NU 671 Final Exam Practice Questions with Correct
Answers and Rationales
Advanced Psychopharmacology & Neurobiology
1. Which neurotransmitter is primarily implicated in the pathophysiology of schizophrenia?
• A) Norepinephrine
• B) Serotonin
• C) Dopamine
• D) GABA
Correct Answer: C) Dopamine
Rationale: Dopamine hyperactivity in the mesolimbic pathway causes positive symptoms of
schizophrenia. The dopamine hypothesis remains central to understanding schizophrenia
pathophysiology, though serotonin and glutamate also play roles .
2. Antagonism of which receptor is most associated with extrapyramidal symptoms (EPS)?
• A) 5-HT2A
• B) D2
• C) M1
• D) H1
Correct Answer: B) D2
Rationale: D2 blockade in the nigrostriatal pathway causes extrapyramidal symptoms. Higher D2
occupancy (>80%) increases EPS risk. 5-HT2A antagonism may actually reduce EPS .
3. Which receptor blockade causes significant weight gain?
• A) D2
• B) 5-HT2C
, • C) H1
• D) Alpha-2
Correct Answer: C) H1
Rationale: Histamine H1 antagonism increases appetite and causes sedation, strongly linked to
weight gain with medications like quetiapine and olanzapine. 5-HT2C blockade also contributes
but H1 is primary .
4. The mechanism of action of SSRIs involves:
• A) Blockade of dopamine reuptake
• B) Inhibition of serotonin reuptake
• C) Antagonism of NMDA receptors
• D) Agonism of GABA-A receptors
Correct Answer: B) Inhibition of serotonin reuptake
Rationale: SSRIs selectively block the serotonin transporter, increasing synaptic serotonin
availability. This mechanism is fundamental to their antidepressant and anti-anxiety effects .
5. The mechanism of action of buspirone involves:
• A) GABA-A agonism
• B) 5-HT1A partial agonism
• C) D2 antagonism
• D) NET inhibition
Correct Answer: B) 5-HT1A partial agonism
Rationale: Buspirone is a 5-HT1A partial agonist, effective for generalized anxiety disorder
without sedation or dependence .
6. Which receptor blockade increases prolactin?
• A) D2 in tuberoinfundibular pathway
, • B) 5-HT2A in cortex
• C) H1 in hypothalamus
• D) M1 in hippocampus
Correct Answer: A) D2 in tuberoinfundibular pathway
Rationale: Dopamine tonically inhibits prolactin release. D2 blockade in the tuberoinfundibular
pathway disinhibits prolactin release, potentially causing galactorrhea and sexual dysfunction .
7. Which receptor is most associated with sedation from psychotropic medications?
• A) D2
• B) 5-HT2A
• C) H1
• D) M1
Correct Answer: C) H1
Rationale: Histamine H1 blockade causes sedation. This is why medications like quetiapine,
olanzapine, and diphenhydramine produce significant sedative effects .
8. Anticholinergic side effects (dry mouth, constipation, blurred vision) result from blockade
of:
• A) Alpha-1
• B) D2
• C) M1 (muscarinic)
• D) H1
Correct Answer: C) M1 (muscarinic)
Rationale: Muscarinic acetylcholine receptor blockade causes peripheral anticholinergic effects
including dry mouth, constipation, urinary retention, and blurred vision .
9. Which medication is a partial agonist at D2 and 5-HT1A receptors?
, • A) Haloperidol
• B) Aripiprazole
• C) Clozapine
• D) Risperidone
Correct Answer: B) Aripiprazole
Rationale: Aripiprazole is a D2 and 5-HT1A partial agonist, which reduces EPS risk compared to
full D2 antagonists .
10. What is the primary inhibitory neurotransmitter in the brain?
• A) Glutamate
• B) Dopamine
• C) GABA
• D) Norepinephrine
Correct Answer: C) GABA
Rationale: GABA (gamma-aminobutyric acid) is the primary inhibitory neurotransmitter in the
brain, counterbalancing excitatory glutamate activity .
Psychiatric Assessment & Mental Status Examination
11. What is the purpose of the psychiatric interview?
• A) To prescribe medication only
• B) To gather information for diagnosis, build rapport, and develop a treatment plan
• C) To complete a physical examination
• D) To refer to another provider
Correct Answer: B) To gather information for diagnosis, build rapport, and develop a
treatment plan
Rationale: The psychiatric interview serves multiple purposes: diagnostic data collection,
establishing therapeutic alliance, and collaborative treatment planning .
