WILKES UNIVERSITY
Passan School of Nursing
NSG 552 — Psychopharmacology
Exam 1 — Complete Review
Latest Update
Course: NSG 552 Psychopharmacology
Exam: Exam 1 - Comprehensive Review
Total Questions: 75 Multiple-Choice Questions
Format: 4 options (A-D) with single best answer
Cognitive Distribution: 25% Recall | 55% Application | 20% Analysis
Question Style: 70% Scenario-based | 20% Direct Recall | 10% NGN Clinical Judgment
Content Coverage: Neurobiology, Pharmacokinetics, Antidepressants, Mood Stabilizers,
Special Populations, NGN Scenarios
Verification: 100% Verified Correct Answers with Comprehensive Rationales
Grade Standard: Grade A+ Aligned with Wilkes Curriculum Standards
Academic Year: 2026 - 2027
This examination review is designed for educational use by graduate nursing students preparing for the NSG 552 Psychopharmacology
Exam 1 at Wilkes University Passan School of Nursing. All answers have been verified against current evidence-based
psychopharmacology references and 2026-2027 curriculum standards. The content integrates the Next-Generation NCLEX clinical
judgment framework for advanced practice psychiatric nursing competency.
Wilkes University • Passan School of Nursing • 2026-2027
Page 1 | Wilkes University Passan School of Nursing | NSG 552 Psychopharmacology
,NSG 552 Exam 1 - Psychopharmacology | Wilkes University Latest Update
NSG 552 Psychopharmacology - Exam 1 Review
This comprehensive examination review contains 75 multiple-choice questions organized into six sections aligned
with the Wilkes University NSG 552 Psychopharmacology curriculum. The questions assess mastery of
neurobiology and neurotransmission, pharmacokinetics and pharmacodynamics, antidepressant pharmacotherapy,
mood stabilizers, special population considerations, and Next-Generation NCLEX clinical judgment scenarios. Each
question is presented in a four-option format with the verified correct answer and a comprehensive rationale that
explains the underlying psychopharmacology reasoning, including mechanisms, indications, side effects, monitoring
parameters, and Wilkes University course-specific competencies.
Sectio
Questions Content Focus
n
1 Q1-Q15 Neurobiology and Neurotransmission
2 Q16-Q25 Pharmacokinetics and Pharmacodynamics
3 Q26-Q45 Antidepressants (SSRIs, SNRIs, TCAs, MAOIs, Atypicals)
4 Q46-Q55 Mood Stabilizers (Lithium, Anticonvulsants)
5 Q56-Q65 Clinical Applications, Special Populations, Integrated Scenarios
6 Q66-Q75 NGN-Style Clinical Scenarios
Section 1: Neurobiology and Neurotransmission
Neuronal structure and function, major neurotransmitter systems (serotonin, dopamine, norepinephrine, GABA,
glutamate, acetylcholine), receptor types, and second messenger systems.
Q1. A graduate nurse is reviewing neuronal structure and function with a peer. The peer asks which
component of the neuron is primarily responsible for receiving incoming signals from other neurons and
conducting them toward the cell body. Which response by the graduate nurse is most accurate?
A. The axon, because it transmits the action potential away from the soma.
B. The dendrites, because their branching architecture maximizes the surface area available for synaptic
input. [CORRECT]
C. The synaptic terminal, because it stores neurotransmitter vesicles awaiting release.
D. The myelin sheath, because it insulates signal conduction and accelerates propagation.
Correct Answer: B
Rationale: Dendrites are the primary receptive surfaces of the neuron; their extensive arborization dramatically
increases the surface area available for synaptic contacts and graded potentials that summate at the axon hillock. The
axon transmits the action potential away from the soma, the synaptic terminal stores vesicles for release (not
reception), and the myelin sheath modulates conduction velocity but does not receive signals. NSG 552 emphasizes
this distinction as foundational to understanding how psychotropic drugs alter neurotransmission.
Page 2 | Wilkes University Passan School of Nursing | NSG 552 Psychopharmacology
,NSG 552 Exam 1 - Psychopharmacology | Wilkes University Latest Update
Q2. A patient is started on a selective serotonin reuptake inhibitor (SSRI) for major depressive disorder. The
PMHNP explains to the patient that serotonin is synthesized in the neuron from a specific dietary amino acid
precursor. Which amino acid is the precursor for serotonin synthesis?
