NSG 552 Psychopharmacology Exam 1 Review
Wilkes University (2024-2026) | Verified Q&A
Study Guide | pdf
Introduction & Coverage
Dominate your NSG 552 (Psychopharmacology) Exam 1 with this high-retention study resource,
specifically built for the Wilkes University and graduate-level PMHNP curriculum. This guide condenses
weeks of complex neurobiology and drug mechanisms into a clear, exam-focused format. It covers
everything from foundational pharmacokinetics to the management of Schizophrenia, Bipolar Disorder,
and Major Depression.
This Exam 1 prep covers high-yield content across all core units:
Foundational Science: PK/PD principles, CYP450 inhibitors/inducers, receptor dynamics
(agonism/antagonism), and steady-state kinetics.
Schizophrenia & Psychosis: 1st vs. 2nd Generation Antipsychotics, the four dopamine pathways, and
managing Clozapine (ANC monitoring).
EPS Management: Identifying and treating Dystonia, Akathisia (Propranolol), Pseudo-parkinsonism,
and Tardive Dyskinesia.
Mood Stabilizers: Lithium (toxicity and therapeutic ranges), Valproate (LFT/CBC monitoring),
and Lamotrigine (SJS/rash protocols).
Antidepressants: SSRI/SNRI mechanisms, Serotonin Syndrome vs. NMS, and MAOI/Tyramine dietary
restrictions.
1. Which term describes what the body does to a drug, including absorption, distribution,
metabolism, and excretion?
A) Pharmacodynamics
B) Pharmacokinetics
C) Bioavailability
D) Agonism
Answer: B) Pharmacokinetics
, Explanation: Pharmacokinetics (PK) is the movement of the drug through the body,
whereas pharmacodynamics is the drug’s effect on the body.
2. A patient is taking a drug that is a CYP450 3A4 inhibitor. If they start a second drug
metabolized by 3A4, the levels of the second drug will:
A) Decrease
B) Increase
C) Stay the same
D) Be eliminated immediately
Answer: B) Increase
Explanation: Inhibitors "block" the metabolic highway, causing substrate drugs to back
up and reach potentially toxic levels.
3. Chronic exposure to an agonist can lead to a decrease in the number of receptors. This
process is called:
A) Up-regulation
B) Down-regulation
C) Potentiation
D) Tolerance
Answer: B) Down-regulation
Explanation: To maintain homeostasis, the cell removes receptors when they are over-
stimulated by an agonist.
4. Which antipsychotic medication requires mandatory monitoring of the Absolute
Neutrophil Count (ANC) due to the risk of agranulocytosis?
A) Risperidone
B) Quetiapine
C) Clozapine
D) Olanzapine
Answer: C) Clozapine
Explanation: Clozapine is a high-risk medication that can cause life-threatening bone
marrow suppression (agranulocytosis).
5. A patient taking Haloperidol develops a "fixed upward gaze" and painful neck spasms.
This is known as:
A) Akathisia
B) Acute Dystonia
C) Tardive Dyskinesia
, D) Pseudo-parkinsonism
Answer: B) Acute Dystonia
Explanation: Acute dystonia involves sudden, involuntary muscle contractions and
occurs early in treatment.
6. What is the first-line treatment for the restlessness and internal "crawling skin"
sensation associated with akathisia?
A) Benztropine (Cogentin)
B) Propropanol (Inderal)
C) Lorazepam (Ativan)
D) Diphenhydramine (Benadryl)
Answer: B) Propropanol (Inderal)
Explanation: Beta-blockers are the gold standard treatment for antipsychotic-induced
akathisia.
7. The "Negative Symptoms" of Schizophrenia (e.g., flat affect, alogia) are primarily
associated with low dopamine in which pathway?
A) Mesolimbic
B) Mesocortical
C) Nigrostriatal
D) Tuberoinfundibular
Answer: B) Mesocortical
Explanation: The "Two-Dopamine" theory suggests hyper-dopamine in the mesolimbic
(positive symptoms) and hypo-dopamine in the mesocortical (negative symptoms).
8. Extrapyramidal Symptoms (EPS) occur when D2 receptors are blocked in which
pathway?
A) Mesolimbic
B) Mesocortical
C) Nigrostriatal
D) Tuberoinfundibular
Answer: C) Nigrostriatal
Explanation: Blockade of dopamine in the nigrostriatal pathway mimics Parkinson’s
disease symptoms.
9. Hyperprolactinemia (leading to gynecomastia or galactorrhea) is caused by D2
blockade in which pathway?
