NSG 552 EXAM 2 – ADVANCED
PSYCHOPHARMACOLOGY
COMPREHENSIVE QUESTIONS AND
ANSWERS
1. Which dopamine pathway is primarily responsible for the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Nigrostriatal pathway
B. Mesocortical pathway
C. Tuberoinfundibular pathway
D. Mesolimbic pathway
Answer: D
Conceptual Explanation: The mesolimbic pathway involves the projection from the
ventral tegmental area to the nucleus accumbens; overactivity in this area is associated
with positive symptoms of psychosis.
,2. A patient taking Clozapine must have regular blood draws to monitor for which life-
threatening condition?
A. Agranulocytosis
B. Hepatic encephalopathy
C. Thrombocytopenia
D. Metabolic syndrome
Answer: A
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis,
requiring strict monitoring of Absolute Neutrophil Count (ANC).
3. Blocking dopamine in the nigrostriatal pathway leads to which of the following side
effects?
A. Extrapyramidal symptoms (EPS)
B. Increased prolactin levels
C. Improved cognitive function
D. Reduction in negative symptoms
Answer: A
Conceptual Explanation: The nigrostriatal pathway controls motor function; blockade of
D2 receptors here results in EPS and tardive dyskinesia.
, 4. Which antidepressant is uniquely characterized as a Norepinephrine-Dopamine Reuptake
Inhibitor (NDRI) and is often used for smoking cessation?
A. Sertraline
B. Bupropion
C. Venlafaxine
D. Mirtazapine
Answer: B
Conceptual Explanation: Bupropion inhibits the reuptake of both norepinephrine and
dopamine and lacks the serotonergic side effects like sexual dysfunction.
5. What is the primary mechanism of action of most Second-Generation Antipsychotics
(SGAs) that distinguishes them from First-Generation Antipsychotics?
A. Potent D2 antagonism only
B. Selective serotonin reuptake inhibition
C. GABA-A receptor modulation
D. 5-HT2A antagonism combined with D2 antagonism
Answer: D
Conceptual Explanation: SGAs are defined by their serotonin-dopamine antagonism,
specifically blocking 5-HT2A receptors which can help mitigate EPS and improve negative
symptoms.
PSYCHOPHARMACOLOGY
COMPREHENSIVE QUESTIONS AND
ANSWERS
1. Which dopamine pathway is primarily responsible for the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Nigrostriatal pathway
B. Mesocortical pathway
C. Tuberoinfundibular pathway
D. Mesolimbic pathway
Answer: D
Conceptual Explanation: The mesolimbic pathway involves the projection from the
ventral tegmental area to the nucleus accumbens; overactivity in this area is associated
with positive symptoms of psychosis.
,2. A patient taking Clozapine must have regular blood draws to monitor for which life-
threatening condition?
A. Agranulocytosis
B. Hepatic encephalopathy
C. Thrombocytopenia
D. Metabolic syndrome
Answer: A
Conceptual Explanation: Clozapine carries a black box warning for agranulocytosis,
requiring strict monitoring of Absolute Neutrophil Count (ANC).
3. Blocking dopamine in the nigrostriatal pathway leads to which of the following side
effects?
A. Extrapyramidal symptoms (EPS)
B. Increased prolactin levels
C. Improved cognitive function
D. Reduction in negative symptoms
Answer: A
Conceptual Explanation: The nigrostriatal pathway controls motor function; blockade of
D2 receptors here results in EPS and tardive dyskinesia.
, 4. Which antidepressant is uniquely characterized as a Norepinephrine-Dopamine Reuptake
Inhibitor (NDRI) and is often used for smoking cessation?
A. Sertraline
B. Bupropion
C. Venlafaxine
D. Mirtazapine
Answer: B
Conceptual Explanation: Bupropion inhibits the reuptake of both norepinephrine and
dopamine and lacks the serotonergic side effects like sexual dysfunction.
5. What is the primary mechanism of action of most Second-Generation Antipsychotics
(SGAs) that distinguishes them from First-Generation Antipsychotics?
A. Potent D2 antagonism only
B. Selective serotonin reuptake inhibition
C. GABA-A receptor modulation
D. 5-HT2A antagonism combined with D2 antagonism
Answer: D
Conceptual Explanation: SGAs are defined by their serotonin-dopamine antagonism,
specifically blocking 5-HT2A receptors which can help mitigate EPS and improve negative
symptoms.
