NSG 552 Exam 3: Psychopharmacology Study Guide 2026/2027 Wilkes
University
1. Which dopamine pathway is primarily responsible for the positive symptoms
of schizophrenia, such as hallucinations and delusions?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesolimbic pathway
Answer: D
Rationale: Hyperactivity of dopamine in the mesolimbic pathway is associated with
positive symptoms of schizophrenia.
2. Which pathway is associated with the negative and cognitive symptoms of
schizophrenia when dopamine levels are too low?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: C
Rationale: Hypofunction or low dopamine in the mesocortical pathway contributes to
negative symptoms and cognitive impairment.
,3. Blockade of dopamine in which pathway leads to extrapyramidal symptoms
(EPS) and tardive dyskinesia?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: B
Rationale: The nigrostriatal pathway controls motor function; its blockade by
antipsychotics results in movement disorders.
4. Increased prolactin levels (hyperprolactinemia) are caused by dopamine
blockade in which pathway?
A. Mesolimbic
B. Nigrostriatal
C. Mesocortical
D. Tuberoinfundibular
Answer: D
Rationale: Dopamine normally inhibits prolactin; blocking it in the tuberoinfundibular
pathway causes prolactin levels to rise.
5. Which of the following is considered a ‘gold standard’ for treatment-resistant
schizophrenia but requires intensive monitoring?
A. Risperidone
B. Clozapine
C. Olanzapine
D. Haloperidol
Answer: B
Rationale: Clozapine is highly effective for treatment-resistant cases but carries risks like
agranulocytosis, necessitating blood monitoring.
, 6. A patient on Clozapine presents with an Absolute Neutrophil Count (ANC) of
900/mm3. What is the appropriate clinical action?
A. Continue the current dose and recheck in a week
B. Increase the dose to manage symptoms
C. Interrupt treatment and monitor ANC daily
D. Switch to another atypical antipsychotic immediately without monitoring
Answer: C
Rationale: An ANC below 1000/mm3 is considered mild to moderate neutropenia
(depending on the protocol), requiring treatment interruption in many cases to prevent
agranulocytosis.
7. What is the therapeutic reference range for Lithium in the maintenance
treatment of Bipolar Disorder?
A. 0.6 - 1.2 mEq/L
B. 0.1 - 0.5 mEq/L
C. 1.5 - 2.0 mEq/L
D. 2.5 - 3.5 mEq/L
Answer: A
Rationale: The standard therapeutic range for Lithium maintenance is 0.6 to 1.2 mEq/L;
levels above 1.5 are considered toxic.
8. Which mood stabilizer is most strongly associated with the risk of Stevens-
Johnson Syndrome (SJS), requiring a slow dose titration?
A. Lamotrigine
B. Valproic Acid
C. Lithium
D. Topiramate
Answer: A
University
1. Which dopamine pathway is primarily responsible for the positive symptoms
of schizophrenia, such as hallucinations and delusions?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesolimbic pathway
Answer: D
Rationale: Hyperactivity of dopamine in the mesolimbic pathway is associated with
positive symptoms of schizophrenia.
2. Which pathway is associated with the negative and cognitive symptoms of
schizophrenia when dopamine levels are too low?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: C
Rationale: Hypofunction or low dopamine in the mesocortical pathway contributes to
negative symptoms and cognitive impairment.
,3. Blockade of dopamine in which pathway leads to extrapyramidal symptoms
(EPS) and tardive dyskinesia?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: B
Rationale: The nigrostriatal pathway controls motor function; its blockade by
antipsychotics results in movement disorders.
4. Increased prolactin levels (hyperprolactinemia) are caused by dopamine
blockade in which pathway?
A. Mesolimbic
B. Nigrostriatal
C. Mesocortical
D. Tuberoinfundibular
Answer: D
Rationale: Dopamine normally inhibits prolactin; blocking it in the tuberoinfundibular
pathway causes prolactin levels to rise.
5. Which of the following is considered a ‘gold standard’ for treatment-resistant
schizophrenia but requires intensive monitoring?
A. Risperidone
B. Clozapine
C. Olanzapine
D. Haloperidol
Answer: B
Rationale: Clozapine is highly effective for treatment-resistant cases but carries risks like
agranulocytosis, necessitating blood monitoring.
, 6. A patient on Clozapine presents with an Absolute Neutrophil Count (ANC) of
900/mm3. What is the appropriate clinical action?
A. Continue the current dose and recheck in a week
B. Increase the dose to manage symptoms
C. Interrupt treatment and monitor ANC daily
D. Switch to another atypical antipsychotic immediately without monitoring
Answer: C
Rationale: An ANC below 1000/mm3 is considered mild to moderate neutropenia
(depending on the protocol), requiring treatment interruption in many cases to prevent
agranulocytosis.
7. What is the therapeutic reference range for Lithium in the maintenance
treatment of Bipolar Disorder?
A. 0.6 - 1.2 mEq/L
B. 0.1 - 0.5 mEq/L
C. 1.5 - 2.0 mEq/L
D. 2.5 - 3.5 mEq/L
Answer: A
Rationale: The standard therapeutic range for Lithium maintenance is 0.6 to 1.2 mEq/L;
levels above 1.5 are considered toxic.
8. Which mood stabilizer is most strongly associated with the risk of Stevens-
Johnson Syndrome (SJS), requiring a slow dose titration?
A. Lamotrigine
B. Valproic Acid
C. Lithium
D. Topiramate
Answer: A
