NR 546 PSYCHOPHARMACOLOGY
FINAL EXAM GUIDE QUESTIONS AND
ANSWERS
1. Which dopaminergic pathway is primarily associated with the development of positive
symptoms in schizophrenia, such as hallucinations and delusions?
A. Mesocortical pathway
B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: B
Conceptual Explanation: Overactivity in the mesolimbic pathway is linked to the positive
symptoms of schizophrenia. Standard antipsychotics target this pathway by blocking D2
receptors.
2. A patient taking Clozapine presents with a sudden onset of fever and a sore throat. What is
the most critical diagnostic test to perform immediately?
A. Complete Blood Count (CBC) with Differential
B. Liver Function Tests (LFTs)
,C. Electrocardiogram (ECG)
D. Fast blood glucose monitoring
Answer: A
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. A CBC
with differential is required to check the Absolute Neutrophil Count (ANC) to ensure the
patient is not experiencing life-threatening neutropenia.
3. Which antidepressant is known for its unique mechanism as a selective alpha-2 antagonist,
enhancing both serotonin and norepinephrine neurotransmission?
A. Fluoxetine
B. Venlafaxine
C. Mirtazapine
D. Bupropion
Answer: C
Conceptual Explanation: Mirtazapine is a Noradrenergic and Specific Serotonergic
Antidepressant (NaSSA). It blocks alpha-2 presynaptic autoreceptors and heteroreceptors,
increasing the release of NE and 5-HT.
4. Lithium toxicity is exacerbated by which of the following electrolyte or physiological
changes?
A. Hyponatremia
, B. Hypernatremia
C. Hyperkalemia
D. Hypocalcemia
Answer: A
Conceptual Explanation: Lithium is a salt. When sodium levels are low (hyponatremia),
the kidneys conserve sodium but inadvertently reabsorb Lithium as well, leading to toxic
serum levels.
5. A patient is switched from an MAOI to an SSRI. How long should the washout period be to
prevent Serotonin Syndrome?
A. 2 days
B. 14 days
C. 7 days
D. 30 days
Answer: B
Conceptual Explanation: A 14-day washout period is required when switching from most
MAOIs to SSRIs (and vice-versa) to allow the MAO enzyme to regenerate and prevent
excessive serotonin accumulation.
FINAL EXAM GUIDE QUESTIONS AND
ANSWERS
1. Which dopaminergic pathway is primarily associated with the development of positive
symptoms in schizophrenia, such as hallucinations and delusions?
A. Mesocortical pathway
B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: B
Conceptual Explanation: Overactivity in the mesolimbic pathway is linked to the positive
symptoms of schizophrenia. Standard antipsychotics target this pathway by blocking D2
receptors.
2. A patient taking Clozapine presents with a sudden onset of fever and a sore throat. What is
the most critical diagnostic test to perform immediately?
A. Complete Blood Count (CBC) with Differential
B. Liver Function Tests (LFTs)
,C. Electrocardiogram (ECG)
D. Fast blood glucose monitoring
Answer: A
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. A CBC
with differential is required to check the Absolute Neutrophil Count (ANC) to ensure the
patient is not experiencing life-threatening neutropenia.
3. Which antidepressant is known for its unique mechanism as a selective alpha-2 antagonist,
enhancing both serotonin and norepinephrine neurotransmission?
A. Fluoxetine
B. Venlafaxine
C. Mirtazapine
D. Bupropion
Answer: C
Conceptual Explanation: Mirtazapine is a Noradrenergic and Specific Serotonergic
Antidepressant (NaSSA). It blocks alpha-2 presynaptic autoreceptors and heteroreceptors,
increasing the release of NE and 5-HT.
4. Lithium toxicity is exacerbated by which of the following electrolyte or physiological
changes?
A. Hyponatremia
, B. Hypernatremia
C. Hyperkalemia
D. Hypocalcemia
Answer: A
Conceptual Explanation: Lithium is a salt. When sodium levels are low (hyponatremia),
the kidneys conserve sodium but inadvertently reabsorb Lithium as well, leading to toxic
serum levels.
5. A patient is switched from an MAOI to an SSRI. How long should the washout period be to
prevent Serotonin Syndrome?
A. 2 days
B. 14 days
C. 7 days
D. 30 days
Answer: B
Conceptual Explanation: A 14-day washout period is required when switching from most
MAOIs to SSRIs (and vice-versa) to allow the MAO enzyme to regenerate and prevent
excessive serotonin accumulation.
