NR 546 ADVANCED
PSYCHOPHARMACOLOGY MIDTERM
EXAM QUESTIONS AND ANSWERS
(LATEST), (A+ GUARANTEE). JUST
RELEASED
1. Which dopamine pathway is responsible for the development of extrapyramidal symptoms
(EPS) when D2 receptors are blocked?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: The nigrostriatal pathway controls motor function.
Antipsychotic-induced D2 blockade in this pathway leads to EPS like dystonia and
akathisia.
2. A patient taking Clozapine presents with a fever and sore throat. What is the priority
nursing action?
A. Order an immediate Absolute Neutrophil Count (ANC)
,B. Administer an antipyretic
C. Prescribe a broad-spectrum antibiotic
D. Document the findings as a common side effect
Answer: A
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. A
fever and sore throat are clinical signs of infection due to low white blood cell counts,
requiring immediate ANC testing.
3. Which cytochrome P450 (CYP) enzyme is primarily inhibited by Fluoxetine and Paroxetine,
potentially increasing levels of TCAs?
A. CYP3A4
B. CYP1A2
C. CYP2D6
D. CYP2C19
Answer: C
Conceptual Explanation: Fluoxetine and Paroxetine are potent inhibitors of CYP2D6,
which is the primary pathway for many tricyclic antidepressants and beta-blockers.
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. GABA-A modulation
Answer: B
Conceptual Explanation: Memantine is an NMDA receptor antagonist that works by
regulating the activity of glutamate, preventing neurotoxicity caused by overstimulation.
5. A patient with Bipolar I disorder presents with a serum lithium level of 1.8 mEq/L. Which
symptom is most likely observed?
A. Mild hand tremor
B. Polyuria
C. Coarse tremors and ataxia
D. Weight gain
Answer: C
Conceptual Explanation: Lithium levels above 1.5 mEq/L indicate toxicity. Coarse
tremors, ataxia, and confusion are signs of moderate to severe toxicity, whereas mild
tremors are common at therapeutic levels.
6. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Sertraline
PSYCHOPHARMACOLOGY MIDTERM
EXAM QUESTIONS AND ANSWERS
(LATEST), (A+ GUARANTEE). JUST
RELEASED
1. Which dopamine pathway is responsible for the development of extrapyramidal symptoms
(EPS) when D2 receptors are blocked?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: The nigrostriatal pathway controls motor function.
Antipsychotic-induced D2 blockade in this pathway leads to EPS like dystonia and
akathisia.
2. A patient taking Clozapine presents with a fever and sore throat. What is the priority
nursing action?
A. Order an immediate Absolute Neutrophil Count (ANC)
,B. Administer an antipyretic
C. Prescribe a broad-spectrum antibiotic
D. Document the findings as a common side effect
Answer: A
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. A
fever and sore throat are clinical signs of infection due to low white blood cell counts,
requiring immediate ANC testing.
3. Which cytochrome P450 (CYP) enzyme is primarily inhibited by Fluoxetine and Paroxetine,
potentially increasing levels of TCAs?
A. CYP3A4
B. CYP1A2
C. CYP2D6
D. CYP2C19
Answer: C
Conceptual Explanation: Fluoxetine and Paroxetine are potent inhibitors of CYP2D6,
which is the primary pathway for many tricyclic antidepressants and beta-blockers.
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. GABA-A modulation
Answer: B
Conceptual Explanation: Memantine is an NMDA receptor antagonist that works by
regulating the activity of glutamate, preventing neurotoxicity caused by overstimulation.
5. A patient with Bipolar I disorder presents with a serum lithium level of 1.8 mEq/L. Which
symptom is most likely observed?
A. Mild hand tremor
B. Polyuria
C. Coarse tremors and ataxia
D. Weight gain
Answer: C
Conceptual Explanation: Lithium levels above 1.5 mEq/L indicate toxicity. Coarse
tremors, ataxia, and confusion are signs of moderate to severe toxicity, whereas mild
tremors are common at therapeutic levels.
6. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Sertraline
