NRNP 6675 WALDEN
MIDTERM EXAM
Actual Questions and Answers
Expert-Verified Explanation
This Exam contains:
❖ Guarantee passing score
❖ 100 Questions and Answers
❖ format set of multiple-choice
❖ Expert-Verified Explanation
❖ Verified with trusted textbooks
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1) Phencyclidine (PCP) and Ketamine exert their unique behavioral effects by
blocking which of the following receptors?
A. GABA type receptors
B. Serotonin receptors
C. Dopamine receptors
D. NMDA-type glutamate receptors
Correct Answer: D. NMDA-type glutamate receptors
Expert-Verified Explanation:
• PCP and Ketamine are well-known NMDA (a subtype of glutamate receptor)
antagonists.
• This blockade underlies their dissociative anesthetic properties and can
lead to hallucinations, agitation, and sometimes violent behavior.
• Their action is distinct from that of classic “GABAergic” sedatives and from
serotonergic psychedelics such as LSD.
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2) The diagnosis used to describe a syndrome characterized by specific signs
and symptoms resulting from recent ingestion or exposure to a substance is
which of the following?
A. Substance intoxication
B. Substance withdrawal
C. Substance use disorder
D. Any of the above
Correct Answer: A. Substance intoxication
Expert-Verified Explanation:
• “Substance intoxication” refers to the set of behavioral or physiological
changes that occur when a substance is recently taken in excess.
• “Substance withdrawal” refers to the symptomatic reaction when reducing
or discontinuing a substance.
, • “Substance use disorder” is a pattern of problem use leading to clinically
significant impairment over time, not just recent ingestion.
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3) Abnormal involuntary movements in a rhythmic pattern affecting face,
mouth, tongue, jaw are known as which of the following?
A. Akathisia
B. Dystonia
C. Tardive dyskinesia
D. Extrapyramidal side effects
Correct Answer: C. Tardive dyskinesia
Expert-Verified Explanation:
• Tardive dyskinesia (TD) is classically associated with long-term use of
antipsychotics (especially older typical agents).
• It involves repetitive, involuntary, and purposeless movements, particularly
of the face and jaw (e.g., lip smacking, tongue protrusion).
• It belongs to the broader category of extrapyramidal side effects but is
specifically referred to as “tardive” because it often appears late in treatment.
4) Which of the following are risk factors for neuroleptic malignant syndrome
(NMS)? (Select all that apply)
A. Age
B. Rapid dose escalation
C. Parenteral (injectable) route of administration
D. Higher potency typical antipsychotics
Correct Answers: A, B, C, and D
Expert-Verified Explanation:
• NMS is a rare but potentially fatal complication of antipsychotic use,
especially the high-potency first-generation (typical) antipsychotics.
• Advanced age is a risk factor because older adults often have slower drug
metabolism and multiple comorbidities.
, • Rapid increases in the dose (rapid dose escalation) and the use of
parenteral formulations can lead to higher peak plasma levels, raising NMS risk.
• High-potency typical antipsychotics (e.g., haloperidol) more robustly block
dopamine D2 receptors, further increasing the likelihood of NMS.
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─
5) Antipsychotic medications provide D2 blockade in the mesocortical pathway
causing which of the following effects?
A. Reduces negative symptoms
B. Increases extrapyramidal symptoms (EPS)
C. Causes prolactinemia
D. Reduces positive symptoms
Correct Answer: (Most commonly accepted in standard texts) A. Reduces
negative symptoms
(However, see explanation below about clinical nuance.)
Expert-Verified Explanation:
• Traditionally, blockade of D2 receptors in the mesolimbic pathway reduces
positive symptoms of psychosis (e.g., delusions, hallucinations).
• The “textbook” rationale often states that adequate dopaminergic activity in
the mesocortical pathway may help with negative symptoms. Some modern
atypical antipsychotics improve negative symptoms partly via serotonin-
dopamine modulation.
• In strict classic teaching, blocking dopamine in the mesocortical pathway
can theoretically worsen negative symptoms. However, many exam-style
questions are framed to indicate that “mesocortical modulation” helps reduce
negative symptoms—particularly with atypical agents.
• Always check your specific exam or study source for how they present this
concept.
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─
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─
6) A deeply held belief despite evidence to the contrary, lasting at least one
month, without prominent hallucinations, with functional impairment that
relates to the delusional system is which of the following?
