NR 546 PSYCHOPHARMACOLOGY
MIDTERM EXAM QUESTIONS AND
ANSWERS (LATEST), (A+ GUARANTEE).
JUST RELEASED
1. Which dopaminergic pathway is primarily 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; blockade of
D2 receptors in this area leads to EPS, including dystonia, parkinsonism, and akathisia.
2. A patient taking a Monoamine Oxidase Inhibitor (MAOI) consumes a meal high in tyramine.
Which condition is the patient at greatest risk for?
A. Hypertensive crisis
B. Serotonin syndrome
C. Neuroleptic malignant syndrome
,D. Agranulocytosis
Answer: A
Conceptual Explanation: Tyramine causes the release of stored norepinephrine; MAOIs
prevent its breakdown, leading to excessive vasoconstriction and a potentially fatal
hypertensive crisis.
3. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders due to an increased risk of seizures?
A. Fluoxetine
B. Venlafaxine
C. Mirtazapine
D. Bupropion
Answer: D
Conceptual Explanation: Bupropion lowers the seizure threshold, especially in patients
with electrolyte imbalances common in eating disorders like bulimia or anorexia.
4. What is the primary mechanism of action for most atypical (second-generation)
antipsychotics?
A. Pure D2 receptor antagonism
B. D2 antagonism and 5HT2A antagonism
C. GABA modulation
, D. Norepinephrine reuptake inhibition
Answer: B
Conceptual Explanation: Atypical antipsychotics are characterized by their dual
mechanism of blocking D2 receptors and 5HT2A (serotonin) receptors, which helps
mitigate EPS and treat negative symptoms.
5. A patient on Clozapine reports a fever and sore throat. Which laboratory test must be
performed immediately?
A. Liver function tests
B. Serum electrolytes
C. Complete Blood Count (CBC) with differential
D. BUN and Creatinine
Answer: C
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. A
fever and sore throat are early signs of infection, requiring an immediate Absolute
Neutrophil Count (ANC) check.
6. Lithium toxicity is most likely to occur in a patient who is also taking which of the following
medications?
A. Acetaminophen
B. Fexofenadine
MIDTERM EXAM QUESTIONS AND
ANSWERS (LATEST), (A+ GUARANTEE).
JUST RELEASED
1. Which dopaminergic pathway is primarily 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; blockade of
D2 receptors in this area leads to EPS, including dystonia, parkinsonism, and akathisia.
2. A patient taking a Monoamine Oxidase Inhibitor (MAOI) consumes a meal high in tyramine.
Which condition is the patient at greatest risk for?
A. Hypertensive crisis
B. Serotonin syndrome
C. Neuroleptic malignant syndrome
,D. Agranulocytosis
Answer: A
Conceptual Explanation: Tyramine causes the release of stored norepinephrine; MAOIs
prevent its breakdown, leading to excessive vasoconstriction and a potentially fatal
hypertensive crisis.
3. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders due to an increased risk of seizures?
A. Fluoxetine
B. Venlafaxine
C. Mirtazapine
D. Bupropion
Answer: D
Conceptual Explanation: Bupropion lowers the seizure threshold, especially in patients
with electrolyte imbalances common in eating disorders like bulimia or anorexia.
4. What is the primary mechanism of action for most atypical (second-generation)
antipsychotics?
A. Pure D2 receptor antagonism
B. D2 antagonism and 5HT2A antagonism
C. GABA modulation
, D. Norepinephrine reuptake inhibition
Answer: B
Conceptual Explanation: Atypical antipsychotics are characterized by their dual
mechanism of blocking D2 receptors and 5HT2A (serotonin) receptors, which helps
mitigate EPS and treat negative symptoms.
5. A patient on Clozapine reports a fever and sore throat. Which laboratory test must be
performed immediately?
A. Liver function tests
B. Serum electrolytes
C. Complete Blood Count (CBC) with differential
D. BUN and Creatinine
Answer: C
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis. A
fever and sore throat are early signs of infection, requiring an immediate Absolute
Neutrophil Count (ANC) check.
6. Lithium toxicity is most likely to occur in a patient who is also taking which of the following
medications?
A. Acetaminophen
B. Fexofenadine
