NSG 552 PSYCHOPHARMACOLOGY COMPLETE EXAM
1, 2 & 3 BANK QUESTIONS AND CORRECT ANSWERS WITH
NGN CASE SCENARIOS & DETAILED RATIONALES
2026/2027 UPDATE
TABLE OF CONTENTS
EXAM 1: NEUROBIOLOGY, PHARMACOKINETICS & PHARMACODYNAMICS
SECTION 1: NEUROANATOMY & NEUROTRANSMISSION ................ Q 1–50
SECTION 2: PHARMACOKINETICS & PHARMACODYNAMICS ............. Q 51–120
SECTION 3: RECEPTORS & SIGNAL TRANSDUCTION ................. Q 121–180
SECTION 4: ANTIPSYCHOTIC MEDICATIONS ....................... Q 181–250
SECTION 5: NGN CASE SCENARIOS — EXAM 1 ..................... Q 251–300
EXAM 2: ANXIETY, MOOD & TRAUMA-RELATED DISORDERS
SECTION 6: BENZODIAZEPINES & ANXIOLYTICS ................... Q 301–370
SECTION 7: ANTIDEPRESSANTS & MOOD STABILIZERS .............. Q 371–460
SECTION 8: OCD, PTSD & TRAUMA-RELATED DISORDERS ............ Q 461–520
SECTION 9: SOMATIC SYMPTOM & RELATED DISORDERS ............. Q 521–550
SECTION 10: NGN CASE SCENARIOS — EXAM 2 .................... Q 551–600
EXAM 3: SUBSTANCE USE, SPECIAL POPULATIONS & ADVANCED PRACTICE
SECTION 11: SUBSTANCE USE DISORDERS — OPIOIDS .............. Q 601–660
SECTION 12: SUBSTANCE USE DISORDERS — ALCOHOL & STIMULANTS .. Q 661–720
SECTION 13: ADHD & NEURODEVELOPMENTAL DISORDERS ............ Q 721–780
SECTION 14: DEMENTIA & GERIATRIC PSYCHOPHARMACOLOGY ........ Q 781–840
SECTION 15: ETHICAL, LEGAL & SPECIAL POPULATIONS ........... Q 841–880
SECTION 16: NGN CASE SCENARIOS — EXAM 3 .................... Q 881–900
SECTION 1: NEUROANATOMY & NEUROTRANSMISSION (Q 1–50)
Q1. The primary excitatory neurotransmitter in the central nervous system is:
A) GABA
B) Glutamate
C) Serotonin
D) Glycine
Answer: B
Rationale: Glutamate is the primary excitatory neurotransmitter in the CNS. It acts
on ionotropic receptors (NMDA, AMPA, kainate) and metabotropic receptors.
1
,Glutamate is involved in learning, memory, and synaptic plasticity. Excess
glutamate (excitotoxicity) is implicated in neurodegeneration. GABA (A) is the
primary inhibitory neurotransmitter. Serotonin (C) is a monoamine. Glycine (D) is
an inhibitory neurotransmitter in the spinal cord.
Q2. The primary inhibitory neurotransmitter in the central nervous system is:
A) Glutamate
B) GABA
C) Norepinephrine
D) Dopamine
Answer: B
Rationale: GABA (gamma-aminobutyric acid) is the primary inhibitory
neurotransmitter in the CNS. It acts on GABA-A receptors (ionotropic, chloride
channel) and GABA-B receptors (metabotropic). GABA is synthesized from
glutamate via glutamic acid decarboxylase (GAD). GABAergic dysfunction is
implicated in anxiety disorders, epilepsy, and insomnia. Glutamate (A) is the
primary excitatory neurotransmitter. Norepinephrine (C) and dopamine (D) are
monoamines.
Q3. Dopamine is synthesized from which amino acid?
