Page 1 of 103
NR 546 / NR546 Midterm Exam 2 Versions (A & B) Questions
& Answers 100%
Guaranteed Pass ||Complete A+ Guide
1. A patient with schizophrenia shows poor response to typical
antipsychotics. Which receptor profile is most associated with
treatment-resistant symptoms?
A) High D2 occupancy only
B) Low 5-HT2A and high D2
C) High D2 and low 5-HT2A
D) Low D2 and high 5-HT1A
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Correct Answer: A – High D2 occupancy alone fails to
address negative/cognitive symptoms; treatment resistance
often involves glutamate/NMDA dysfunction.
2. Which brain region’s hypofunction is most linked to negative
symptoms of schizophrenia?
A) Nucleus accumbens
B) Prefrontal cortex
C) VTA
D) Hypothalamus
Correct Answer: B – Hypofrontality correlates with negative
symptoms (avolition, anhedonia).
3. A patient develops EPS after haloperidol. Which pathway is
primarily affected?
A) Mesolimbic
B) Mesocortical
C) Nigrostriatal
D) Tuberoinfundibular
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Correct Answer: C – Nigrostriatal D2 blockade causes EPS.
4. Scenario: A 45-year-old male on risperidone reports
galactorrhea. Which receptor action explains this?
A) 5-HT2A antagonism
B) D2 blockade in tuberoinfundibular pathway
C) H1 blockade
D) M1 antagonism
Correct Answer: B – D2 blockade in tuberoinfundibular →
increased prolactin.
5. Which neurotransmitter is primarily degraded by MAO-B?
A) Norepinephrine
B) Serotonin
C) Dopamine
D) Acetylcholine
Correct Answer: C – MAO-B prefers dopamine.
6. The therapeutic lag of SSRIs is best explained by:
A) Rapid receptor desensitization
, Page 4 of 103
B) Delayed downregulation of 5-HT1A autoreceptors
C) Blood-brain barrier transport delay
D) Protein binding saturation
Correct Answer: B – Autoreceptor downregulation takes 2–4
weeks.
7. Which medication’s efficacy in bipolar disorder is mediated
by glycogen synthase kinase-3 (GSK-3) inhibition?
A) Lamotrigine
B) Valproate
C) Lithium
D) Carbamazepine
Correct Answer: C – Lithium inhibits GSK-3, neuroprotective.
8. Scenario: A patient on clozapine develops seizures. Which
receptor is most implicated?
A) D4 blockade
B) 5-HT2C blockade
NR 546 / NR546 Midterm Exam 2 Versions (A & B) Questions
& Answers 100%
Guaranteed Pass ||Complete A+ Guide
1. A patient with schizophrenia shows poor response to typical
antipsychotics. Which receptor profile is most associated with
treatment-resistant symptoms?
A) High D2 occupancy only
B) Low 5-HT2A and high D2
C) High D2 and low 5-HT2A
D) Low D2 and high 5-HT1A
,Page 2 of 103
Correct Answer: A – High D2 occupancy alone fails to
address negative/cognitive symptoms; treatment resistance
often involves glutamate/NMDA dysfunction.
2. Which brain region’s hypofunction is most linked to negative
symptoms of schizophrenia?
A) Nucleus accumbens
B) Prefrontal cortex
C) VTA
D) Hypothalamus
Correct Answer: B – Hypofrontality correlates with negative
symptoms (avolition, anhedonia).
3. A patient develops EPS after haloperidol. Which pathway is
primarily affected?
A) Mesolimbic
B) Mesocortical
C) Nigrostriatal
D) Tuberoinfundibular
,Page 3 of 103
Correct Answer: C – Nigrostriatal D2 blockade causes EPS.
4. Scenario: A 45-year-old male on risperidone reports
galactorrhea. Which receptor action explains this?
A) 5-HT2A antagonism
B) D2 blockade in tuberoinfundibular pathway
C) H1 blockade
D) M1 antagonism
Correct Answer: B – D2 blockade in tuberoinfundibular →
increased prolactin.
5. Which neurotransmitter is primarily degraded by MAO-B?
A) Norepinephrine
B) Serotonin
C) Dopamine
D) Acetylcholine
Correct Answer: C – MAO-B prefers dopamine.
6. The therapeutic lag of SSRIs is best explained by:
A) Rapid receptor desensitization
, Page 4 of 103
B) Delayed downregulation of 5-HT1A autoreceptors
C) Blood-brain barrier transport delay
D) Protein binding saturation
Correct Answer: B – Autoreceptor downregulation takes 2–4
weeks.
7. Which medication’s efficacy in bipolar disorder is mediated
by glycogen synthase kinase-3 (GSK-3) inhibition?
A) Lamotrigine
B) Valproate
C) Lithium
D) Carbamazepine
Correct Answer: C – Lithium inhibits GSK-3, neuroprotective.
8. Scenario: A patient on clozapine develops seizures. Which
receptor is most implicated?
A) D4 blockade
B) 5-HT2C blockade
