NRNP 6675 MIDTERM EXAM COMPLETE QUESTIONS WITH 100% VERIFIED ANSWERS

NRNP 6675 MIDTERM EXAM COMPLETE QUESTIONS WITH 100% VERIFIED ANSWERS 1. Which of the following are risk factors for neuroleptic malignant syndrome? Select all that apply. A. Age B. Rapid dose escalation C. Parenteral route of administration D. Higher potency typical antipsychotics Correct Answers: B, C, D Rationale: Neuroleptic malignant syndrome (NMS) is a life-threatening complication of antipsychotic medication use. Rapid dose escalation increases the risk by causing sudden and intense dopamine receptor blockade. The parenteral route of administration leads to higher peak serum concentrations and faster onset of action, increasing NMS risk. Higher potency typical antipsychotics such as haloperidol and fluphenazine have greater D2 receptor affinity and are more strongly associated with NMS. While age is a risk factor for many medication adverse effects, it is not consistently identified as an independent risk factor for NMS compared to these other factors. ________________________________________ 2. Antipsychotic medications provide D2 blockade in the mesocortical pathway, causing which of the following effects? A. Reduces negative symptoms B. Increases extrapyramidal symptoms (EPS) C. Causes prolactinemia D. Reduces positive symptoms Correct Answer: B Rationale: D2 blockade in the mesocortical pathway leads to decreased dopamine transmission in the prefrontal cortex, which can worsen negative and cognitive symptoms of schizophrenia. This pathway projects from the ventral tegmental area to the prefrontal cortex. When antipsychotics block D2 receptors here, it can result in increased extrapyramidal symptoms due to the disruption of dopamine signaling. D2 blockade in the tuberoinfundibular pathway causes prolactinemia, while D2 blockade in the mesolimbic pathway reduces positive symptoms. The mesocortical pathway specifically is associated with cognitive function and negative symptoms. ________________________________________ 3. Phencyclidine (PCP) and Ketamine exert their unique behavioral effects by blocking which of the following receptors? A. GABA type receptors B. Serotonin receptors C. Dopamine receptors D. NMDA type receptors Correct Answer: D Rationale: PCP and ketamine are noncompetitive antagonists at the N-methyl-D-aspartate (NMDA) subtype of glutamate receptors. By blocking NMDA receptors, these drugs produce a dissociative state characterized by analgesia, amnesia, and hallucinations. The NMDA receptor is an ionotropic glutamate receptor that plays a crucial role in synaptic plasticity and memory function. PCP and ketamine block the ion channel of the NMDA receptor, preventing calcium influx and disrupting normal glutamatergic transmission, which leads to their unique behavioral effects including psychosis-like symptoms. ________________________________________ 4. The diagnosis used to describe a syndrome characterized by specific signs and symptoms resulting from recent ingestion or exposure to a substance is known as which of the following? A. Substance intoxication B. Substance withdrawal C. Substance use disorder D. Any of the above Correct Answer: A Rationale: Substance intoxication is defined as a reversible substance-specific syndrome due to recent ingestion or exposure to a substance. It involves clinically significant problematic behavioral or psychological changes that develop during or shortly after substance use. These changes are directly attributable to the physiological effects of the substance on the central nervous system. Substance withdrawal refers to symptoms that occur when a person stops or reduces substance use after prolonged use. Substance use disorder involves a pattern of pathological use with impairment or distress over 12 months. ________________________________________ 5. Abnormal involuntary movements in a rhythmic pattern affecting the face, mouth, tongue, and jaw are known as which of the following? A. Akathisia B. Dystonia C. Tardive dyskinesia D. Extrapyramidal side effects Correct Answer: C Rationale: Tardive dyskinesia is characterized by abnormal involuntary movements, typically rhythmic, affecting the face, mouth, tongue, and jaw. These movements include tongue protrusion, lip smacking, chewing movements, and facial grimacing. Tardive dyskinesia is a late-onset complication of long-term antipsychotic use. Akathisia presents as subjective restlessness and objective pacing or fidgeting movements. Dystonia involves sustained muscle contractions causing twisting movements and abnormal postures. Extrapyramidal side effects encompass a broader category that includes Parkinsonism, akathisia, dystonia, and tardive dyskinesia. ________________________________________ 6. A deeply held belief despite evidence to the contrary, lasting at least one month, without prominent hallucinations, with functional impairment that relates to the delusional system, is characteristic of which of the following? A. Schizophrenia B. Delusional disorder