NSG 552 EXAM 1 – WILKES
PSYCHOPHARMACOLOGY (2026)
ACTUAL QUESTIONS 2026/2027
1. Which of the following best describes the action of an inverse agonist at a G-protein
coupled receptor?
A. It blocks the endogenous ligand from binding but has no intrinsic activity.
B. It binds to a site other than the primary ligand site to enhance the agonist’s effect.
C. It binds to the receptor and produces the opposite effect of an agonist, reducing
constitutive activity.
D. It mimics the effect of the natural neurotransmitter but with lower efficacy.
Answer: C
Conceptual Explanation: An inverse agonist not only blocks the agonist but also reduces
the baseline constitutive activity of the receptor, effectively producing the opposite effect of
an agonist.
,2. A patient stabilized on Clozapine begins smoking a pack of cigarettes daily. How does this
behavior affect the metabolism of the medication?
A. Polycyclic aromatic hydrocarbons in smoke induce CYP1A2, potentially decreasing
clozapine levels.
B. Cigarette smoke induces CYP2D6, leading to increased clozapine levels.
C. Nicotine inhibits CYP3A4, leading to toxic levels of clozapine.
D. Smoking has no significant impact on clozapine plasma concentrations.
Answer: A
Conceptual Explanation: Hydrocarbons in cigarette smoke (not nicotine itself) induce the
CYP1A2 enzyme, which is the primary metabolic pathway for clozapine, often requiring a
dose increase in smokers.
3. When a drug is said to be a ‘partial agonist,’ what does this imply regarding its intrinsic
activity compared to a full agonist?
A. It has zero intrinsic activity.
B. It has an intrinsic activity of 1.0.
C. It has an intrinsic activity greater than 1.0.
D. It has an intrinsic activity between 0 and 1.0.
Answer: D
, Conceptual Explanation: A partial agonist binds to the receptor but elicits a submaximal
response even at full receptor occupancy, placing its intrinsic activity between that of an
antagonist (0) and a full agonist (1).
4. Which Dopamine pathway is associated with the negative symptoms of schizophrenia and
cognitive dysfunction?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesolimbic pathway
Answer: A
Conceptual Explanation: A deficit of dopamine in the mesocortical pathway (particularly
the DLPFC) is theorized to cause negative symptoms and cognitive impairment in
schizophrenia.
5. The ‘thermostat’ analogy in psychopharmacology, where a drug can either increase or
decrease neurotransmission based on the environment, best describes:
A. Full Agonists
B. Competitive Antagonists
C. Irreversible Inhibitors
D. Partial Agonists
PSYCHOPHARMACOLOGY (2026)
ACTUAL QUESTIONS 2026/2027
1. Which of the following best describes the action of an inverse agonist at a G-protein
coupled receptor?
A. It blocks the endogenous ligand from binding but has no intrinsic activity.
B. It binds to a site other than the primary ligand site to enhance the agonist’s effect.
C. It binds to the receptor and produces the opposite effect of an agonist, reducing
constitutive activity.
D. It mimics the effect of the natural neurotransmitter but with lower efficacy.
Answer: C
Conceptual Explanation: An inverse agonist not only blocks the agonist but also reduces
the baseline constitutive activity of the receptor, effectively producing the opposite effect of
an agonist.
,2. A patient stabilized on Clozapine begins smoking a pack of cigarettes daily. How does this
behavior affect the metabolism of the medication?
A. Polycyclic aromatic hydrocarbons in smoke induce CYP1A2, potentially decreasing
clozapine levels.
B. Cigarette smoke induces CYP2D6, leading to increased clozapine levels.
C. Nicotine inhibits CYP3A4, leading to toxic levels of clozapine.
D. Smoking has no significant impact on clozapine plasma concentrations.
Answer: A
Conceptual Explanation: Hydrocarbons in cigarette smoke (not nicotine itself) induce the
CYP1A2 enzyme, which is the primary metabolic pathway for clozapine, often requiring a
dose increase in smokers.
3. When a drug is said to be a ‘partial agonist,’ what does this imply regarding its intrinsic
activity compared to a full agonist?
A. It has zero intrinsic activity.
B. It has an intrinsic activity of 1.0.
C. It has an intrinsic activity greater than 1.0.
D. It has an intrinsic activity between 0 and 1.0.
Answer: D
, Conceptual Explanation: A partial agonist binds to the receptor but elicits a submaximal
response even at full receptor occupancy, placing its intrinsic activity between that of an
antagonist (0) and a full agonist (1).
4. Which Dopamine pathway is associated with the negative symptoms of schizophrenia and
cognitive dysfunction?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesolimbic pathway
Answer: A
Conceptual Explanation: A deficit of dopamine in the mesocortical pathway (particularly
the DLPFC) is theorized to cause negative symptoms and cognitive impairment in
schizophrenia.
5. The ‘thermostat’ analogy in psychopharmacology, where a drug can either increase or
decrease neurotransmission based on the environment, best describes:
A. Full Agonists
B. Competitive Antagonists
C. Irreversible Inhibitors
D. Partial Agonists
