamazepine D. Risperidone