NSG 552: COMPREHENSIVE FINAL EXAM
ADVANCED PSYCHOPHARMACOLY
COVERAGE : MODULES 1 - 10
2026/2027/2028 TESTING CYCLE
100 VERIFIED Q & A, WITH EXPERT RATIONALES | GUARANTEED PASS
GRADED A+
Q1: Which brain structure serves as the primary relay station for sensory information (except
smell) to the cerebral cortex?
A. Amygdala
B. Hippocampus
C. Thalamus
D. Hypothalamus
Correct Answer: C
Rationale: The thalamus relays sensory information (except smell) to the cerebral cortex. The
amygdala processes fear; the hippocampus is for memory; the hypothalamus controls
homeostasis.
Q2: A nurse is teaching about neurotransmitter reuptake. Which statement by the patient
indicates understanding?
A. "Reuptake increases neurotransmitter availability in the synaptic cleft."
B. "Reuptake terminates neurotransmitter action by returning it to the presynaptic neuron."
C. "Reuptake occurs in the postsynaptic neuron."
D. "Reuptake is the same as enzymatic degradation."
Correct Answer: B
Rationale: Reuptake terminates neurotransmitter action by transporting neurotransmitters back
into the presynaptic neuron for reuse or degradation. SSRIs and SNRIs block reuptake to
increase neurotransmitter availability.
,Q3: Which second messenger is produced by phospholipase C?
A. cAMP
B. IP3 and DAG
C. cGMP
D. Calcium
Correct Answer: B
Rationale: Phospholipase C produces IP3 (inositol triphosphate) and DAG (diacylglycerol) from
membrane phospholipids. IP3 releases calcium; DAG activates protein kinase C.
Q4: A medication has a half-life of 48 hours. How long will it take to reach steady-state?
A. 2 days
B. 4 days
C. 8 days
D. 10 days
Correct Answer: D
Rationale: Steady-state is reached after 4–5 half-lives. 5 × 48 hours = 240 hours = 10 days.
Q5: Which CYP450 enzyme is primarily responsible for metabolizing fluoxetine?
A. CYP1A2
B. CYP2C19
C. CYP2D6
D. CYP3A4
Correct Answer: C
Rationale: Fluoxetine is primarily metabolized by CYP2D6. It is also a potent CYP2D6 inhibitor,
increasing levels of other CYP2D6 substrates.
,Q6: A patient on paroxetine is prescribed metoprolol. Which effect should the nurse anticipate?
A. Decreased metoprolol levels
B. Increased metoprolol levels and bradycardia
C. No interaction
D. Decreased paroxetine levels
Correct Answer: B
Rationale: Paroxetine is a potent CYP2D6 inhibitor. Metoprolol is metabolized by CYP2D6.
Combining these medications can increase metoprolol levels, causing bradycardia and
hypotension.
Q7: Which dopamine pathway is associated with positive symptoms of schizophrenia?
A. Mesocortical
B. Mesolimbic
C. Nigrostriatal
D. Tuberoinfundibular
Correct Answer: B
Rationale: The mesolimbic pathway is associated with positive symptoms of schizophrenia
(hallucinations, delusions). It is the target for antipsychotic efficacy.
Q8: Which antipsychotic has the lowest risk of extrapyramidal symptoms?
A. Haloperidol
B. Fluphenazine
C. Clozapine
D. Chlorpromazine
Correct Answer: C
Rationale: Clozapine has the lowest risk of EPS among antipsychotics due to its rapid
dissociation from D2 receptors and broad receptor profile.
, Q9: A patient on clozapine has a serum level of 1,200 ng/mL. Which action should the nurse
take?
A. Continue the current dose
B. Notify the provider immediately
C. Administer the next dose as scheduled
D. Document and reassess in 1 week
Correct Answer: B
Rationale: Clozapine levels above 1,000 ng/mL are associated with increased risk of toxicity,
including seizures and myocarditis. The nurse should notify the provider immediately.
Q10: Which medication is used to treat clozapine-induced seizures?
A. Valproate
B. Topiramate
C. Carbamazepine
D. Phenytoin
Correct Answer: B
Rationale: Topiramate is the safest, best-tolerated anticonvulsant for managing clozapine-related
seizures.
Q11: Which medication is a partial D2 agonist?
A. Haloperidol
B. Aripiprazole
C. Risperidone
D. Olanzapine
Correct Answer: B
Rationale: Aripiprazole is a partial D2 agonist (dopamine stabilizer) with lower EPS and
metabolic risk.
