NSG552 PSYCHOPHARMACOLOGY
ADVANCED EXAM PREP QUESTIONS
AND ANSWERS
1. Which dopaminergic pathway is primarily associated with the development of
extrapyramidal symptoms (EPS) and tardive dyskinesia when D2 receptors are blocked?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: B
Conceptual Explanation: The nigrostriatal pathway controls motor function and
movement. Blockade of D2 receptors in this pathway leads to extrapyramidal side effects
and tardive dyskinesia.
2. A patient taking an MAOI presents with a blood pressure of 210/120 mmHg after
consuming aged cheese. What is the physiological mechanism behind this hypertensive crisis?
A. Inhibition of norepinephrine reuptake
,B. Release of stored catecholamines by tyramine
C. Direct stimulation of alpha-2 receptors
D. Serotonin receptor hypersensitivity
Answer: B
Conceptual Explanation: MAOIs inhibit the breakdown of tyramine. Tyramine promotes
the release of stored norepinephrine and other catecholamines, leading to vasoconstriction
and hypertensive crisis.
3. Which of the following describes the mechanism of action of Memantine in the treatment
of Alzheimer’s disease?
A. NMDA receptor antagonism
B. Irreversible inhibition of butyrylcholinesterase
C. Reversible acetylcholinesterase inhibition
D. Beta-amyloid plaque degradation
Answer: A
Conceptual Explanation: Memantine is an uncompetitive NMDA receptor antagonist that
regulates glutamate activity to prevent excitotoxicity in neurons.
4. What is the therapeutic reference range for Lithium in the maintenance phase of Bipolar
Disorder?
A. 0.6 - 1.2 mEq/L
, B. 0.4 - 0.8 mEq/L
C. 1.0 - 1.5 mEq/L
D. 1.2 - 2.0 mEq/L
Answer: A
Conceptual Explanation: The standard therapeutic window for Lithium maintenance is
0.6 to 1.2 mEq/L; levels above 1.5 mEq/L are typically considered toxic.
5. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders like bulimia?
A. Mirtazapine
B. Fluoxetine
C. Bupropion
D. Duloxetine
Answer: C
Conceptual Explanation: Bupropion lowers the seizure threshold, particularly in patients
with electrolyte imbalances common in eating disorders.
6. A patient on Clozapine reports a sore throat and fever. The absolute neutrophil count
(ANC) is 450/mm3. What is the most appropriate action?
A. Continue the medication and monitor blood work daily
B. Reduce the dose by 50% and retest in 48 hours
ADVANCED EXAM PREP QUESTIONS
AND ANSWERS
1. Which dopaminergic pathway is primarily associated with the development of
extrapyramidal symptoms (EPS) and tardive dyskinesia when D2 receptors are blocked?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: B
Conceptual Explanation: The nigrostriatal pathway controls motor function and
movement. Blockade of D2 receptors in this pathway leads to extrapyramidal side effects
and tardive dyskinesia.
2. A patient taking an MAOI presents with a blood pressure of 210/120 mmHg after
consuming aged cheese. What is the physiological mechanism behind this hypertensive crisis?
A. Inhibition of norepinephrine reuptake
,B. Release of stored catecholamines by tyramine
C. Direct stimulation of alpha-2 receptors
D. Serotonin receptor hypersensitivity
Answer: B
Conceptual Explanation: MAOIs inhibit the breakdown of tyramine. Tyramine promotes
the release of stored norepinephrine and other catecholamines, leading to vasoconstriction
and hypertensive crisis.
3. Which of the following describes the mechanism of action of Memantine in the treatment
of Alzheimer’s disease?
A. NMDA receptor antagonism
B. Irreversible inhibition of butyrylcholinesterase
C. Reversible acetylcholinesterase inhibition
D. Beta-amyloid plaque degradation
Answer: A
Conceptual Explanation: Memantine is an uncompetitive NMDA receptor antagonist that
regulates glutamate activity to prevent excitotoxicity in neurons.
4. What is the therapeutic reference range for Lithium in the maintenance phase of Bipolar
Disorder?
A. 0.6 - 1.2 mEq/L
, B. 0.4 - 0.8 mEq/L
C. 1.0 - 1.5 mEq/L
D. 1.2 - 2.0 mEq/L
Answer: A
Conceptual Explanation: The standard therapeutic window for Lithium maintenance is
0.6 to 1.2 mEq/L; levels above 1.5 mEq/L are typically considered toxic.
5. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders like bulimia?
A. Mirtazapine
B. Fluoxetine
C. Bupropion
D. Duloxetine
Answer: C
Conceptual Explanation: Bupropion lowers the seizure threshold, particularly in patients
with electrolyte imbalances common in eating disorders.
6. A patient on Clozapine reports a sore throat and fever. The absolute neutrophil count
(ANC) is 450/mm3. What is the most appropriate action?
A. Continue the medication and monitor blood work daily
B. Reduce the dose by 50% and retest in 48 hours
