NR 546 Week 5 Exam V3 | NR 546
Advanced Pharmacology
Psychopharmacology for the PMHNP |
Actual Q&A with Rationale (NR546 Week 5
Exam) | Chamberlain University
1. A patient with schizophrenia is experiencing significant auditory hallucinations and
paranoia. Which dopamine pathway is primarily associated with these positive symptoms?
A. Mesocortical pathway
B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: B
Rationale: The mesolimbic pathway is the primary circuit associated with the positive
symptoms of schizophrenia. Excessive dopamine activity in this region leads to
hallucinations and delusions. Blocking D2 receptors in this pathway is the main mechanism
for reducing these psychotic symptoms.
2. A PMHNP is treating a patient with negative symptoms of schizophrenia, such as alogia and
flat affect. These symptoms are thought to be caused by dopamine deficiency in which
pathway?
A. Mesolimbic pathway
,B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesocortical pathway
Answer: D
Rationale: The mesocortical pathway is associated with cognitive and negative symptoms
of schizophrenia when dopamine levels are too low. Avolition and social withdrawal are
classic examples of symptoms originating from this area. Second-generation antipsychotics
aim to improve these symptoms by modulating serotonin-dopamine interactions.
3. When prescribing a first-generation antipsychotic, the PMHNP monitors for extrapyramidal
symptoms (EPS). This side effect is caused by D2 blockade in which pathway?
A. Mesolimbic
B. Mesocortical
C. Nigrostriatal
D. Tuberoinfundibular
Answer: C
Rationale: The nigrostriatal pathway controls motor movements and is part of the
extrapyramidal system. When D2 receptors are blocked here, patients develop motor side
effects like dystonia and parkinsonism. This pathway is usually unaffected in schizophrenia
but is a target for medication side effects.
, 4. A female patient taking Risperidone reports galactorrhea and amenorrhea. The PMHNP
explains that this is due to D2 blockade in which pathway?
A. Mesolimbic
B. Tuberoinfundibular
C. Nigrostriatal
D. Mesocortical
Answer: B
Rationale: Dopamine normally inhibits prolactin release in the tuberoinfundibular
pathway. When antipsychotics block D2 receptors here, prolactin levels rise, leading to
hyperprolactinemia. This can result in side effects such as breast enlargement, milk
production, and menstrual irregularities.
5. What is the primary pharmacological difference between First-Generation Antipsychotics
(FGAs) and Second-Generation Antipsychotics (SGAs)?
A. SGAs lack D2 antagonism entirely
B. FGAs have higher 5HT2A affinity than D2
C. SGAs add 5HT2A antagonism to D2 antagonism
D. FGAs are only used for negative symptoms
Answer: C
Advanced Pharmacology
Psychopharmacology for the PMHNP |
Actual Q&A with Rationale (NR546 Week 5
Exam) | Chamberlain University
1. A patient with schizophrenia is experiencing significant auditory hallucinations and
paranoia. Which dopamine pathway is primarily associated with these positive symptoms?
A. Mesocortical pathway
B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: B
Rationale: The mesolimbic pathway is the primary circuit associated with the positive
symptoms of schizophrenia. Excessive dopamine activity in this region leads to
hallucinations and delusions. Blocking D2 receptors in this pathway is the main mechanism
for reducing these psychotic symptoms.
2. A PMHNP is treating a patient with negative symptoms of schizophrenia, such as alogia and
flat affect. These symptoms are thought to be caused by dopamine deficiency in which
pathway?
A. Mesolimbic pathway
,B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesocortical pathway
Answer: D
Rationale: The mesocortical pathway is associated with cognitive and negative symptoms
of schizophrenia when dopamine levels are too low. Avolition and social withdrawal are
classic examples of symptoms originating from this area. Second-generation antipsychotics
aim to improve these symptoms by modulating serotonin-dopamine interactions.
3. When prescribing a first-generation antipsychotic, the PMHNP monitors for extrapyramidal
symptoms (EPS). This side effect is caused by D2 blockade in which pathway?
A. Mesolimbic
B. Mesocortical
C. Nigrostriatal
D. Tuberoinfundibular
Answer: C
Rationale: The nigrostriatal pathway controls motor movements and is part of the
extrapyramidal system. When D2 receptors are blocked here, patients develop motor side
effects like dystonia and parkinsonism. This pathway is usually unaffected in schizophrenia
but is a target for medication side effects.
, 4. A female patient taking Risperidone reports galactorrhea and amenorrhea. The PMHNP
explains that this is due to D2 blockade in which pathway?
A. Mesolimbic
B. Tuberoinfundibular
C. Nigrostriatal
D. Mesocortical
Answer: B
Rationale: Dopamine normally inhibits prolactin release in the tuberoinfundibular
pathway. When antipsychotics block D2 receptors here, prolactin levels rise, leading to
hyperprolactinemia. This can result in side effects such as breast enlargement, milk
production, and menstrual irregularities.
5. What is the primary pharmacological difference between First-Generation Antipsychotics
(FGAs) and Second-Generation Antipsychotics (SGAs)?
A. SGAs lack D2 antagonism entirely
B. FGAs have higher 5HT2A affinity than D2
C. SGAs add 5HT2A antagonism to D2 antagonism
D. FGAs are only used for negative symptoms
Answer: C