MIDTERM EXAM
Actual Questions and Answers
Expert-Verified Explanation
This Exam contains:
❖ Guarantee passing score
❖ 100 Questions and Answers
❖ format set of multiple-choice
❖ Expert-Verified Explanation
❖ Verified with trusted textbooks
,───────────────────────────────────────────────────────
─
1) Phencyclidine (PCP) and Ketamine exert their unique behavioral effects by
blocking which of the following receptors?
A. GABA type receptors
B. Serotonin receptors
C. Dopamine receptors
D. NMDA-type glutamate receptors
Correct Answer: D. NMDA-type glutamate receptors
Expert-Verified Explanation:
• PCP and Ketamine are well-known NMDA (a subtype of glutamate receptor)
antagonists.
• This blockade underlies their dissociative anesthetic properties and can
lead to hallucinations, agitation, and sometimes violent behavior.
• Their action is distinct from that of classic “GABAergic” sedatives and from
serotonergic psychedelics such as LSD.
───────────────────────────────────────────────────────
─
2) The diagnosis used to describe a syndrome characterized by specific signs
and symptoms resulting from recent ingestion or exposure to a substance is
which of the following?
A. Substance intoxication
B. Substance withdrawal
C. Substance use disorder
D. Any of the above
Correct Answer: A. Substance intoxication
Expert-Verified Explanation:
• “Substance intoxication” refers to the set of behavioral or physiological
changes that occur when a substance is recently taken in excess.
• “Substance withdrawal” refers to the symptomatic reaction when reducing
or discontinuing a substance.
, • “Substance use disorder” is a pattern of problem use leading to clinically
significant impairment over time, not just recent ingestion.
───────────────────────────────────────────────────────
─
3) Abnormal involuntary movements in a rhythmic pattern affecting face,
mouth, tongue, jaw are known as which of the following?
A. Akathisia
B. Dystonia
C. Tardive dyskinesia
D. Extrapyramidal side effects
Correct Answer: C. Tardive dyskinesia
Expert-Verified Explanation:
• Tardive dyskinesia (TD) is classically associated with long-term use of
antipsychotics (especially older typical agents).
• It involves repetitive, involuntary, and purposeless movements, particularly
of the face and jaw (e.g., lip smacking, tongue protrusion).
• It belongs to the broader category of extrapyramidal side effects but is
specifically referred to as “tardive” because it often appears late in treatment.
4) Which of the following are risk factors for neuroleptic malignant syndrome
(NMS)? (Select all that apply)
A. Age
B. Rapid dose escalation
C. Parenteral (injectable) route of administration
D. Higher potency typical antipsychotics
Correct Answers: A, B, C, and D
Expert-Verified Explanation:
• NMS is a rare but potentially fatal complication of antipsychotic use,
especially the high-potency first-generation (typical) antipsychotics.
• Advanced age is a risk factor because older adults often have slower drug
metabolism and multiple comorbidities.
, • Rapid increases in the dose (rapid dose escalation) and the use of
parenteral formulations can lead to higher peak plasma levels, raising NMS risk.
• High-potency typical antipsychotics (e.g., haloperidol) more robustly block
dopamine D2 receptors, further increasing the likelihood of NMS.
───────────────────────────────────────────────────────
─
5) Antipsychotic medications provide D2 blockade in the mesocortical pathway
causing which of the following effects?
A. Reduces negative symptoms
B. Increases extrapyramidal symptoms (EPS)
C. Causes prolactinemia
D. Reduces positive symptoms
Correct Answer: (Most commonly accepted in standard texts) A. Reduces
negative symptoms
(However, see explanation below about clinical nuance.)
Expert-Verified Explanation:
• Traditionally, blockade of D2 receptors in the mesolimbic pathway reduces
positive symptoms of psychosis (e.g., delusions, hallucinations).
• The “textbook” rationale often states that adequate dopaminergic activity in
the mesocortical pathway may help with negative symptoms. Some modern
atypical antipsychotics improve negative symptoms partly via serotonin-
dopamine modulation.
• In strict classic teaching, blocking dopamine in the mesocortical pathway
can theoretically worsen negative symptoms. However, many exam-style
questions are framed to indicate that “mesocortical modulation” helps reduce
negative symptoms—particularly with atypical agents.
• Always check your specific exam or study source for how they present this
concept.
───────────────────────────────────────────────────────
─
───────────────────────────────────────────────────────
─
6) A deeply held belief despite evidence to the contrary, lasting at least one
month, without prominent hallucinations, with functional impairment that
relates to the delusional system is which of the following?
