NSG 552 Psychopharmacology Exam 2 Study Guide |Wilkes University
1. Which neurotransmitter pathway is primarily associated with the positive
symptoms of schizophrenia, such as hallucinations and delusions?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: A
Rationale: The mesolimbic pathway involves the projection of dopamine from the ventral
tegmental area to the nucleus accumbens. Excess dopamine in this pathway is linked to
positive symptoms.
2. A patient taking Haloperidol develops severe muscle rigidity, a temperature
of 104°F, and autonomic instability. What is the most likely diagnosis?
A. Serotonin Syndrome
B. Acute Dystonia
C. Neuroleptic Malignant Syndrome (NMS)
D. Akathisia
Answer: C
Rationale: NMS is a life-threatening reaction to antipsychotics characterized by lead-pipe
rigidity, hyperpyrexia, and mental status changes.
,3. What is the therapeutic reference range for Lithium in the maintenance phase
of treating Bipolar Disorder?
A. 0.4 - 0.8 mEq/L
B. 1.0 - 1.5 mEq/L
C. 0.6 - 1.2 mEq/L
D. 1.5 - 2.0 mEq/L
Answer: C
Rationale: The standard therapeutic range for Lithium maintenance is 0.6 to 1.2 mEq/L;
levels above 1.5 mEq/L are generally considered toxic.
4. Which antipsychotic medication requires frequent monitoring of the Absolute
Neutrophil Count (ANC) due to the risk of agranulocytosis?
A. Risperidone
B. Clozapine
C. Quetiapine
D. Olanzapine
Answer: B
Rationale: Clozapine is associated with a risk of life-threatening agranulocytosis,
necessitating strict ANC monitoring per the REMS program.
5. A patient starting Lamotrigine should be educated to immediately report
which side effect?
A. Weight gain
B. Sedation
C. Skin rash
D. Increased appetite
Answer: C
Rationale: A skin rash may indicate Stevens-Johnson Syndrome (SJS), a rare but fatal
dermatological emergency associated with Lamotrigine titration.
, 6. Which medication is considered a first-line treatment for an acute dystonic
reaction?
A. Dantrolene
B. Propranolol
C. Lorazepam
D. Benztropine
Answer: D
Rationale: Anticholinergics like Benztropine or antihistamines like Diphenhydramine are
used to reverse acute dystonia caused by D2 blockade.
7. Which mood stabilizer is most strongly associated with polycystic ovary
syndrome (PCOS) and hepatotoxicity?
A. Lithium
B. Oxcarbazepine
C. Carbamazepine
D. Valproate
Answer: D
Rationale: Valproate (Depakote) can cause weight gain, hair loss, hepatotoxicity, and
increased risk of PCOS in female patients.
8. Which antidepressant is contraindicated in patients with a history of bulimia
or seizure disorders?
A. Sertraline
B. Bupropion
C. Fluoxetine
D. Mirtazapine
Answer: B
Rationale: Bupropion lowers the seizure threshold, particularly in patients with eating
disorders due to electrolyte imbalances.
1. Which neurotransmitter pathway is primarily associated with the positive
symptoms of schizophrenia, such as hallucinations and delusions?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: A
Rationale: The mesolimbic pathway involves the projection of dopamine from the ventral
tegmental area to the nucleus accumbens. Excess dopamine in this pathway is linked to
positive symptoms.
2. A patient taking Haloperidol develops severe muscle rigidity, a temperature
of 104°F, and autonomic instability. What is the most likely diagnosis?
A. Serotonin Syndrome
B. Acute Dystonia
C. Neuroleptic Malignant Syndrome (NMS)
D. Akathisia
Answer: C
Rationale: NMS is a life-threatening reaction to antipsychotics characterized by lead-pipe
rigidity, hyperpyrexia, and mental status changes.
,3. What is the therapeutic reference range for Lithium in the maintenance phase
of treating Bipolar Disorder?
A. 0.4 - 0.8 mEq/L
B. 1.0 - 1.5 mEq/L
C. 0.6 - 1.2 mEq/L
D. 1.5 - 2.0 mEq/L
Answer: C
Rationale: The standard therapeutic range for Lithium maintenance is 0.6 to 1.2 mEq/L;
levels above 1.5 mEq/L are generally considered toxic.
4. Which antipsychotic medication requires frequent monitoring of the Absolute
Neutrophil Count (ANC) due to the risk of agranulocytosis?
A. Risperidone
B. Clozapine
C. Quetiapine
D. Olanzapine
Answer: B
Rationale: Clozapine is associated with a risk of life-threatening agranulocytosis,
necessitating strict ANC monitoring per the REMS program.
5. A patient starting Lamotrigine should be educated to immediately report
which side effect?
A. Weight gain
B. Sedation
C. Skin rash
D. Increased appetite
Answer: C
Rationale: A skin rash may indicate Stevens-Johnson Syndrome (SJS), a rare but fatal
dermatological emergency associated with Lamotrigine titration.
, 6. Which medication is considered a first-line treatment for an acute dystonic
reaction?
A. Dantrolene
B. Propranolol
C. Lorazepam
D. Benztropine
Answer: D
Rationale: Anticholinergics like Benztropine or antihistamines like Diphenhydramine are
used to reverse acute dystonia caused by D2 blockade.
7. Which mood stabilizer is most strongly associated with polycystic ovary
syndrome (PCOS) and hepatotoxicity?
A. Lithium
B. Oxcarbazepine
C. Carbamazepine
D. Valproate
Answer: D
Rationale: Valproate (Depakote) can cause weight gain, hair loss, hepatotoxicity, and
increased risk of PCOS in female patients.
8. Which antidepressant is contraindicated in patients with a history of bulimia
or seizure disorders?
A. Sertraline
B. Bupropion
C. Fluoxetine
D. Mirtazapine
Answer: B
Rationale: Bupropion lowers the seizure threshold, particularly in patients with eating
disorders due to electrolyte imbalances.
