NR 546 Week 5 Exam V1 | NR 546 Advanced
Pharmacology Psychopharmacology for the
PMHNP | Actual Q&A with Rationale (NR546 Week
5 Exam) | Chamberlain University
1. A patient with schizophrenia is experiencing auditory hallucinations and delusions. Which
dopamine pathway is primarily associated with these positive symptoms?
A. Nigrostriatal pathway
B. Mesocortical pathway
C. Mesolimbic pathway
D. Tuberoinfundibular pathway
Correct Answer: C
Explanation: The mesolimbic pathway is associated with the positive symptoms of
schizophrenia, such as hallucinations and delusions, due to overactivity of dopamine.
Antipsychotics target this pathway by blocking D2 receptors to reduce these symptoms.
Excessive dopamine in this circuit is thought to mediate the salience of external stimuli,
leading to psychotic experiences.
2. Which side effect is a patient most likely to experience if a medication causes dopamine
blockade in the tuberoinfundibular pathway?
A. Hyperprolactinemia
B. Tardive dyskinesia
,C. Weight gain
D. Orthostatic hypotension
Correct Answer: A
Explanation: The tuberoinfundibular pathway regulates prolactin secretion from the
pituitary gland. When D2 receptors are blocked in this pathway by antipsychotics, prolactin
levels rise because dopamine normally inhibits its release. This can lead to symptoms like
galactorrhea, gynecomastia, and menstrual irregularities.
3. A patient taking Haloperidol (Haldol) develops acute dystonia. Which dopamine pathway is
involved in the development of extrapyramidal symptoms (EPS)?
A. Mesocortical pathway
B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Correct Answer: C
Explanation: The nigrostriatal pathway is part of the extrapyramidal nervous system and
controls motor function and movement. Blockade of D2 receptors in this pathway leads to
EPS, including dystonia, parkinsonism, and akathisia. Chronic blockade can eventually lead
to tardive dyskinesia due to receptor up-regulation.
, 4. Negative symptoms of schizophrenia, such as cognitive impairment and flat affect, are
hypothesized to be caused by which of the following?
A. Dopamine excess in the mesolimbic pathway
B. Dopamine deficit in the mesocortical pathway
C. Serotonin deficit in the nigrostriatal pathway
D. GABA excess in the prefrontal cortex
Correct Answer: B
Explanation: Negative symptoms and cognitive deficits in schizophrenia are linked to a
deficiency of dopamine activity in the mesocortical pathway. Traditional antipsychotics
(FGAs) may worsen these symptoms by further blocking dopamine in this area. Second-
generation antipsychotics aim to modulate this via serotonin-dopamine antagonism.
5. What is the primary mechanism of action of First-Generation Antipsychotics (FGAs)?
A. 5HT2A receptor antagonism
B. D2 receptor partial agonism
C. D2 receptor antagonism
D. NMDA receptor antagonism
Correct Answer: C
Explanation: First-generation antipsychotics, also known as typical antipsychotics,
primarily work by blocking D2 receptors in the brain. Their efficacy is closely tied to the
Pharmacology Psychopharmacology for the
PMHNP | Actual Q&A with Rationale (NR546 Week
5 Exam) | Chamberlain University
1. A patient with schizophrenia is experiencing auditory hallucinations and delusions. Which
dopamine pathway is primarily associated with these positive symptoms?
A. Nigrostriatal pathway
B. Mesocortical pathway
C. Mesolimbic pathway
D. Tuberoinfundibular pathway
Correct Answer: C
Explanation: The mesolimbic pathway is associated with the positive symptoms of
schizophrenia, such as hallucinations and delusions, due to overactivity of dopamine.
Antipsychotics target this pathway by blocking D2 receptors to reduce these symptoms.
Excessive dopamine in this circuit is thought to mediate the salience of external stimuli,
leading to psychotic experiences.
2. Which side effect is a patient most likely to experience if a medication causes dopamine
blockade in the tuberoinfundibular pathway?
A. Hyperprolactinemia
B. Tardive dyskinesia
,C. Weight gain
D. Orthostatic hypotension
Correct Answer: A
Explanation: The tuberoinfundibular pathway regulates prolactin secretion from the
pituitary gland. When D2 receptors are blocked in this pathway by antipsychotics, prolactin
levels rise because dopamine normally inhibits its release. This can lead to symptoms like
galactorrhea, gynecomastia, and menstrual irregularities.
3. A patient taking Haloperidol (Haldol) develops acute dystonia. Which dopamine pathway is
involved in the development of extrapyramidal symptoms (EPS)?
A. Mesocortical pathway
B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Correct Answer: C
Explanation: The nigrostriatal pathway is part of the extrapyramidal nervous system and
controls motor function and movement. Blockade of D2 receptors in this pathway leads to
EPS, including dystonia, parkinsonism, and akathisia. Chronic blockade can eventually lead
to tardive dyskinesia due to receptor up-regulation.
, 4. Negative symptoms of schizophrenia, such as cognitive impairment and flat affect, are
hypothesized to be caused by which of the following?
A. Dopamine excess in the mesolimbic pathway
B. Dopamine deficit in the mesocortical pathway
C. Serotonin deficit in the nigrostriatal pathway
D. GABA excess in the prefrontal cortex
Correct Answer: B
Explanation: Negative symptoms and cognitive deficits in schizophrenia are linked to a
deficiency of dopamine activity in the mesocortical pathway. Traditional antipsychotics
(FGAs) may worsen these symptoms by further blocking dopamine in this area. Second-
generation antipsychotics aim to modulate this via serotonin-dopamine antagonism.
5. What is the primary mechanism of action of First-Generation Antipsychotics (FGAs)?
A. 5HT2A receptor antagonism
B. D2 receptor partial agonism
C. D2 receptor antagonism
D. NMDA receptor antagonism
Correct Answer: C
Explanation: First-generation antipsychotics, also known as typical antipsychotics,
primarily work by blocking D2 receptors in the brain. Their efficacy is closely tied to the