A. Tyrosine, which is also the precursor for dopamine and norepinephrine.
B. Tryptophan, which is hydroxylated to 5-hydroxytryptophan and then decarboxylated to form
serotonin. [CORRECT]
C. Glutamate, which is converted through the glutamic acid decarboxylase pathway.
D. Histidine, which undergoes decarboxylation to produce histamine and serotonin.
Correct Answer: B
Rationale: Serotonin (5-HT) is synthesized from the essential amino acid tryptophan via two enzymatic steps:
tryptophan hydroxylase (rate-limiting) converts tryptophan to 5-hydroxytryptophan (5-HTP), and aromatic L-amino
acid decarboxylase then converts 5-HTP to 5-HT. Tyrosine is the precursor for dopamine and norepinephrine (not
serotonin). Glutamate is the precursor for GABA, and histidine produces histamine. This precursor relationship is
clinically relevant because tryptophan depletion can transiently induce depressive symptoms in vulnerable patients.
Q3. The PMHNP is mapping the neuroanatomy of serotonin neurotransmission for a case conference.
Serotonergic neurons originate in a specific brainstem structure and project widely to the cortex, limbic
system, and hypothalamus. Which structure contains the cell bodies of serotonergic neurons?
A. The substantia nigra, which also houses dopaminergic cell bodies.
B. The locus coeruleus, the primary source of norepinephrine.
C. The raphe nuclei, located along the midline of the brainstem from the midbrain to the medulla.
[CORRECT]
D. The basal nucleus of Meynert, the major cholinergic nucleus.
Correct Answer: C
Rationale: The raphe nuclei are a cluster of nuclei located in the midline of the brainstem (midbrain, pons, and
medulla) and constitute the primary source of serotonin in the brain. Projections from the dorsal and median raphe
reach the cortex, limbic system, hypothalamus, and other regions, explaining serotonin's broad role in mood, sleep,
appetite, pain modulation, and sexual behavior. The substantia nigra produces dopamine (parkinsonian
degeneration), the locus coeruleus produces norepinephrine, and the basal nucleus of Meynert produces
acetylcholine.
Q4. A 24-year-old patient with newly diagnosed schizophrenia is started on an antipsychotic medication. The
PMHNP explains that positive symptoms of schizophrenia (hallucinations, delusions) are thought to arise
from dopaminergic hyperactivity in a specific pathway. Which dopamine pathway is most associated with
reward, motivation, and the positive symptoms of schizophrenia?
A. The nigrostriatal pathway, which controls voluntary movement.
B. The mesolimbic pathway, which projects from the ventral tegmental area to the nucleus accumbens
and limbic structures. [CORRECT]
C. The tuberoinfundibular pathway, which regulates prolactin secretion.
D. The mesocortical pathway, which projects to the prefrontal cortex and primarily modulates cognition.
Correct Answer: B
Rationale: The mesolimbic pathway projects from the ventral tegmental area (VTA) to the nucleus accumbens and
other limbic structures and is central to reward, motivation, and reinforcement. Hyperactivity in this pathway is the
prevailing explanation for positive psychotic symptoms, which is why D2 antagonism in this pathway underlies the
efficacy of antipsychotics. The nigrostriatal pathway governs movement (D2 blockade causes EPS), the
tuberoinfundibular pathway inhibits prolactin (D2 blockade causes hyperprolactinemia), and the mesocortical
pathway modulates cognition and negative symptoms.
Page 3 | Wilkes University Passan School of Nursing | NSG 552 Psychopharmacology
, NSG 552 Exam 1 - Psychopharmacology | Wilkes University Latest Update
Q5. A patient receiving a first-generation antipsychotic develops parkinsonian symptoms including
bradykinesia, rigidity, and a pill-rolling tremor. The PMHNP recognizes this as drug-induced parkinsonism
resulting from dopamine D2 blockade in a specific pathway. Which pathway is responsible for this adverse
effect?
A. The mesolimbic pathway, which modulates reward processing.
B. The mesocortical pathway, which modulates executive function.
C. The nigrostriatal pathway, which projects from the substantia nigra to the striatum and controls
voluntary movement. [CORRECT]
D. The tuberoinfundibular pathway, which regulates prolactin inhibition.
Correct Answer: C
Rationale: The nigrostriatal pathway projects from the substantia nigra pars compacta to the dorsal striatum
(caudate and putamen) and is essential for the initiation and modulation of voluntary movement. D2 receptor
blockade in this pathway produces drug-induced parkinsonism (bradykinesia, rigidity, tremor), and idiopathic
Parkinson's disease results from progressive degeneration of these same neurons. Understanding pathway-specific
effects allows the PMHNP to anticipate and manage antipsychotic adverse effects, a core NSG 552 competency.