A) Tyrosine
B) Tryptophan
C) Glutamine
D) GABA
Answer: A
Rationale: Dopamine is synthesized from the amino acid tyrosine through a two-
step process: tyrosine → L-DOPA (via tyrosine hydroxylase) → dopamine (via
DOPA decarboxylase). This pathway also produces norepinephrine and
epinephrine. Tryptophan (B) is the precursor for serotonin. Glutamine (C) is a
precursor for glutamate and GABA. GABA (D) is a neurotransmitter, not an amino
acid precursor.
Q4. Serotonin is synthesized from which amino acid?
A) Tyrosine
B) Tryptophan
C) Glutamine
D) Glycine
2
,Answer: B
Rationale: Serotonin (5-HT) is synthesized from the amino acid tryptophan
through a two-step process: tryptophan → 5-hydroxytryptophan (5-HTP) (via
tryptophan hydroxylase) → serotonin (via L-aromatic amino acid decarboxylase).
Tryptophan is an essential amino acid that must be obtained through the diet.
Tyrosine (A) is the precursor for catecholamines. Glutamine (C) is a precursor for
glutamate and GABA. Glycine (D) is an inhibitory neurotransmitter.
Q5. The rate-limiting step in catecholamine synthesis is:
A) Tyrosine hydroxylase
B) DOPA decarboxylase
C) Dopamine beta-hydroxylase
D) COMT
Answer: A
Rationale: Tyrosine hydroxylase (TH) is the rate-limiting enzyme in catecholamine
(dopamine, norepinephrine, epinephrine) synthesis. It converts tyrosine to L-
DOPA. TH is regulated by feedback inhibition, phosphorylation, and gene
expression. DOPA decarboxylase (B) converts L-DOPA to dopamine. Dopamine
beta-hydroxylase (C) converts dopamine to norepinephrine. COMT (D) is a
metabolic enzyme that degrades catecholamines.
Q6. Which dopamine pathway is primarily associated with the positive symptoms
of schizophrenia when overactive?
A) The nigrostriatal pathway
B) The mesolimbic pathway
C) The mesocortical pathway
D) The tuberoinfundibular pathway
Answer: B
Rationale: The mesolimbic dopamine pathway projects from the ventral
tegmental area (VTA) to the nucleus accumbens and limbic structures, and is the
primary pathway implicated in the positive symptoms of schizophrenia
(hallucinations, delusions, thought disorganization) when dopamine activity is
excessive. The nigrostriatal pathway regulates motor function. The mesocortical
pathway modulates cognition and executive function. The tuberoinfundibular
pathway inhibits prolactin release.
3
, Q7. Which dopamine pathway is associated with extrapyramidal symptoms when
blocked by antipsychotic medications?
A) The mesolimbic pathway
B) The mesocortical pathway
C) The nigrostriatal pathway
D) The tuberoinfundibular pathway
Answer: C
Rationale: The nigrostriatal pathway projects from the substantia nigra to the
striatum and is involved in motor control. Blockade of dopamine D2 receptors in
this pathway by antipsychotic medications leads to extrapyramidal symptoms
(EPS), including parkinsonism, dystonia, akathisia, and tardive dyskinesia.
Q8. Which dopamine pathway is associated with hyperprolactinemia when
blocked by antipsychotic medications?
A) The mesolimbic pathway
B) The mesocortical pathway
C) The nigrostriatal pathway
D) The tuberoinfundibular pathway
Answer: D
Rationale: The tuberoinfundibular pathway projects from the hypothalamus to
the anterior pituitary and inhibits prolactin release. Blockade of dopamine D2
receptors in this pathway by antipsychotic medications leads to
hyperprolactinemia, which can cause galactorrhea, gynecomastia, amenorrhea,
and sexual dysfunction.
Q9. Which dopamine pathway is associated with negative symptoms and
cognitive deficits in schizophrenia when underactive?
A) The mesolimbic pathway
B) The mesocortical pathway
C) The nigrostriatal pathway
D) The tuberoinfundibular pathway
Answer: B
Rationale: The mesocortical pathway projects from the VTA to the prefrontal
cortex and is involved in cognition, motivation, and executive function.
Hypoactivity of dopamine in this pathway (hypofrontality) is associated with
negative symptoms (flat affect, avolition, social withdrawal) and cognitive deficits
in schizophrenia.
