,NR 546 Advanced Psychopharmacology PMHNP Midterm Exam | Questions
and Answers
1. A patient presents with anxiety, frequent episodes of feeling frozen in place, a pounding
heart, and difficulty sleeping. The PMHNP suspects elevated levels of which neurotransmitter?
A) Serotonin
B) GABA
C) Norepinephrine
D) Dopamine
Correct Answer: Norepinephrine
Rationale: Norepinephrine (NE) is a monoamine neurotransmitter responsible for regulating
the "fight or flight" response. Excessive NE activity can lead to symptoms such as anxiety,
restlessness, hyperarousal, palpitations, and sleep disturbances, as described in the scenario .
2. A patient recovering from a stroke has trouble with speech comprehension and works with a
speech therapist twice a week. Which part of the patient's brain has been affected by the
stroke?
A) Broca's area
B) The basal ganglia
C) The limbic system
D) Wernicke's area
Correct Answer: Wernicke's area
, Rationale: Wernicke's area is responsible for language comprehension (receptive speech).
Damage to this area results in receptive aphasia, where a patient can speak but cannot
understand language . Broca's area controls speech production, not comprehension .
3. A patient on Haldol 10mg daily is noted to have an extreme form of slowness. The PMHNP
understands which dopamine pathway is associated with this?
A) Tuberoinfundibular pathway
B) Mesocortical pathway
C) Nigrostriatal pathway
D) Mesolimbic pathway
Correct Answer: Nigrostriatal pathway
Rationale: The nigrostriatal dopamine pathway is part of the extrapyramidal nervous system
and is responsible for motor control. Blockade of dopamine D2 receptors in this pathway,
particularly with typical antipsychotics like haloperidol, results in extrapyramidal symptoms
(EPS), including drug-induced parkinsonism, which is characterized by slowness (bradykinesia)
and rigidity .
4. The PMHNP recognizes which of the following medications as an atypical antipsychotic?
A) Chlorpromazine
B) Aripiprazole
C) Haloperidol
D) Mesoridazine
Correct Answer: Aripiprazole
, Rationale: Aripiprazole is a second-generation (atypical) antipsychotic . Chlorpromazine,
haloperidol, and mesoridazine are first-generation (typical) antipsychotics.
5. A 74-year-old, right-handed patient presents with significant memory loss, expressive
aphasia, and a left plantar extensor response. The most likely diagnosis is:
A) Alzheimer's disease
B) Vascular dementia
C) Frontotemporal dementia
D) Lewy body dementia
Correct Answer: Vascular dementia
Rationale: The presence of focal neurological signs (left plantar extensor response) along with
cognitive deficits (memory loss, expressive aphasia) suggests vascular dementia rather than
Alzheimer's disease. Vascular dementia results from cerebrovascular events that cause focal
brain damage .
6. Which of the following is a type of neuroglial cell found in the central nervous system?
A) Schwann cells
B) Satellite cells
C) Astrocytes
D) Ganglion cells
Correct Answer: Astrocytes
Rationale: Astrocytes are a type of neuroglial cell found in the central nervous system . They
regulate the chemical environment of neurons and help form the blood-brain barrier. Schwann
cells are found in the peripheral nervous system.
and Answers
1. A patient presents with anxiety, frequent episodes of feeling frozen in place, a pounding
heart, and difficulty sleeping. The PMHNP suspects elevated levels of which neurotransmitter?
A) Serotonin
B) GABA
C) Norepinephrine
D) Dopamine
Correct Answer: Norepinephrine
Rationale: Norepinephrine (NE) is a monoamine neurotransmitter responsible for regulating
the "fight or flight" response. Excessive NE activity can lead to symptoms such as anxiety,
restlessness, hyperarousal, palpitations, and sleep disturbances, as described in the scenario .
2. A patient recovering from a stroke has trouble with speech comprehension and works with a
speech therapist twice a week. Which part of the patient's brain has been affected by the
stroke?
A) Broca's area
B) The basal ganglia
C) The limbic system
D) Wernicke's area
Correct Answer: Wernicke's area
, Rationale: Wernicke's area is responsible for language comprehension (receptive speech).
Damage to this area results in receptive aphasia, where a patient can speak but cannot
understand language . Broca's area controls speech production, not comprehension .
3. A patient on Haldol 10mg daily is noted to have an extreme form of slowness. The PMHNP
understands which dopamine pathway is associated with this?
A) Tuberoinfundibular pathway
B) Mesocortical pathway
C) Nigrostriatal pathway
D) Mesolimbic pathway
Correct Answer: Nigrostriatal pathway
Rationale: The nigrostriatal dopamine pathway is part of the extrapyramidal nervous system
and is responsible for motor control. Blockade of dopamine D2 receptors in this pathway,
particularly with typical antipsychotics like haloperidol, results in extrapyramidal symptoms
(EPS), including drug-induced parkinsonism, which is characterized by slowness (bradykinesia)
and rigidity .
4. The PMHNP recognizes which of the following medications as an atypical antipsychotic?
A) Chlorpromazine
B) Aripiprazole
C) Haloperidol
D) Mesoridazine
Correct Answer: Aripiprazole
, Rationale: Aripiprazole is a second-generation (atypical) antipsychotic . Chlorpromazine,
haloperidol, and mesoridazine are first-generation (typical) antipsychotics.
5. A 74-year-old, right-handed patient presents with significant memory loss, expressive
aphasia, and a left plantar extensor response. The most likely diagnosis is:
A) Alzheimer's disease
B) Vascular dementia
C) Frontotemporal dementia
D) Lewy body dementia
Correct Answer: Vascular dementia
Rationale: The presence of focal neurological signs (left plantar extensor response) along with
cognitive deficits (memory loss, expressive aphasia) suggests vascular dementia rather than
Alzheimer's disease. Vascular dementia results from cerebrovascular events that cause focal
brain damage .
6. Which of the following is a type of neuroglial cell found in the central nervous system?
A) Schwann cells
B) Satellite cells
C) Astrocytes
D) Ganglion cells
Correct Answer: Astrocytes
Rationale: Astrocytes are a type of neuroglial cell found in the central nervous system . They
regulate the chemical environment of neurons and help form the blood-brain barrier. Schwann
cells are found in the peripheral nervous system.
