NSG 552
Psychopharmacology Exam 2
Review 2026/2027 – Verified
Questions & Answers | Pass
Guaranteed A+
Question 1
A 35-year-old female on long-term haloperidol decanoate
100 mg IM monthly develops a 4-week history of lip-
smacking, tongue protrusion, and choreoathetoid finger
movements. Symptoms worsen when her haloperidol dose
is increased. Which pathophysiologic process is most likely
responsible?
A. Acute D2 hypersensitivity in the nigrostriatal pathway
causing transient dyskinesia
B. Dopamine receptor supersensitivity from chronic D2
blockade leading to tardive dyskinesia
C. Serotonin 5-HT2A receptor upregulation causing
choreiform movements
,D. Anticholinergic-induced pseudoparkinsonism masked
by haloperidol's low anticholinergic activity
Rationale: Tardive dyskinesia results from chronic D2
receptor blockade producing postsynaptic supersensitivity in
the nigrostriatal pathway. The classical presentation
includes orofacial choreoathetosis, and symptoms often
worsen with antipsychotic dose increases as the
supersensitive receptors are further denervated. VMAT2
inhibitors are FDA-approved treatments.
Question 2
A 19-year-old African American male receives haloperidol
10 mg IM for acute agitation. Six hours later he develops
neck hypertension, upward eye deviation, and a torticollis-
like posture. Vital signs are stable. The MOST appropriate
immediate intervention is:
A. Increase haloperidol dose to suppress the dystonia
B. Administer diphenhydramine 50 mg IM or
benztropine 1-2 mg IM and reassess
C. Discontinue all antipsychotics permanently and start
lithium
D. Administer propranolol 20 mg PO for akathisia
,Rationale: Acute dystonia typically emerges within 24-72
hours of high-potency D2 antagonist initiation, especially
after IM administration in young males. Treatment is
parenteral anticholinergic (diphenhydramine 25-50 mg
IM/IV or benztropine 1-2 mg IM/IV), which produces rapid
resolution by restoring cholinergic-dopaminergic balance.
Question 3
Which statement CORRECTLY ranks the first-generation
antipsychotics by approximate chlorpromazine-equivalent
potency?
A. Haloperidol > fluphenazine > thioridazine >
chlorpromazine
B. Fluphenazine > haloperidol > chlorpromazine >
thioridazine
C. Fluphenazine > haloperidol > thioridazine >
chlorpromazine
D. Haloperidol > chlorpromazine > fluphenazine >
thioridazine
Rationale: Potency ranking of common FGAs by
chlorpromazine equivalents: fluphenazine ~2 mg (highest
potency), haloperidol ~2-5 mg, thioridazine ~100 mg,
, chlorpromazine 100 mg (reference, lowest potency). Higher
potency = more EPS but less
sedation/orthostasis/anticholinergic burden.
Question 4
A patient with PTSD is started on prazosin for trauma-
related nightmares. Which monitoring parameter is most
important during therapy?
A. Serum creatinine
B. Blood pressure
C. Liver function tests
D. Complete blood count
Rationale: Prazosin is an alpha-1 adrenergic antagonist that
can cause orthostatic hypotension, particularly during dose
initiation and titration. Blood pressure monitoring, including
supine and standing readings, is essential to prevent falls
and symptomatic hypotension.
Question 5
Psychopharmacology Exam 2
Review 2026/2027 – Verified
Questions & Answers | Pass
Guaranteed A+
Question 1
A 35-year-old female on long-term haloperidol decanoate
100 mg IM monthly develops a 4-week history of lip-
smacking, tongue protrusion, and choreoathetoid finger
movements. Symptoms worsen when her haloperidol dose
is increased. Which pathophysiologic process is most likely
responsible?
A. Acute D2 hypersensitivity in the nigrostriatal pathway
causing transient dyskinesia
B. Dopamine receptor supersensitivity from chronic D2
blockade leading to tardive dyskinesia
C. Serotonin 5-HT2A receptor upregulation causing
choreiform movements
,D. Anticholinergic-induced pseudoparkinsonism masked
by haloperidol's low anticholinergic activity
Rationale: Tardive dyskinesia results from chronic D2
receptor blockade producing postsynaptic supersensitivity in
the nigrostriatal pathway. The classical presentation
includes orofacial choreoathetosis, and symptoms often
worsen with antipsychotic dose increases as the
supersensitive receptors are further denervated. VMAT2
inhibitors are FDA-approved treatments.
Question 2
A 19-year-old African American male receives haloperidol
10 mg IM for acute agitation. Six hours later he develops
neck hypertension, upward eye deviation, and a torticollis-
like posture. Vital signs are stable. The MOST appropriate
immediate intervention is:
A. Increase haloperidol dose to suppress the dystonia
B. Administer diphenhydramine 50 mg IM or
benztropine 1-2 mg IM and reassess
C. Discontinue all antipsychotics permanently and start
lithium
D. Administer propranolol 20 mg PO for akathisia
,Rationale: Acute dystonia typically emerges within 24-72
hours of high-potency D2 antagonist initiation, especially
after IM administration in young males. Treatment is
parenteral anticholinergic (diphenhydramine 25-50 mg
IM/IV or benztropine 1-2 mg IM/IV), which produces rapid
resolution by restoring cholinergic-dopaminergic balance.
Question 3
Which statement CORRECTLY ranks the first-generation
antipsychotics by approximate chlorpromazine-equivalent
potency?
A. Haloperidol > fluphenazine > thioridazine >
chlorpromazine
B. Fluphenazine > haloperidol > chlorpromazine >
thioridazine
C. Fluphenazine > haloperidol > thioridazine >
chlorpromazine
D. Haloperidol > chlorpromazine > fluphenazine >
thioridazine
Rationale: Potency ranking of common FGAs by
chlorpromazine equivalents: fluphenazine ~2 mg (highest
potency), haloperidol ~2-5 mg, thioridazine ~100 mg,
, chlorpromazine 100 mg (reference, lowest potency). Higher
potency = more EPS but less
sedation/orthostasis/anticholinergic burden.
Question 4
A patient with PTSD is started on prazosin for trauma-
related nightmares. Which monitoring parameter is most
important during therapy?
A. Serum creatinine
B. Blood pressure
C. Liver function tests
D. Complete blood count
Rationale: Prazosin is an alpha-1 adrenergic antagonist that
can cause orthostatic hypotension, particularly during dose
initiation and titration. Blood pressure monitoring, including
supine and standing readings, is essential to prevent falls
and symptomatic hypotension.
Question 5
