NRNP 6635 – FINAL EXAM STUDY
GUIDE 2027 QUESTIONS AND ANSWERS
1. Which dopaminergic pathway is primarily associated with the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: The mesolimbic pathway involves the projection from the
ventral tegmental area to the nucleus accumbens; overactivity here is linked to positive
symptoms.
2. A patient on Clozapine shows an Absolute Neutrophil Count (ANC) of 900/mm³. What is the
most appropriate next step?
A. Continue the medication but monitor weekly
B. Switch to Olanzapine immediately without tapering
,C. Increase the dose to compensate for marrow suppression
D. Interrupt treatment and consult hematology
Answer: D
Conceptual Explanation: An ANC below 1000/mm³ (moderate neutropenia) requires
interruption of Clozapine therapy and hematological consultation to prevent
agranulocytosis.
3. Which neurotransmitter system is the primary target for Benzodiazepines to exert their
anxiolytic effect?
A. Glutamate via NMDA receptors
B. Dopamine via D2 receptors
C. GABA via GABA-A receptors
D. Serotonin via 5-HT1A receptors
Answer: C
Conceptual Explanation: Benzodiazepines act as positive allosteric modulators at the
GABA-A receptor, increasing the frequency of chloride channel opening.
4. A 24-year-old female experiences at least 4 days of abnormally elevated mood, increased
energy, and decreased need for sleep, but her functioning is not severely impaired and there
are no psychotic features. What is the diagnosis?
A. Bipolar I Disorder
, B. Major Depressive Disorder
C. Bipolar II Disorder
D. Cyclothymic Disorder
Answer: C
Conceptual Explanation: Bipolar II requires a history of at least one hypomanic episode
(lasting 4 days, no psychosis/hospitalization) and one major depressive episode.
5. Which medication is most likely to cause Stevens-Johnson Syndrome (SJS) if not titrated
slowly?
A. Lithium
B. Valproate
C. Quetiapine
D. Lamotrigine
Answer: D
Conceptual Explanation: Lamotrigine carries a black box warning for serious rashes,
including SJS, which is mitigated by a very slow dose titration schedule.
6. In the treatment of ADHD, which non-stimulant medication acts as a selective
norepinephrine reuptake inhibitor?
A. Methylphenidate
B. Guanfacine
GUIDE 2027 QUESTIONS AND ANSWERS
1. Which dopaminergic pathway is primarily associated with the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: The mesolimbic pathway involves the projection from the
ventral tegmental area to the nucleus accumbens; overactivity here is linked to positive
symptoms.
2. A patient on Clozapine shows an Absolute Neutrophil Count (ANC) of 900/mm³. What is the
most appropriate next step?
A. Continue the medication but monitor weekly
B. Switch to Olanzapine immediately without tapering
,C. Increase the dose to compensate for marrow suppression
D. Interrupt treatment and consult hematology
Answer: D
Conceptual Explanation: An ANC below 1000/mm³ (moderate neutropenia) requires
interruption of Clozapine therapy and hematological consultation to prevent
agranulocytosis.
3. Which neurotransmitter system is the primary target for Benzodiazepines to exert their
anxiolytic effect?
A. Glutamate via NMDA receptors
B. Dopamine via D2 receptors
C. GABA via GABA-A receptors
D. Serotonin via 5-HT1A receptors
Answer: C
Conceptual Explanation: Benzodiazepines act as positive allosteric modulators at the
GABA-A receptor, increasing the frequency of chloride channel opening.
4. A 24-year-old female experiences at least 4 days of abnormally elevated mood, increased
energy, and decreased need for sleep, but her functioning is not severely impaired and there
are no psychotic features. What is the diagnosis?
A. Bipolar I Disorder
, B. Major Depressive Disorder
C. Bipolar II Disorder
D. Cyclothymic Disorder
Answer: C
Conceptual Explanation: Bipolar II requires a history of at least one hypomanic episode
(lasting 4 days, no psychosis/hospitalization) and one major depressive episode.
5. Which medication is most likely to cause Stevens-Johnson Syndrome (SJS) if not titrated
slowly?
A. Lithium
B. Valproate
C. Quetiapine
D. Lamotrigine
Answer: D
Conceptual Explanation: Lamotrigine carries a black box warning for serious rashes,
including SJS, which is mitigated by a very slow dose titration schedule.
6. In the treatment of ADHD, which non-stimulant medication acts as a selective
norepinephrine reuptake inhibitor?
A. Methylphenidate
B. Guanfacine
