ORIGINAL Q UE STIONS
UNOFFICIAL STUD Y COLLECTION · ED ITION
NR668 Week 3
Antipsychotics and Mood Stabilizers
25 2 100%
O R I G I N A L Q U ES T I O N S C O N T EN T A R EA S A N S W ER ED +
EX P L A I N ED
W HAT THIS COV ER S
Antipsychotic Therapy Mood Stabilizers
A B O U T THIS A S S ES S MENT
This assessment is an original collection of 25 multiple-choice questions assembled for self-
directed review of antipsychotic and mood-stabilizer pharmacotherapy. Every item was written
fresh for this edition and is placed in one of 2 content areas, so the topic mix mirrors how the
material is actually examined. Each question is followed by the keyed answer and a rationale that
explains why the correct choice is right and why the remaining options are less defensible.
Work through the set in two passes. First answer the items without looking at the keys, marking
any question where you hesitate. Then read every rationale, including those for correct answers,
and revisit the flagged items after a day. Answer positions are balanced across A, B, C, and D, so
keys cannot be predicted from letter patterns.
Independent educational material. This collection is unofficial and is not affiliated with, endorsed by, or connected
to any examination body, credentialing board, or university. Credential and course names appear only to indicate
the subject area. Content is provided for study purposes and is not clinical, legal, or examination advice.
UNOFFICIAL STUDY AID
, How to Use This Assessment
This collection contains 25 original multiple-choice items organized into 2 content areas. Read each stem
carefully and choose the single best option before moving on, exactly as you would under testing conditions. The
keyed answer and a detailed rationale appear directly beneath every question, so review each explanation,
including for items you answered correctly, to consolidate the underlying concept.
SECTION 1 · Antipsychotic Therapy
1. Which dopamine pathway is most closely linked to the positive symptoms of schizophrenia and to
antipsychotic efficacy?
A. The mesolimbic pathway, where D2 blockade reduces hallucinations and delusions
B. The tuberoinfundibular pathway, which controls prolactin release
C. The nigrostriatal pathway, which regulates voluntary motor movement
D. The mesocortical pathway, which modulates negative and cognitive symptoms
Correct Answer: A - The mesolimbic pathway, where D2 blockade reduces hallucinations and delusions
Rationale: Excess dopaminergic activity in the mesolimbic pathway corresponds to positive symptoms, and D2
antagonism there underlies antipsychotic benefit. Nigrostriatal blockade produces EPS, tuberoinfundibular blockade
raises prolactin, and the mesocortical pathway is associated with negative symptoms that D2 blockade may worsen.
2. A young man started haloperidol three days ago and develops neck muscle spasm, tongue protrusion, and
jaw rigidity. What is the diagnosis and treatment?
A. Neuroleptic malignant syndrome, treated with dantrolene
B. Tardive dyskinesia, treated with valbenazine
C. Akathisia, treated by adding propranolol
D. Acute dystonia, treated with intramuscular or oral benztropine or diphenhydramine
Correct Answer: D - Acute dystonia, treated with intramuscular or oral benztropine or diphenhydramine
Rationale: Painful sustained muscle contractions of the neck, tongue, and jaw within days of starting a high-potency
D2 antagonist define acute dystonia, which responds to anticholinergics or antihistamines. Akathisia is subjective
restlessness, tardive dyskinesia appears after months with orofacial choreiform movements, and NMS involves fever
and rigidity.
3. A patient on risperidone describes an inner sense of crawling restlessness that worsens in the evening and
is mistaken for anxiety. The correct management is:
A. Add lorazepam indefinitely without reassessment
B. Switch to clozapine immediately
C. Recognize akathisia and reduce the dose or add propranolol, avoiding unnecessary antipsychotic
increases
D. Increase the antipsychotic dose to control the agitation
Correct Answer: C - Recognize akathisia and reduce the dose or add propranolol, avoiding unnecessary
antipsychotic increases
Rationale: Akathisia is a subjective, distressing motor restlessness often misread as worsening psychosis or anxiety;
raising the antipsychotic worsens it. First steps are dose reduction or beta-blocker therapy. Benzodiazepines are
adjunctive at most, and clozapine is reserved for treatment resistance, not akathisia.