4
1, 2 & 3 BANK QUESTIONS AND CORRECT ANSWERS WITH
NGN CASE SCENARIOS & DETAILED RATIONALES
2026/2027 UPDATE
TABLE OF CONTENTS
EXAM 1: NEUROBIOLOGY, PHARMACOKINETICS & PHARMACODYNAMICS
SECTION 1: NEUROANATOMY & NEUROTRANSMISSION ................ Q 1–50
SECTION 2: PHARMACOKINETICS & PHARMACODYNAMICS ............. Q 51–120
SECTION 3: RECEPTORS & SIGNAL TRANSDUCTION ................. Q 121–180
SECTION 4: ANTIPSYCHOTIC MEDICATIONS ....................... Q 181–250
SECTION 5: NGN CASE SCENARIOS — EXAM 1 ..................... Q 251–300
EXAM 2: ANXIETY, MOOD & TRAUMA-RELATED DISORDERS
SECTION 6: BENZODIAZEPINES & ANXIOLYTICS ................... Q 301–370
SECTION 7: ANTIDEPRESSANTS & MOOD STABILIZERS .............. Q 371–460
SECTION 8: OCD, PTSD & TRAUMA-RELATED DISORDERS ............ Q 461–520
SECTION 9: SOMATIC SYMPTOM & RELATED DISORDERS ............. Q 521–550
SECTION 10: NGN CASE SCENARIOS — EXAM 2 .................... Q 551–600
EXAM 3: SUBSTANCE USE, SPECIAL POPULATIONS & ADVANCED PRACTICE
SECTION 11: SUBSTANCE USE DISORDERS — OPIOIDS .............. Q 601–660
SECTION 12: SUBSTANCE USE DISORDERS — ALCOHOL & STIMULANTS .. Q 661–720
SECTION 13: ADHD & NEURODEVELOPMENTAL DISORDERS ............ Q 721–780
SECTION 14: DEMENTIA & GERIATRIC PSYCHOPHARMACOLOGY ........ Q 781–840
SECTION 15: ETHICAL, LEGAL & SPECIAL POPULATIONS ........... Q 841–880
SECTION 16: NGN CASE SCENARIOS — EXAM 3 .................... Q 881–900
SECTION 1: NEUROANATOMY & NEUROTRANSMISSION (Q 1–50)
Q1. The primary excitatory neurotransmitter in the central nervous system is:
A) GABA
B) Glutamate
C) Serotonin
D) Glycine
Answer: B
Rationale: Glutamate is the primary excitatory neurotransmitter in the CNS. It acts
on ionotropic receptors (NMDA, AMPA, kainate) and metabotropic receptors.
1
,Glutamate is involved in learning, memory, and synaptic plasticity. Excess
glutamate (excitotoxicity) is implicated in neurodegeneration. GABA (A) is the
primary inhibitory neurotransmitter. Serotonin (C) is a monoamine. Glycine (D) is
an inhibitory neurotransmitter in the spinal cord.
Q2. The primary inhibitory neurotransmitter in the central nervous system is:
A) Glutamate
B) GABA
C) Norepinephrine
D) Dopamine
Answer: B
Rationale: GABA (gamma-aminobutyric acid) is the primary inhibitory
neurotransmitter in the CNS. It acts on GABA-A receptors (ionotropic, chloride
channel) and GABA-B receptors (metabotropic). GABA is synthesized from
glutamate via glutamic acid decarboxylase (GAD). GABAergic dysfunction is
implicated in anxiety disorders, epilepsy, and insomnia. Glutamate (A) is the
primary excitatory neurotransmitter. Norepinephrine (C) and dopamine (D) are
monoamines.
Q3. Dopamine is synthesized from which amino acid?
A) Tyrosine
B) Tryptophan
C) Glutamine
D) GABA
Answer: A
Rationale: Dopamine is synthesized from the amino acid tyrosine through a two-
step process: tyrosine → L-DOPA (via tyrosine hydroxylase) → dopamine (via
DOPA decarboxylase). This pathway also produces norepinephrine and
epinephrine. Tryptophan (B) is the precursor for serotonin. Glutamine (C) is a
precursor for glutamate and GABA. GABA (D) is a neurotransmitter, not an amino
acid precursor.
