NURS 5359 EXAM 1: ANTIPSYCHOTIC
MEDICATIONS NEWEST UPDATED (2026-2027)
COMPREHENSIVE PRACTICE EXAMINATION|
PREMIUM QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES| KEY
RELIABLE SOLUTIONS |NURS 5359 EXIT EXAM
SECTION A: DOPAMINE PATHWAYS AND THE DOPAMINE HYPOTHESIS
(Questions 1–20)
1. Which dopamine pathway is primarily associated with the positive
symptoms of schizophrenia when overactive?
A) Mes cortical pathway
B) Nigrostriatal pathway
C) Mesolimbic pathway
D) Tuberoinfundibular pathway
Correct Answer: C
The mesolimbic pathway is part of the brain's reward system.
Overactivity of dopamine transmission in this pathway is linked to
,positive symptoms such as hallucinations and delusions. Antipsychotic
blockade of D2 receptors in this pathway reduces these symptoms.
2. Blockade of dopamine receptors in which pathway is most directly
responsible for extrapyramidal symptoms (EPS)?
A) Mesolimbic pathway
B) Nigrostriatal pathway
C) Mes cortical pathway
D) Tuberoinfundibular pathway
Correct Answer: B
The nigrostriatal pathway is involved in motor control. When
antipsychotics block D2 receptors here, drug-induced parkinsonism,
dystonia, akathisia, and tardive dyskinesia can occur.
3. Hyperprolactinemia, manifesting as galactorrhea and sexual
dysfunction, results from blockade of which dopamine pathway?
A) Mesolimbic pathway
B) Nigrostriatal pathway
C) Mes cortical pathway
D) Tuberoinfundibular pathway
,Correct Answer: D
The tuberoinfundibular pathway regulates prolactin secretion.
Dopamine normally inhibits prolactin release. When antipsychotics
block D2 receptors here, prolactin levels rise, causing galactorrhea,
amenorrhea, gynecomastia, and sexual dysfunction.
4. Underactivity of dopamine in which pathway is associated with
negative symptoms of schizophrenia such as apathy and social
withdrawal?
A) Mesolimbic pathway
B) Nigrostriatal pathway
C) Mes cortical pathway
D) Tuberoinfundibular pathway
Correct Answer: C
The neocortical pathway projects to the prefrontal cortex.
Underactivity here is linked to negative symptoms (apathy,
anhedonia, social withdrawal) and cognitive deficits. Blockade of this
pathway by antipsychotics may worsen these symptoms.
5. A patient on haloperidol develops a shuffling gait, pill-rolling
tremor, and mask-like facies. Which dopamine pathway is implicated?
, A) Mesolimbic pathway
B) Nigrostriatal pathway
C) Mes cortical pathway
D) Tuberoinfundibular pathway
Correct Answer: B
These are classic signs of drug-induced parkinsonism, caused by D2
blockade in the nigrostriatal pathway. This pathway is critical for
smooth motor control.
6. The therapeutic effect of antipsychotics on hallucinations and
delusions is primarily mediated by blockade of D2 receptors in which
pathway?
A) Mes cortical pathway
B) Nigrostriatal pathway
C) Mesolimbic pathway
D) Tuberoinfundibular pathway
Correct Answer: C
The mesolimbic pathway is the primary site where D2 blockade
reduces positive psychotic symptoms. This is the therapeutic target of
antipsychotic medications.
MEDICATIONS NEWEST UPDATED (2026-2027)
COMPREHENSIVE PRACTICE EXAMINATION|
PREMIUM QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES| KEY
RELIABLE SOLUTIONS |NURS 5359 EXIT EXAM
SECTION A: DOPAMINE PATHWAYS AND THE DOPAMINE HYPOTHESIS
(Questions 1–20)
1. Which dopamine pathway is primarily associated with the positive
symptoms of schizophrenia when overactive?
A) Mes cortical pathway
B) Nigrostriatal pathway
C) Mesolimbic pathway
D) Tuberoinfundibular pathway
Correct Answer: C
The mesolimbic pathway is part of the brain's reward system.
Overactivity of dopamine transmission in this pathway is linked to
,positive symptoms such as hallucinations and delusions. Antipsychotic
blockade of D2 receptors in this pathway reduces these symptoms.
2. Blockade of dopamine receptors in which pathway is most directly
responsible for extrapyramidal symptoms (EPS)?
A) Mesolimbic pathway
B) Nigrostriatal pathway
C) Mes cortical pathway
D) Tuberoinfundibular pathway
Correct Answer: B
The nigrostriatal pathway is involved in motor control. When
antipsychotics block D2 receptors here, drug-induced parkinsonism,
dystonia, akathisia, and tardive dyskinesia can occur.
3. Hyperprolactinemia, manifesting as galactorrhea and sexual
dysfunction, results from blockade of which dopamine pathway?
A) Mesolimbic pathway
B) Nigrostriatal pathway
C) Mes cortical pathway
D) Tuberoinfundibular pathway
,Correct Answer: D
The tuberoinfundibular pathway regulates prolactin secretion.
Dopamine normally inhibits prolactin release. When antipsychotics
block D2 receptors here, prolactin levels rise, causing galactorrhea,
amenorrhea, gynecomastia, and sexual dysfunction.
4. Underactivity of dopamine in which pathway is associated with
negative symptoms of schizophrenia such as apathy and social
withdrawal?
A) Mesolimbic pathway
B) Nigrostriatal pathway
C) Mes cortical pathway
D) Tuberoinfundibular pathway
Correct Answer: C
The neocortical pathway projects to the prefrontal cortex.
Underactivity here is linked to negative symptoms (apathy,
anhedonia, social withdrawal) and cognitive deficits. Blockade of this
pathway by antipsychotics may worsen these symptoms.
5. A patient on haloperidol develops a shuffling gait, pill-rolling
tremor, and mask-like facies. Which dopamine pathway is implicated?
, A) Mesolimbic pathway
B) Nigrostriatal pathway
C) Mes cortical pathway
D) Tuberoinfundibular pathway
Correct Answer: B
These are classic signs of drug-induced parkinsonism, caused by D2
blockade in the nigrostriatal pathway. This pathway is critical for
smooth motor control.
6. The therapeutic effect of antipsychotics on hallucinations and
delusions is primarily mediated by blockade of D2 receptors in which
pathway?
A) Mes cortical pathway
B) Nigrostriatal pathway
C) Mesolimbic pathway
D) Tuberoinfundibular pathway
Correct Answer: C
The mesolimbic pathway is the primary site where D2 blockade
reduces positive psychotic symptoms. This is the therapeutic target of
antipsychotic medications.
