NRNP 6635 COMPREHENSIVE FINAL
EXAM STUDY GUIDE
1. Which neurotransmitter 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 of dopamine
from the ventral tegmental area to the nucleus accumbens. Hyperactivity in this pathway is
linked to positive symptoms of schizophrenia.
2. A patient taking lithium for Bipolar I Disorder presents with coarse tremors, ataxia, and
confusion. What is the most likely lithium serum level?
A. 0.6 mEq/L
B. 0.9 mEq/L
,C. 2.0 mEq/L
D. 1.2 mEq/L
Answer: C
Conceptual Explanation: Lithium toxicity typically occurs at levels above 1.5 mEq/L, with
severe symptoms like ataxia and confusion manifesting as levels approach or exceed 2.0
mEq/L.
3. Which brain region is considered the ‘fear center’ and is hyperactive in patients with Post-
Traumatic Stress Disorder (PTSD)?
A. Amygdala
B. Hippocampus
C. Prefrontal Cortex
D. Basal Ganglia
Answer: A
Conceptual Explanation: The amygdala is responsible for emotional processing and the
fear response. In PTSD, the amygdala is often hyper-responsive to trauma-related cues.
4. Which of the following antidepressants is contraindicated in a patient with a history of
Bulimia Nervosa due to an increased risk of seizures?
A. Fluoxetine
B. Bupropion
, C. Sertraline
D. Venlafaxine
Answer: B
Conceptual Explanation: Bupropion is contraindicated in patients with eating disorders
(bulimia or anorexia) because it significantly lowers the seizure threshold in these
populations.
5. A 25-year-old female presents with a 2-week history of elevated mood, decreased need for
sleep (3 hours/night), and pressured speech. She has no history of hospitalization. Which
diagnosis is most appropriate?
A. Major Depressive Disorder
B. Bipolar II Disorder, Hypomanic Episode
C. Cyclothymic Disorder
D. Bipolar I Disorder, Manic Episode
Answer: D
Conceptual Explanation: The presence of a manic episode (elevated mood, decreased
sleep, pressured speech lasting at least one week) meets the criteria for Bipolar I Disorder,
regardless of prior history.
EXAM STUDY GUIDE
1. Which neurotransmitter 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 of dopamine
from the ventral tegmental area to the nucleus accumbens. Hyperactivity in this pathway is
linked to positive symptoms of schizophrenia.
2. A patient taking lithium for Bipolar I Disorder presents with coarse tremors, ataxia, and
confusion. What is the most likely lithium serum level?
A. 0.6 mEq/L
B. 0.9 mEq/L
,C. 2.0 mEq/L
D. 1.2 mEq/L
Answer: C
Conceptual Explanation: Lithium toxicity typically occurs at levels above 1.5 mEq/L, with
severe symptoms like ataxia and confusion manifesting as levels approach or exceed 2.0
mEq/L.
3. Which brain region is considered the ‘fear center’ and is hyperactive in patients with Post-
Traumatic Stress Disorder (PTSD)?
A. Amygdala
B. Hippocampus
C. Prefrontal Cortex
D. Basal Ganglia
Answer: A
Conceptual Explanation: The amygdala is responsible for emotional processing and the
fear response. In PTSD, the amygdala is often hyper-responsive to trauma-related cues.
4. Which of the following antidepressants is contraindicated in a patient with a history of
Bulimia Nervosa due to an increased risk of seizures?
A. Fluoxetine
B. Bupropion
, C. Sertraline
D. Venlafaxine
Answer: B
Conceptual Explanation: Bupropion is contraindicated in patients with eating disorders
(bulimia or anorexia) because it significantly lowers the seizure threshold in these
populations.
5. A 25-year-old female presents with a 2-week history of elevated mood, decreased need for
sleep (3 hours/night), and pressured speech. She has no history of hospitalization. Which
diagnosis is most appropriate?
A. Major Depressive Disorder
B. Bipolar II Disorder, Hypomanic Episode
C. Cyclothymic Disorder
D. Bipolar I Disorder, Manic Episode
Answer: D
Conceptual Explanation: The presence of a manic episode (elevated mood, decreased
sleep, pressured speech lasting at least one week) meets the criteria for Bipolar I Disorder,
regardless of prior history.