Q6. A 32-year-old woman on risperidone reports galactorrhea, amenorrhea, and decreased libido. Laboratory
testing reveals a markedly elevated prolactin level. The PMHNP explains that this adverse effect results from
D2 blockade in a specific dopamine pathway. Which pathway normally inhibits prolactin secretion from the
anterior pituitary?
A. The mesolimbic pathway, projecting to the nucleus accumbens.
B. The nigrostriatal pathway, projecting to the striatum.
C. The tuberoinfundibular pathway, projecting from the hypothalamus to the pituitary. [CORRECT]
D. The mesocortical pathway, projecting to the prefrontal cortex.
Correct Answer: C
Rationale: The tuberoinfundibular pathway projects from the arcuate nucleus of the hypothalamus to the median
eminence, where dopamine is released into the hypophyseal portal system and acts on D2 receptors of the anterior
pituitary to tonically inhibit prolactin secretion. D2 blockade by antipsychotics (especially risperidone) removes this
inhibition, causing hyperprolactinemia, galactorrhea, gynecomastia, menstrual irregularities, and sexual
dysfunction. Risperidone is the highest-risk atypical; aripiprazole is partial-agonist and lowers prolactin.
Q7. A patient presents with acute panic attacks characterized by autonomic hyperarousal including
tachycardia, sweating, tremor, and pupillary dilation. The PMHNP recognizes that many of these
'fight-or-flight' symptoms are mediated by norepinephrine released from neurons originating in a specific
brainstem nucleus. Which nucleus is the primary source of norepinephrine in the brain?
A. The raphe nuclei, which synthesize and release serotonin.
B. The substantia nigra, which synthesizes and releases dopamine.
C. The locus coeruleus, located in the dorsal pons. [CORRECT]
D. The nucleus accumbens, located in the ventral striatum.
Correct Answer: C
Rationale: The locus coeruleus is a small nucleus in the dorsal pons and is the principal source of norepinephrine in
the brain, with widespread projections to the cortex, limbic system, hypothalamus, and spinal cord. It regulates
arousal, attention, mood, and the stress response. The raphe nuclei produce serotonin, and the substantia nigra
produces dopamine. The nucleus accumbens is a target (not a source) of catecholamine projections. Locus coeruleus
hyperactivity is implicated in panic and anxiety disorders.
Page 4 | Wilkes University Passan School of Nursing | NSG 552 Psychopharmacology
Passan School of Nursing
NSG 552 — Psychopharmacology
Exam 1 — Complete Review
Latest Update
Course: NSG 552 Psychopharmacology
Exam: Exam 1 - Comprehensive Review
Total Questions: 75 Multiple-Choice Questions
Format: 4 options (A-D) with single best answer
Cognitive Distribution: 25% Recall | 55% Application | 20% Analysis
Question Style: 70% Scenario-based | 20% Direct Recall | 10% NGN Clinical Judgment
Content Coverage: Neurobiology, Pharmacokinetics, Antidepressants, Mood Stabilizers,
Special Populations, NGN Scenarios
Verification: 100% Verified Correct Answers with Comprehensive Rationales
Grade Standard: Grade A+ Aligned with Wilkes Curriculum Standards
Academic Year: 2026 - 2027
This examination review is designed for educational use by graduate nursing students preparing for the NSG 552 Psychopharmacology
Exam 1 at Wilkes University Passan School of Nursing. All answers have been verified against current evidence-based
psychopharmacology references and 2026-2027 curriculum standards. The content integrates the Next-Generation NCLEX clinical
judgment framework for advanced practice psychiatric nursing competency.
Wilkes University • Passan School of Nursing • 2026-2027
Page 1 | Wilkes University Passan School of Nursing | NSG 552 Psychopharmacology
,NSG 552 Exam 1 - Psychopharmacology | Wilkes University Latest Update
NSG 552 Psychopharmacology - Exam 1 Review
This comprehensive examination review contains 75 multiple-choice questions organized into six sections aligned
with the Wilkes University NSG 552 Psychopharmacology curriculum. The questions assess mastery of
neurobiology and neurotransmission, pharmacokinetics and pharmacodynamics, antidepressant pharmacotherapy,
mood stabilizers, special population considerations, and Next-Generation NCLEX clinical judgment scenarios. Each
question is presented in a four-option format with the verified correct answer and a comprehensive rationale that
explains the underlying psychopharmacology reasoning, including mechanisms, indications, side effects, monitoring
parameters, and Wilkes University course-specific competencies.
