NRNP 6635 ADVANCED
PSYCHOPHARMACOLOGY
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. Which dopamine pathway is primarily responsible for the development of extrapyramidal
symptoms (EPS) when D2 receptors are blocked?
A. Nigrostriatal pathway
B. Mesocortical pathway
C. Mesolimbic pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: The nigrostriatal pathway controls motor function; blockade of
D2 receptors in this pathway leads to EPS and tardive dyskinesia.
2. A patient taking Clozapine must have their Absolute Neutrophil Count (ANC) monitored
regularly to screen for which life-threatening condition?
A. Neuroleptic Malignant Syndrome
,B. Thrombocytopenia
C. Metabolic Syndrome
D. Agranulocytosis
Answer: D
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis, a
severe reduction in white blood cell count that increases infection risk.
3. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Sertraline
B. Venlafaxine
C. Bupropion
D. Mirtazapine
Answer: C
Conceptual Explanation: Bupropion lowers the seizure threshold, particularly in patients
with bulimia or anorexia nervosa.
4. What is the primary mechanism of action of Memantine in the treatment of Alzheimer’s
disease?
A. Cholinesterase inhibition
B. NMDA receptor antagonism
, C. Dopamine agonism
D. Serotonin reuptake inhibition
Answer: B
Conceptual Explanation: Memantine acts as a low-to-moderate affinity noncompetitive
NMDA receptor antagonist, preventing glutamate excitotoxicity.
5. Which mood stabilizer is most strongly associated with the risk of Stevens-Johnson
Syndrome (SJS), particularly in patients of Asian descent?
A. Lithium
B. Valproate
C. Topiramate
D. Carbamazepine
Answer: D
Conceptual Explanation: Carbamazepine is associated with SJS, especially in those with
the HLA-B*1502 allele common in Asian populations.
6. Serotonin syndrome is characterized by a triad of symptoms. Which of the following is NOT
part of that triad?
A. Neuromuscular hyperactivity
B. Autonomic instability
C. Severe bradycardia
PSYCHOPHARMACOLOGY
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. Which dopamine pathway is primarily responsible for the development of extrapyramidal
symptoms (EPS) when D2 receptors are blocked?
A. Nigrostriatal pathway
B. Mesocortical pathway
C. Mesolimbic pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: The nigrostriatal pathway controls motor function; blockade of
D2 receptors in this pathway leads to EPS and tardive dyskinesia.
2. A patient taking Clozapine must have their Absolute Neutrophil Count (ANC) monitored
regularly to screen for which life-threatening condition?
A. Neuroleptic Malignant Syndrome
,B. Thrombocytopenia
C. Metabolic Syndrome
D. Agranulocytosis
Answer: D
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis, a
severe reduction in white blood cell count that increases infection risk.
3. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Sertraline
B. Venlafaxine
C. Bupropion
D. Mirtazapine
Answer: C
Conceptual Explanation: Bupropion lowers the seizure threshold, particularly in patients
with bulimia or anorexia nervosa.
4. What is the primary mechanism of action of Memantine in the treatment of Alzheimer’s
disease?
A. Cholinesterase inhibition
B. NMDA receptor antagonism
, C. Dopamine agonism
D. Serotonin reuptake inhibition
Answer: B
Conceptual Explanation: Memantine acts as a low-to-moderate affinity noncompetitive
NMDA receptor antagonist, preventing glutamate excitotoxicity.
5. Which mood stabilizer is most strongly associated with the risk of Stevens-Johnson
Syndrome (SJS), particularly in patients of Asian descent?
A. Lithium
B. Valproate
C. Topiramate
D. Carbamazepine
Answer: D
Conceptual Explanation: Carbamazepine is associated with SJS, especially in those with
the HLA-B*1502 allele common in Asian populations.
6. Serotonin syndrome is characterized by a triad of symptoms. Which of the following is NOT
part of that triad?
A. Neuromuscular hyperactivity
B. Autonomic instability
C. Severe bradycardia
