NR546 / NR 546 ACTUAL MIDTERM EXAM 2024
QUESTIONS AND ANSWERS (UPDATED 2025)
A 34-year old male recently began experiencing breast secretions while receiving
risperidone . Which dopamine pathway is associated with this side effect? -
✔️CORRECT ANSWER✅-tuberoinfundibular pathway
A 44-year-old woman is initiated on an atypical antipsychotic for the treatment of
schizophrenia. Regarding affinity, atypical antipsychotics demonstrate which of
the following most often? - ✔️CORRECT ANSWER✅-Atypical antipsychotics
have equal positive symptom antipsychotic actions and low extrapyramidal
symptoms.
Disorders from this lobe include dementia, affective disorders, and attention
deficit hyperactivity disorders (ADHD). - ✔️CORRECT ANSWER✅-Temporal
Lobe
controls visual processing. Damage to this lobe results in the inability to form
visual memories. Bilateral lobe damage results in the inability to recognize items
by sight even though vision is normal. - ✔️CORRECT ANSWER✅-Occipital Lobe
,This separates the frontal lobe from the parietal lobe. - ✔️CORRECT
ANSWER✅-Central sulcus
(BARS) Barnes Akathisia Rating Scale - ✔️CORRECT ANSWER✅-rating scale to
assess the severity of drug-induced akathisia.
-includes objective and subjective items such as the level of the patient's
restlessness
(AIMS) Abnormal Involuntary Movement Scale - ✔️CORRECT ANSWER✅-tool
used to monitor involuntary movements and tardive dyskinesia in clients who take
antipsychotic medication
-best practice/recommendation to document the AIMS at minimum every 6
months for patients taking an antipsychotic agent/dopamine blocker
Low-potency medications - ✔️CORRECT ANSWER✅--require higher doses to
achieve efficacy
-have more anticholinergic, antihistaminic, and α1- properties, can result in more
sedation
Targeting mesolimbic/mesostriatal dopamine D2 receptors causes: -
✔️CORRECT ANSWER✅-antipsychotic actions
,Targeting dopamine D2 receptors in Mesolimbic/mesostriatal and mesocortical
pathways causes: - ✔️CORRECT ANSWER✅-secondary negative symptoms
Targeting tuberoinfudibular dopamine D2 receptors causes: - ✔️CORRECT
ANSWER✅-elevation of prolactin
-associated with gynecomastia, galactorrhea, amenorrhea
Targeting nigrostriatal dopamine D2 receptors causes: - ✔️CORRECT
ANSWER✅-motor side effects
-can cause drug induced parkinsonism
overactivity of the mesolimbic dopamine system - ✔️CORRECT ANSWER✅-may
mediate the positive symptoms of psychosis
any abnormal motor symptoms caused by D2 receptor blockers are lumped
together and called collectively: - ✔️CORRECT ANSWER✅-extrapyramidal
symptsom (EPS)
-motor side effects of D2 antagonists
caused by chronic blockade of D2 receptors in the nigrostriatal dopamine pathway
- ✔️CORRECT ANSWER✅-tardive dyskinesia (TD)
, -tx: interventions that lower dopamine neurotransmission, inhibiting the vesicular
monoamine transporter type 2 (VMAT2) lowers the "go" signals - deuterated
tetrabenazine (deutetrabenazine), Valbenazine (most selective and potent) ,
the most common side effect of drugs that target D2 receptors for psychosis -
✔️CORRECT ANSWER✅-Drug induced parkinsonism (DIP)
-akinesia, bradykinesia, rigidity, and tremor
*anticholinergics-drugs that block muscarinic cholinergic receptors
adding 5HT2A antagonism: - ✔️CORRECT ANSWER✅-improve side effects of D2
blockade and enhance the antipsychotic efficacy of D2 blockade
Sedative-hypnotic agents - ✔️CORRECT ANSWER✅-benzodiazepine &
barbiturates, clinical indications for use:
-sedation & anxiolysis
-treatment of insomnia
-general anesthesia
-seizures
-alcohol withdrawal states
-as adjunctive management with neuromuscular blockage/muscle relaxation
-to induce or maintain sleep
QUESTIONS AND ANSWERS (UPDATED 2025)
A 34-year old male recently began experiencing breast secretions while receiving
risperidone . Which dopamine pathway is associated with this side effect? -
✔️CORRECT ANSWER✅-tuberoinfundibular pathway
A 44-year-old woman is initiated on an atypical antipsychotic for the treatment of
schizophrenia. Regarding affinity, atypical antipsychotics demonstrate which of
the following most often? - ✔️CORRECT ANSWER✅-Atypical antipsychotics
have equal positive symptom antipsychotic actions and low extrapyramidal
symptoms.