Original Question Set - Unofficial Study Aid 1
UNOFFICIAL STUD Y COLLECTION · ED ITION
NR668 Week 3
Antipsychotics and Mood Stabilizers
25 2 100%
O R I G I N A L Q U ES T I O N S C O N T EN T A R EA S A N S W ER ED +
EX P L A I N ED
W HAT THIS COV ER S
Antipsychotic Therapy Mood Stabilizers
A B O U T THIS A S S ES S MENT
This assessment is an original collection of 25 multiple-choice questions assembled for self-
directed review of antipsychotic and mood-stabilizer pharmacotherapy. Every item was written
fresh for this edition and is placed in one of 2 content areas, so the topic mix mirrors how the
material is actually examined. Each question is followed by the keyed answer and a rationale that
explains why the correct choice is right and why the remaining options are less defensible.
Work through the set in two passes. First answer the items without looking at the keys, marking
any question where you hesitate. Then read every rationale, including those for correct answers,
and revisit the flagged items after a day. Answer positions are balanced across A, B, C, and D, so
keys cannot be predicted from letter patterns.
Independent educational material. This collection is unofficial and is not affiliated with, endorsed by, or connected
to any examination body, credentialing board, or university. Credential and course names appear only to indicate
the subject area. Content is provided for study purposes and is not clinical, legal, or examination advice.
UNOFFICIAL STUDY AID
, How to Use This Assessment
This collection contains 25 original multiple-choice items organized into 2 content areas. Read each stem
carefully and choose the single best option before moving on, exactly as you would under testing conditions. The
keyed answer and a detailed rationale appear directly beneath every question, so review each explanation,
including for items you answered correctly, to consolidate the underlying concept.
SECTION 1 · Antipsychotic Therapy
1. Which dopamine pathway is most closely linked to the positive symptoms of schizophrenia and to
antipsychotic efficacy?
A. The mesolimbic pathway, where D2 blockade reduces hallucinations and delusions
B. The tuberoinfundibular pathway, which controls prolactin release
C. The nigrostriatal pathway, which regulates voluntary motor movement
D. The mesocortical pathway, which modulates negative and cognitive symptoms
Correct Answer: A - The mesolimbic pathway, where D2 blockade reduces hallucinations and delusions
Rationale: Excess dopaminergic activity in the mesolimbic pathway corresponds to positive symptoms, and D2
antagonism there underlies antipsychotic benefit. Nigrostriatal blockade produces EPS, tuberoinfundibular blockade
raises prolactin, and the mesocortical pathway is associated with negative symptoms that D2 blockade may worsen.
2. A young man started haloperidol three days ago and develops neck muscle spasm, tongue protrusion, and
jaw rigidity. What is the diagnosis and treatment?
A. Neuroleptic malignant syndrome, treated with dantrolene
B. Tardive dyskinesia, treated with valbenazine
C. Akathisia, treated by adding propranolol
D. Acute dystonia, treated with intramuscular or oral benztropine or diphenhydramine
Correct Answer: D - Acute dystonia, treated with intramuscular or oral benztropine or diphenhydramine
Rationale: Painful sustained muscle contractions of the neck, tongue, and jaw within days of starting a high-potency
D2 antagonist define acute dystonia, which responds to anticholinergics or antihistamines. Akathisia is subjective
restlessness, tardive dyskinesia appears after months with orofacial choreiform movements, and NMS involves fever
and rigidity.
3. A patient on risperidone describes an inner sense of crawling restlessness that worsens in the evening and
is mistaken for anxiety. The correct management is:
A. Add lorazepam indefinitely without reassessment
B. Switch to clozapine immediately
C. Recognize akathisia and reduce the dose or add propranolol, avoiding unnecessary antipsychotic
increases
D. Increase the antipsychotic dose to control the agitation
Correct Answer: C - Recognize akathisia and reduce the dose or add propranolol, avoiding unnecessary
antipsychotic increases
Rationale: Akathisia is a subjective, distressing motor restlessness often misread as worsening psychosis or anxiety;
raising the antipsychotic worsens it. First steps are dose reduction or beta-blocker therapy. Benzodiazepines are
adjunctive at most, and clozapine is reserved for treatment resistance, not akathisia.
Original Question Set - Unofficial Study Aid 1
