NR 546 MIDTERM EXAM - ADVANCED
PSYCHOPHARMACOLOGY QUESTIONS
AND ANSWERS (LATEST), (A+
GUARANTEE). JUST RELEASED
1. A patient with schizophrenia is experiencing auditory hallucinations and delusions. Which
dopamine pathway is primarily responsible for these positive symptoms?
A. Mesocortical pathway
B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: B
Conceptual Explanation: The mesolimbic pathway involves the projection of dopamine
from the ventral tegmental area to the nucleus accumbens. Hyperactivity in this pathway is
associated with positive symptoms like hallucinations and delusions.
2. A 28-year-old female patient on Lithium for Bipolar I Disorder presents with a fine hand
tremor, polyuria, and mild nausea. Her lithium level is 0.8 mEq/L. What is the most
appropriate next step?
A. Hold the dose and check for toxicity
,B. Administer a bolus of IV fluids
C. Immediately switch to Valproate
D. Continue the current dose as these are common side effects
Answer: D
Conceptual Explanation: A lithium level of 0.8 mEq/L is within the therapeutic range (0.6-
1.2 mEq/L). Fine tremors, polyuria, and mild nausea are common expected side effects at
therapeutic levels.
3. Which antidepressant is contraindicated in patients with a history of seizure disorders or
bulimia nervosa?
A. Fluoxetine
B. Sertraline
C. Venlafaxine
D. Bupropion
Answer: D
Conceptual Explanation: Bupropion lowers the seizure threshold and is specifically
contraindicated in patients with seizure disorders and eating disorders due to increased
risk of seizures.
, 4. Which medication acts as a partial agonist at the D2 receptor, often referred to as a
‘dopamine stabilizer’?
A. Haloperidol
B. Risperidone
C. Aripiprazole
D. Quetiapine
Answer: C
Conceptual Explanation: Aripiprazole is a third-generation antipsychotic that acts as a
partial D2 agonist, modulating dopamine activity depending on whether levels are high or
low.
5. A patient is started on Clozapine. Which laboratory value must be monitored weekly for
the first six months?
A. Liver Function Tests (LFTs)
B. Serum Creatinine
C. Thyroid Stimulating Hormone (TSH)
D. Absolute Neutrophil Count (ANC)
Answer: D
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis,
requiring strict monitoring of the Absolute Neutrophil Count (ANC) via the REMS program.
PSYCHOPHARMACOLOGY QUESTIONS
AND ANSWERS (LATEST), (A+
GUARANTEE). JUST RELEASED
1. A patient with schizophrenia is experiencing auditory hallucinations and delusions. Which
dopamine pathway is primarily responsible for these positive symptoms?
A. Mesocortical pathway
B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: B
Conceptual Explanation: The mesolimbic pathway involves the projection of dopamine
from the ventral tegmental area to the nucleus accumbens. Hyperactivity in this pathway is
associated with positive symptoms like hallucinations and delusions.
2. A 28-year-old female patient on Lithium for Bipolar I Disorder presents with a fine hand
tremor, polyuria, and mild nausea. Her lithium level is 0.8 mEq/L. What is the most
appropriate next step?
A. Hold the dose and check for toxicity
,B. Administer a bolus of IV fluids
C. Immediately switch to Valproate
D. Continue the current dose as these are common side effects
Answer: D
Conceptual Explanation: A lithium level of 0.8 mEq/L is within the therapeutic range (0.6-
1.2 mEq/L). Fine tremors, polyuria, and mild nausea are common expected side effects at
therapeutic levels.
3. Which antidepressant is contraindicated in patients with a history of seizure disorders or
bulimia nervosa?
A. Fluoxetine
B. Sertraline
C. Venlafaxine
D. Bupropion
Answer: D
Conceptual Explanation: Bupropion lowers the seizure threshold and is specifically
contraindicated in patients with seizure disorders and eating disorders due to increased
risk of seizures.
, 4. Which medication acts as a partial agonist at the D2 receptor, often referred to as a
‘dopamine stabilizer’?
A. Haloperidol
B. Risperidone
C. Aripiprazole
D. Quetiapine
Answer: C
Conceptual Explanation: Aripiprazole is a third-generation antipsychotic that acts as a
partial D2 agonist, modulating dopamine activity depending on whether levels are high or
low.
5. A patient is started on Clozapine. Which laboratory value must be monitored weekly for
the first six months?
A. Liver Function Tests (LFTs)
B. Serum Creatinine
C. Thyroid Stimulating Hormone (TSH)
D. Absolute Neutrophil Count (ANC)
Answer: D
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis,
requiring strict monitoring of the Absolute Neutrophil Count (ANC) via the REMS program.