Answers and Rationales
Advanced Psychopharmacology & Neurobiology
1. Which neurotransmitter is primarily implicated in the pathophysiology of schizophrenia?
• A) Norepinephrine
• B) Serotonin
• C) Dopamine
• D) GABA
Correct Answer: C) Dopamine
Rationale: Dopamine hyperactivity in the mesolimbic pathway causes positive symptoms of
schizophrenia. The dopamine hypothesis remains central to understanding schizophrenia
pathophysiology, though serotonin and glutamate also play roles .
2. Antagonism of which receptor is most associated with extrapyramidal symptoms (EPS)?
• A) 5-HT2A
• B) D2
• C) M1
• D) H1
Correct Answer: B) D2
Rationale: D2 blockade in the nigrostriatal pathway causes extrapyramidal symptoms. Higher D2
occupancy (>80%) increases EPS risk. 5-HT2A antagonism may actually reduce EPS .
3. Which receptor blockade causes significant weight gain?
• A) D2
• B) 5-HT2C
, • C) H1
• D) Alpha-2
Correct Answer: C) H1
Rationale: Histamine H1 antagonism increases appetite and causes sedation, strongly linked to
weight gain with medications like quetiapine and olanzapine. 5-HT2C blockade also contributes
but H1 is primary .
4. The mechanism of action of SSRIs involves:
• A) Blockade of dopamine reuptake
• B) Inhibition of serotonin reuptake
• C) Antagonism of NMDA receptors
• D) Agonism of GABA-A receptors
Correct Answer: B) Inhibition of serotonin reuptake
Rationale: SSRIs selectively block the serotonin transporter, increasing synaptic serotonin
availability. This mechanism is fundamental to their antidepressant and anti-anxiety effects .
5. The mechanism of action of buspirone involves:
• A) GABA-A agonism
• B) 5-HT1A partial agonism
• C) D2 antagonism
• D) NET inhibition
Correct Answer: B) 5-HT1A partial agonism
Rationale: Buspirone is a 5-HT1A partial agonist, effective for generalized anxiety disorder
without sedation or dependence .
6. Which receptor blockade increases prolactin?
• A) D2 in tuberoinfundibular pathway
, • B) 5-HT2A in cortex
• C) H1 in hypothalamus
• D) M1 in hippocampus
Correct Answer: A) D2 in tuberoinfundibular pathway
Rationale: Dopamine tonically inhibits prolactin release. D2 blockade in the tuberoinfundibular
pathway disinhibits prolactin release, potentially causing galactorrhea and sexual dysfunction .
7. Which receptor is most associated with sedation from psychotropic medications?
• A) D2
• B) 5-HT2A
• C) H1
• D) M1
Correct Answer: C) H1
Rationale: Histamine H1 blockade causes sedation. This is why medications like quetiapine,
olanzapine, and diphenhydramine produce significant sedative effects .
8. Anticholinergic side effects (dry mouth, constipation, blurred vision) result from blockade
of:
• A) Alpha-1
• B) D2
• C) M1 (muscarinic)
• D) H1
Correct Answer: C) M1 (muscarinic)
Rationale: Muscarinic acetylcholine receptor blockade causes peripheral anticholinergic effects
including dry mouth, constipation, urinary retention, and blurred vision .
9. Which medication is a partial agonist at D2 and 5-HT1A receptors?
, • A) Haloperidol
• B) Aripiprazole
• C) Clozapine
• D) Risperidone
Correct Answer: B) Aripiprazole
Rationale: Aripiprazole is a D2 and 5-HT1A partial agonist, which reduces EPS risk compared to
full D2 antagonists .
10. What is the primary inhibitory neurotransmitter in the brain?
• A) Glutamate
• B) Dopamine
• C) GABA
• D) Norepinephrine
Correct Answer: C) GABA
Rationale: GABA (gamma-aminobutyric acid) is the primary inhibitory neurotransmitter in the
brain, counterbalancing excitatory glutamate activity .
Psychiatric Assessment & Mental Status Examination
11. What is the purpose of the psychiatric interview?
• A) To prescribe medication only
• B) To gather information for diagnosis, build rapport, and develop a treatment plan
• C) To complete a physical examination
• D) To refer to another provider
Correct Answer: B) To gather information for diagnosis, build rapport, and develop a
treatment plan
Rationale: The psychiatric interview serves multiple purposes: diagnostic data collection,
establishing therapeutic alliance, and collaborative treatment planning .