Disorders from this lobe include dementia, affective disorders, and attention
deficit hyperactivity disorders (ADHD). - ✔️CORRECT ANSWER✅-Temporal
Lobe
controls visual processing. Damage to this lobe results in the inability to form
visual memories. Bilateral lobe damage results in the inability to recognize items
by sight even though vision is normal. - ✔️CORRECT ANSWER✅-Occipital Lobe
,This separates the frontal lobe from the parietal lobe. - ✔️CORRECT
ANSWER✅-Central sulcus
(BARS) Barnes Akathisia Rating Scale - ✔️CORRECT ANSWER✅-rating scale to
assess the severity of drug-induced akathisia.
-includes objective and subjective items such as the level of the patient's
restlessness
(AIMS) Abnormal Involuntary Movement Scale - ✔️CORRECT ANSWER✅-tool
used to monitor involuntary movements and tardive dyskinesia in clients who take
antipsychotic medication
-best practice/recommendation to document the AIMS at minimum every 6
months for patients taking an antipsychotic agent/dopamine blocker
Low-potency medications - ✔️CORRECT ANSWER✅--require higher doses to
achieve efficacy
-have more anticholinergic, antihistaminic, and α1- properties, can result in more
sedation
Targeting mesolimbic/mesostriatal dopamine D2 receptors causes: -
✔️CORRECT ANSWER✅-antipsychotic actions
,Targeting dopamine D2 receptors in Mesolimbic/mesostriatal and mesocortical
pathways causes: - ✔️CORRECT ANSWER✅-secondary negative symptoms
Targeting tuberoinfudibular dopamine D2 receptors causes: - ✔️CORRECT
ANSWER✅-elevation of prolactin
-associated with gynecomastia, galactorrhea, amenorrhea
Targeting nigrostriatal dopamine D2 receptors causes: - ✔️CORRECT
ANSWER✅-motor side effects
-can cause drug induced parkinsonism
overactivity of the mesolimbic dopamine system - ✔️CORRECT ANSWER✅-may
mediate the positive symptoms of psychosis
any abnormal motor symptoms caused by D2 receptor blockers are lumped
together and called collectively: - ✔️CORRECT ANSWER✅-extrapyramidal
symptsom (EPS)
-motor side effects of D2 antagonists
caused by chronic blockade of D2 receptors in the nigrostriatal dopamine pathway
- ✔️CORRECT ANSWER✅-tardive dyskinesia (TD)
, -tx: interventions that lower dopamine neurotransmission, inhibiting the vesicular
monoamine transporter type 2 (VMAT2) lowers the "go" signals - deuterated
tetrabenazine (deutetrabenazine), Valbenazine (most selective and potent) ,
the most common side effect of drugs that target D2 receptors for psychosis -
✔️CORRECT ANSWER✅-Drug induced parkinsonism (DIP)
-akinesia, bradykinesia, rigidity, and tremor
*anticholinergics-drugs that block muscarinic cholinergic receptors
adding 5HT2A antagonism: - ✔️CORRECT ANSWER✅-improve side effects of D2
blockade and enhance the antipsychotic efficacy of D2 blockade
Sedative-hypnotic agents - ✔️CORRECT ANSWER✅-benzodiazepine &
barbiturates, clinical indications for use:
-sedation & anxiolysis
-treatment of insomnia
-general anesthesia
-seizures
-alcohol withdrawal states
-as adjunctive management with neuromuscular blockage/muscle relaxation
-to induce or maintain sleep