ADVANCED PSYCHOPHARMACOLY
COVERAGE : MODULES 1 - 10
2026/2027/2028 TESTING CYCLE
100 VERIFIED Q & A, WITH EXPERT RATIONALES | GUARANTEED PASS
GRADED A+
Q1: Which brain structure serves as the primary relay station for sensory information (except
smell) to the cerebral cortex?
A. Amygdala
B. Hippocampus
C. Thalamus
D. Hypothalamus
Correct Answer: C
Rationale: The thalamus relays sensory information (except smell) to the cerebral cortex. The
amygdala processes fear; the hippocampus is for memory; the hypothalamus controls
homeostasis.
Q2: A nurse is teaching about neurotransmitter reuptake. Which statement by the patient
indicates understanding?
A. "Reuptake increases neurotransmitter availability in the synaptic cleft."
B. "Reuptake terminates neurotransmitter action by returning it to the presynaptic neuron."
C. "Reuptake occurs in the postsynaptic neuron."
D. "Reuptake is the same as enzymatic degradation."
Correct Answer: B
Rationale: Reuptake terminates neurotransmitter action by transporting neurotransmitters back
into the presynaptic neuron for reuse or degradation. SSRIs and SNRIs block reuptake to
increase neurotransmitter availability.
,Q3: Which second messenger is produced by phospholipase C?
A. cAMP
B. IP3 and DAG
C. cGMP
D. Calcium
Correct Answer: B
Rationale: Phospholipase C produces IP3 (inositol triphosphate) and DAG (diacylglycerol) from
membrane phospholipids. IP3 releases calcium; DAG activates protein kinase C.
Q4: A medication has a half-life of 48 hours. How long will it take to reach steady-state?
A. 2 days
B. 4 days
C. 8 days
D. 10 days
Correct Answer: D
Rationale: Steady-state is reached after 4–5 half-lives. 5 × 48 hours = 240 hours = 10 days.
Q5: Which CYP450 enzyme is primarily responsible for metabolizing fluoxetine?
A. CYP1A2
B. CYP2C19
C. CYP2D6
D. CYP3A4
Correct Answer: C
Rationale: Fluoxetine is primarily metabolized by CYP2D6. It is also a potent CYP2D6 inhibitor,
increasing levels of other CYP2D6 substrates.
,Q6: A patient on paroxetine is prescribed metoprolol. Which effect should the nurse anticipate?
A. Decreased metoprolol levels
B. Increased metoprolol levels and bradycardia
C. No interaction
D. Decreased paroxetine levels
Correct Answer: B
Rationale: Paroxetine is a potent CYP2D6 inhibitor. Metoprolol is metabolized by CYP2D6.
Combining these medications can increase metoprolol levels, causing bradycardia and
hypotension.
Q7: Which dopamine pathway is associated with positive symptoms of schizophrenia?
A. Mesocortical
B. Mesolimbic
C. Nigrostriatal
D. Tuberoinfundibular
Correct Answer: B
Rationale: The mesolimbic pathway is associated with positive symptoms of schizophrenia
(hallucinations, delusions). It is the target for antipsychotic efficacy.
Q8: Which antipsychotic has the lowest risk of extrapyramidal symptoms?
A. Haloperidol
B. Fluphenazine
C. Clozapine
D. Chlorpromazine
Correct Answer: C
Rationale: Clozapine has the lowest risk of EPS among antipsychotics due to its rapid
dissociation from D2 receptors and broad receptor profile.
, Q9: A patient on clozapine has a serum level of 1,200 ng/mL. Which action should the nurse
take?
A. Continue the current dose
B. Notify the provider immediately
C. Administer the next dose as scheduled
D. Document and reassess in 1 week
Correct Answer: B
Rationale: Clozapine levels above 1,000 ng/mL are associated with increased risk of toxicity,
including seizures and myocarditis. The nurse should notify the provider immediately.
Q10: Which medication is used to treat clozapine-induced seizures?
A. Valproate
B. Topiramate
C. Carbamazepine
D. Phenytoin
Correct Answer: B
Rationale: Topiramate is the safest, best-tolerated anticonvulsant for managing clozapine-related
seizures.
Q11: Which medication is a partial D2 agonist?
A. Haloperidol
B. Aripiprazole
C. Risperidone
D. Olanzapine
Correct Answer: B
Rationale: Aripiprazole is a partial D2 agonist (dopamine stabilizer) with lower EPS and
metabolic risk.