Sectio
Questions Content Focus
n
1 Q1-Q15 Neurobiology and Neurotransmission
2 Q16-Q25 Pharmacokinetics and Pharmacodynamics
3 Q26-Q45 Antidepressants (SSRIs, SNRIs, TCAs, MAOIs, Atypicals)
4 Q46-Q55 Mood Stabilizers (Lithium, Anticonvulsants)
5 Q56-Q65 Clinical Applications, Special Populations, Integrated Scenarios
6 Q66-Q75 NGN-Style Clinical Scenarios
Section 1: Neurobiology and Neurotransmission
Neuronal structure and function, major neurotransmitter systems (serotonin, dopamine, norepinephrine, GABA,
glutamate, acetylcholine), receptor types, and second messenger systems.
Q1. A graduate nurse is reviewing neuronal structure and function with a peer. The peer asks which
component of the neuron is primarily responsible for receiving incoming signals from other neurons and
conducting them toward the cell body. Which response by the graduate nurse is most accurate?
A. The axon, because it transmits the action potential away from the soma.
B. The dendrites, because their branching architecture maximizes the surface area available for synaptic
input. [CORRECT]
C. The synaptic terminal, because it stores neurotransmitter vesicles awaiting release.
D. The myelin sheath, because it insulates signal conduction and accelerates propagation.
Correct Answer: B
Rationale: Dendrites are the primary receptive surfaces of the neuron; their extensive arborization dramatically
increases the surface area available for synaptic contacts and graded potentials that summate at the axon hillock. The
axon transmits the action potential away from the soma, the synaptic terminal stores vesicles for release (not
reception), and the myelin sheath modulates conduction velocity but does not receive signals. NSG 552 emphasizes
this distinction as foundational to understanding how psychotropic drugs alter neurotransmission.
Page 2 | Wilkes University Passan School of Nursing | NSG 552 Psychopharmacology
,NSG 552 Exam 1 - Psychopharmacology | Wilkes University Latest Update
Q2. A patient is started on a selective serotonin reuptake inhibitor (SSRI) for major depressive disorder. The
PMHNP explains to the patient that serotonin is synthesized in the neuron from a specific dietary amino acid
precursor. Which amino acid is the precursor for serotonin synthesis?
A. Tyrosine, which is also the precursor for dopamine and norepinephrine.
B. Tryptophan, which is hydroxylated to 5-hydroxytryptophan and then decarboxylated to form
serotonin. [CORRECT]
C. Glutamate, which is converted through the glutamic acid decarboxylase pathway.
D. Histidine, which undergoes decarboxylation to produce histamine and serotonin.
Correct Answer: B
Rationale: Serotonin (5-HT) is synthesized from the essential amino acid tryptophan via two enzymatic steps:
tryptophan hydroxylase (rate-limiting) converts tryptophan to 5-hydroxytryptophan (5-HTP), and aromatic L-amino
acid decarboxylase then converts 5-HTP to 5-HT. Tyrosine is the precursor for dopamine and norepinephrine (not
serotonin). Glutamate is the precursor for GABA, and histidine produces histamine. This precursor relationship is
clinically relevant because tryptophan depletion can transiently induce depressive symptoms in vulnerable patients.
Q3. The PMHNP is mapping the neuroanatomy of serotonin neurotransmission for a case conference.
Serotonergic neurons originate in a specific brainstem structure and project widely to the cortex, limbic
system, and hypothalamus. Which structure contains the cell bodies of serotonergic neurons?
A. The substantia nigra, which also houses dopaminergic cell bodies.
B. The locus coeruleus, the primary source of norepinephrine.
C. The raphe nuclei, located along the midline of the brainstem from the midbrain to the medulla.
[CORRECT]
D. The basal nucleus of Meynert, the major cholinergic nucleus.
Correct Answer: C
Rationale: The raphe nuclei are a cluster of nuclei located in the midline of the brainstem (midbrain, pons, and
medulla) and constitute the primary source of serotonin in the brain. Projections from the dorsal and median raphe
reach the cortex, limbic system, hypothalamus, and other regions, explaining serotonin's broad role in mood, sleep,
appetite, pain modulation, and sexual behavior. The substantia nigra produces dopamine (parkinsonian
degeneration), the locus coeruleus produces norepinephrine, and the basal nucleus of Meynert produces
acetylcholine.
Q4. A 24-year-old patient with newly diagnosed schizophrenia is started on an antipsychotic medication. The
PMHNP explains that positive symptoms of schizophrenia (hallucinations, delusions) are thought to arise
from dopaminergic hyperactivity in a specific pathway. Which dopamine pathway is most associated with
reward, motivation, and the positive symptoms of schizophrenia?