Q4. Serotonin is synthesized from which amino acid?
A) Tyrosine
B) Tryptophan
C) Glutamine
D) Glycine
2
,Answer: B
Rationale: Serotonin (5-HT) is synthesized from the amino acid tryptophan
through a two-step process: tryptophan → 5-hydroxytryptophan (5-HTP) (via
tryptophan hydroxylase) → serotonin (via L-aromatic amino acid decarboxylase).
Tryptophan is an essential amino acid that must be obtained through the diet.
Tyrosine (A) is the precursor for catecholamines. Glutamine (C) is a precursor for
glutamate and GABA. Glycine (D) is an inhibitory neurotransmitter.
Q5. The rate-limiting step in catecholamine synthesis is:
A) Tyrosine hydroxylase
B) DOPA decarboxylase
C) Dopamine beta-hydroxylase
D) COMT
Answer: A
Rationale: Tyrosine hydroxylase (TH) is the rate-limiting enzyme in catecholamine
(dopamine, norepinephrine, epinephrine) synthesis. It converts tyrosine to L-
DOPA. TH is regulated by feedback inhibition, phosphorylation, and gene
expression. DOPA decarboxylase (B) converts L-DOPA to dopamine. Dopamine
beta-hydroxylase (C) converts dopamine to norepinephrine. COMT (D) is a
metabolic enzyme that degrades catecholamines.
Q6. Which dopamine pathway is primarily associated with the positive symptoms
of schizophrenia when overactive?
A) The nigrostriatal pathway
B) The mesolimbic pathway
C) The mesocortical pathway
D) The tuberoinfundibular pathway
Answer: B
Rationale: The mesolimbic dopamine pathway projects from the ventral
tegmental area (VTA) to the nucleus accumbens and limbic structures, and is the
primary pathway implicated in the positive symptoms of schizophrenia
(hallucinations, delusions, thought disorganization) when dopamine activity is
excessive. The nigrostriatal pathway regulates motor function. The mesocortical
pathway modulates cognition and executive function. The tuberoinfundibular
pathway inhibits prolactin release.
3
, Q7. Which dopamine pathway is associated with extrapyramidal symptoms when
blocked by antipsychotic medications?
A) The mesolimbic pathway
B) The mesocortical pathway
C) The nigrostriatal pathway
D) The tuberoinfundibular pathway
Answer: C
Rationale: The nigrostriatal pathway projects from the substantia nigra to the
striatum and is involved in motor control. Blockade of dopamine D2 receptors in
this pathway by antipsychotic medications leads to extrapyramidal symptoms
(EPS), including parkinsonism, dystonia, akathisia, and tardive dyskinesia.
Q8. Which dopamine pathway is associated with hyperprolactinemia when
blocked by antipsychotic medications?
A) The mesolimbic pathway
B) The mesocortical pathway
C) The nigrostriatal pathway
D) The tuberoinfundibular pathway
Answer: D
Rationale: The tuberoinfundibular pathway projects from the hypothalamus to
the anterior pituitary and inhibits prolactin release. Blockade of dopamine D2
receptors in this pathway by antipsychotic medications leads to
hyperprolactinemia, which can cause galactorrhea, gynecomastia, amenorrhea,
and sexual dysfunction.
Q9. Which dopamine pathway is associated with negative symptoms and
cognitive deficits in schizophrenia when underactive?
A) The mesolimbic pathway
B) The mesocortical pathway
C) The nigrostriatal pathway
D) The tuberoinfundibular pathway
Answer: B
Rationale: The mesocortical pathway projects from the VTA to the prefrontal
cortex and is involved in cognition, motivation, and executive function.
Hypoactivity of dopamine in this pathway (hypofrontality) is associated with
negative symptoms (flat affect, avolition, social withdrawal) and cognitive deficits
in schizophrenia.
4
