NR 546 FINAL EXAM STUDY GUIDE
QUESTIONS & ANSWERS
(CHAMBERLAIN) 100% GUARANTEE
PASS
1. In the treatment of Schizophrenia, which dopamine pathway is primarily associated with
the development of Extrapyramidal Symptoms (EPS) when D2 receptors are blocked?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Tuberoinfundibular pathway
D. Nigrostriatal pathway
Answer: D
Conceptual Explanation: The nigrostriatal pathway controls motor function; blockade of
D2 receptors in this pathway leads to EPS. The mesolimbic is associated with positive
symptoms, the mesocortical with negative symptoms, and the tuberoinfundibular with
prolactin regulation.
2. A patient taking Clozapine presents for their routine lab work. Which Absolute Neutrophil
Count (ANC) result would require immediate discontinuation of the medication and
hematology consultation?
A. ANC 2000/mm3
,B. ANC 1600/mm3
C. ANC 450/mm3
D. ANC 1200/mm3
Answer: C
Conceptual Explanation: Clozapine-induced agranulocytosis is a severe risk. An ANC
below 500/mm3 is classified as severe neutropenia and requires immediate cessation of
the drug and emergency hematological management.
3. Which mechanism of action distinguishes ‘Atypical’ Second-Generation Antipsychotics
(SGAs) from ‘Typical’ First-Generation Antipsychotics (FGAs)?
A. D2 receptor antagonism only
B. 5-HT2A receptor antagonism combined with D2 antagonism
C. GABA-A receptor modulation
D. Selective Norepinephrine Reuptake Inhibition
Answer: B
Conceptual Explanation: SGAs are defined by their ability to block 5-HT2A serotonin
receptors in addition to D2 dopamine receptors, which helps mitigate EPS and may
improve negative symptoms compared to FGAs.
, 4. When differentiating between Serotonin Syndrome and Neuroleptic Malignant Syndrome
(NMS), which clinical finding is most characteristic of Serotonin Syndrome?
A. Lead-pipe muscle rigidity
B. Hyperreflexia and myoclonus
C. Elevated Creatine Kinase (CK)
D. High fever (Hyperpyrexia)
Answer: B
Conceptual Explanation: Hyperreflexia and myoclonus are hallmark signs of Serotonin
Syndrome. NMS is characterized more by ‘lead-pipe’ rigidity and significantly elevated CK
levels, though both involve autonomic instability and fever.
5. A patient with Bipolar Disorder is prescribed Lithium. What is the standard therapeutic
serum range for the maintenance phase of treatment?
A. 0.2 - 0.5 mEq/L
B. 1.5 - 2.0 mEq/L
C. 0.6 - 1.2 mEq/L
D. 2.5 - 3.0 mEq/L
Answer: C
QUESTIONS & ANSWERS
(CHAMBERLAIN) 100% GUARANTEE
PASS
1. In the treatment of Schizophrenia, which dopamine pathway is primarily associated with
the development of Extrapyramidal Symptoms (EPS) when D2 receptors are blocked?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Tuberoinfundibular pathway
D. Nigrostriatal pathway
Answer: D
Conceptual Explanation: The nigrostriatal pathway controls motor function; blockade of
D2 receptors in this pathway leads to EPS. The mesolimbic is associated with positive
symptoms, the mesocortical with negative symptoms, and the tuberoinfundibular with
prolactin regulation.
2. A patient taking Clozapine presents for their routine lab work. Which Absolute Neutrophil
Count (ANC) result would require immediate discontinuation of the medication and
hematology consultation?
A. ANC 2000/mm3
,B. ANC 1600/mm3
C. ANC 450/mm3
D. ANC 1200/mm3
Answer: C
Conceptual Explanation: Clozapine-induced agranulocytosis is a severe risk. An ANC
below 500/mm3 is classified as severe neutropenia and requires immediate cessation of
the drug and emergency hematological management.
3. Which mechanism of action distinguishes ‘Atypical’ Second-Generation Antipsychotics
(SGAs) from ‘Typical’ First-Generation Antipsychotics (FGAs)?
A. D2 receptor antagonism only
B. 5-HT2A receptor antagonism combined with D2 antagonism
C. GABA-A receptor modulation
D. Selective Norepinephrine Reuptake Inhibition
Answer: B
Conceptual Explanation: SGAs are defined by their ability to block 5-HT2A serotonin
receptors in addition to D2 dopamine receptors, which helps mitigate EPS and may
improve negative symptoms compared to FGAs.
, 4. When differentiating between Serotonin Syndrome and Neuroleptic Malignant Syndrome
(NMS), which clinical finding is most characteristic of Serotonin Syndrome?
A. Lead-pipe muscle rigidity
B. Hyperreflexia and myoclonus
C. Elevated Creatine Kinase (CK)
D. High fever (Hyperpyrexia)
Answer: B
Conceptual Explanation: Hyperreflexia and myoclonus are hallmark signs of Serotonin
Syndrome. NMS is characterized more by ‘lead-pipe’ rigidity and significantly elevated CK
levels, though both involve autonomic instability and fever.
5. A patient with Bipolar Disorder is prescribed Lithium. What is the standard therapeutic
serum range for the maintenance phase of treatment?
A. 0.2 - 0.5 mEq/L
B. 1.5 - 2.0 mEq/L
C. 0.6 - 1.2 mEq/L
D. 2.5 - 3.0 mEq/L
Answer: C