A. The nigrostriatal pathway, which controls voluntary movement.
B. The mesolimbic pathway, which projects from the ventral tegmental area to the nucleus accumbens
and limbic structures. [CORRECT]
C. The tuberoinfundibular pathway, which regulates prolactin secretion.
D. The mesocortical pathway, which projects to the prefrontal cortex and primarily modulates cognition.
Correct Answer: B
Rationale: The mesolimbic pathway projects from the ventral tegmental area (VTA) to the nucleus accumbens and
other limbic structures and is central to reward, motivation, and reinforcement. Hyperactivity in this pathway is the
prevailing explanation for positive psychotic symptoms, which is why D2 antagonism in this pathway underlies the
efficacy of antipsychotics. The nigrostriatal pathway governs movement (D2 blockade causes EPS), the
tuberoinfundibular pathway inhibits prolactin (D2 blockade causes hyperprolactinemia), and the mesocortical
pathway modulates cognition and negative symptoms.
Page 3 | Wilkes University Passan School of Nursing | NSG 552 Psychopharmacology
, NSG 552 Exam 1 - Psychopharmacology | Wilkes University Latest Update
Q5. A patient receiving a first-generation antipsychotic develops parkinsonian symptoms including
bradykinesia, rigidity, and a pill-rolling tremor. The PMHNP recognizes this as drug-induced parkinsonism
resulting from dopamine D2 blockade in a specific pathway. Which pathway is responsible for this adverse
effect?
A. The mesolimbic pathway, which modulates reward processing.
B. The mesocortical pathway, which modulates executive function.
C. The nigrostriatal pathway, which projects from the substantia nigra to the striatum and controls
voluntary movement. [CORRECT]
D. The tuberoinfundibular pathway, which regulates prolactin inhibition.
Correct Answer: C
Rationale: The nigrostriatal pathway projects from the substantia nigra pars compacta to the dorsal striatum
(caudate and putamen) and is essential for the initiation and modulation of voluntary movement. D2 receptor
blockade in this pathway produces drug-induced parkinsonism (bradykinesia, rigidity, tremor), and idiopathic
Parkinson's disease results from progressive degeneration of these same neurons. Understanding pathway-specific
effects allows the PMHNP to anticipate and manage antipsychotic adverse effects, a core NSG 552 competency.
Q6. A 32-year-old woman on risperidone reports galactorrhea, amenorrhea, and decreased libido. Laboratory
testing reveals a markedly elevated prolactin level. The PMHNP explains that this adverse effect results from
D2 blockade in a specific dopamine pathway. Which pathway normally inhibits prolactin secretion from the
anterior pituitary?
A. The mesolimbic pathway, projecting to the nucleus accumbens.
B. The nigrostriatal pathway, projecting to the striatum.
C. The tuberoinfundibular pathway, projecting from the hypothalamus to the pituitary. [CORRECT]
D. The mesocortical pathway, projecting to the prefrontal cortex.
Correct Answer: C
Rationale: The tuberoinfundibular pathway projects from the arcuate nucleus of the hypothalamus to the median
eminence, where dopamine is released into the hypophyseal portal system and acts on D2 receptors of the anterior
pituitary to tonically inhibit prolactin secretion. D2 blockade by antipsychotics (especially risperidone) removes this
inhibition, causing hyperprolactinemia, galactorrhea, gynecomastia, menstrual irregularities, and sexual
dysfunction. Risperidone is the highest-risk atypical; aripiprazole is partial-agonist and lowers prolactin.
Q7. A patient presents with acute panic attacks characterized by autonomic hyperarousal including
tachycardia, sweating, tremor, and pupillary dilation. The PMHNP recognizes that many of these
'fight-or-flight' symptoms are mediated by norepinephrine released from neurons originating in a specific
brainstem nucleus. Which nucleus is the primary source of norepinephrine in the brain?
A. The raphe nuclei, which synthesize and release serotonin.
B. The substantia nigra, which synthesizes and releases dopamine.
C. The locus coeruleus, located in the dorsal pons. [CORRECT]
D. The nucleus accumbens, located in the ventral striatum.
Correct Answer: C
Rationale: The locus coeruleus is a small nucleus in the dorsal pons and is the principal source of norepinephrine in
the brain, with widespread projections to the cortex, limbic system, hypothalamus, and spinal cord. It regulates
arousal, attention, mood, and the stress response. The raphe nuclei produce serotonin, and the substantia nigra
produces dopamine. The nucleus accumbens is a target (not a source) of catecholamine projections. Locus coeruleus
hyperactivity is implicated in panic and anxiety disorders.
Page 4 | Wilkes University Passan School of Nursing | NSG 552 Psychopharmacology