A) Mesolimbic
Wilkes University (2024-2026) | Verified Q&A
Study Guide | pdf
Introduction & Coverage
Dominate your NSG 552 (Psychopharmacology) Exam 1 with this high-retention study resource,
specifically built for the Wilkes University and graduate-level PMHNP curriculum. This guide condenses
weeks of complex neurobiology and drug mechanisms into a clear, exam-focused format. It covers
everything from foundational pharmacokinetics to the management of Schizophrenia, Bipolar Disorder,
and Major Depression.
This Exam 1 prep covers high-yield content across all core units:
Foundational Science: PK/PD principles, CYP450 inhibitors/inducers, receptor dynamics
(agonism/antagonism), and steady-state kinetics.
Schizophrenia & Psychosis: 1st vs. 2nd Generation Antipsychotics, the four dopamine pathways, and
managing Clozapine (ANC monitoring).
EPS Management: Identifying and treating Dystonia, Akathisia (Propranolol), Pseudo-parkinsonism,
and Tardive Dyskinesia.
Mood Stabilizers: Lithium (toxicity and therapeutic ranges), Valproate (LFT/CBC monitoring),
and Lamotrigine (SJS/rash protocols).
Antidepressants: SSRI/SNRI mechanisms, Serotonin Syndrome vs. NMS, and MAOI/Tyramine dietary
restrictions.
1. Which term describes what the body does to a drug, including absorption, distribution,
metabolism, and excretion?
A) Pharmacodynamics
B) Pharmacokinetics
C) Bioavailability
D) Agonism
Answer: B) Pharmacokinetics
, Explanation: Pharmacokinetics (PK) is the movement of the drug through the body,
whereas pharmacodynamics is the drug’s effect on the body.
2. A patient is taking a drug that is a CYP450 3A4 inhibitor. If they start a second drug
metabolized by 3A4, the levels of the second drug will:
A) Decrease
B) Increase
C) Stay the same
D) Be eliminated immediately
Answer: B) Increase
Explanation: Inhibitors "block" the metabolic highway, causing substrate drugs to back
up and reach potentially toxic levels.
3. Chronic exposure to an agonist can lead to a decrease in the number of receptors. This
process is called:
A) Up-regulation
B) Down-regulation
C) Potentiation
D) Tolerance
Answer: B) Down-regulation
Explanation: To maintain homeostasis, the cell removes receptors when they are over-
stimulated by an agonist.
4. Which antipsychotic medication requires mandatory monitoring of the Absolute
Neutrophil Count (ANC) due to the risk of agranulocytosis?
A) Risperidone
B) Quetiapine
C) Clozapine
D) Olanzapine
Answer: C) Clozapine
Explanation: Clozapine is a high-risk medication that can cause life-threatening bone
marrow suppression (agranulocytosis).
5. A patient taking Haloperidol develops a "fixed upward gaze" and painful neck spasms.
This is known as:
A) Akathisia
B) Acute Dystonia
C) Tardive Dyskinesia
, D) Pseudo-parkinsonism
Answer: B) Acute Dystonia
Explanation: Acute dystonia involves sudden, involuntary muscle contractions and
occurs early in treatment.
6. What is the first-line treatment for the restlessness and internal "crawling skin"
sensation associated with akathisia?
A) Benztropine (Cogentin)
B) Propropanol (Inderal)
C) Lorazepam (Ativan)
D) Diphenhydramine (Benadryl)
Answer: B) Propropanol (Inderal)
Explanation: Beta-blockers are the gold standard treatment for antipsychotic-induced
akathisia.
7. The "Negative Symptoms" of Schizophrenia (e.g., flat affect, alogia) are primarily
associated with low dopamine in which pathway?
A) Mesolimbic
B) Mesocortical
C) Nigrostriatal
D) Tuberoinfundibular
Answer: B) Mesocortical
Explanation: The "Two-Dopamine" theory suggests hyper-dopamine in the mesolimbic
(positive symptoms) and hypo-dopamine in the mesocortical (negative symptoms).
8. Extrapyramidal Symptoms (EPS) occur when D2 receptors are blocked in which
pathway?
A) Mesolimbic
B) Mesocortical
C) Nigrostriatal
D) Tuberoinfundibular
Answer: C) Nigrostriatal
Explanation: Blockade of dopamine in the nigrostriatal pathway mimics Parkinson’s
disease symptoms.
9. Hyperprolactinemia (leading to gynecomastia or galactorrhea) is caused by D2
blockade in which pathway?
A) Mesolimbic
