NR 546 PSYCHOPHARMACOLOGY
FINAL EXAM REVIEW 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 in this pathway is linked to
positive symptoms of schizophrenia.
2. Second-generation antipsychotics (SGAs) differ from first-generation antipsychotics (FGAs)
primarily due to their antagonism of which receptor?
A. 5-HT2A receptors
,B. D1 receptors
C. GABA-A receptors
D. Alpha-2 receptors
Answer: A
Conceptual Explanation: SGAs are defined by their dual antagonism of D2 and 5-HT2A
receptors, which helps reduce EPS and improve negative symptoms compared to FGAs.
3. A patient taking Clozapine must have their Absolute Neutrophil Count (ANC) monitored
regularly to screen for which life-threatening condition?
A. Agranulocytosis
B. Metabolic syndrome
C. Neuroleptic malignant syndrome
D. Tardive dyskinesia
Answer: A
Conceptual Explanation: Clozapine carries a risk of agranulocytosis (severe low white
blood cell count), necessitating strict ANC monitoring via the REMS program.
4. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Bupropion
B. Fluoxetine
, C. Sertraline
D. Venlafaxine
Answer: A
Conceptual Explanation: Bupropion lowers the seizure threshold and is specifically
contraindicated in patients with bulimia or anorexia due to increased seizure risk from
electrolyte imbalances.
5. Which mood stabilizer is most strongly associated with the rare but severe risk of Stevens-
Johnson Syndrome (SJS)?
A. Lithium
B. Lamotrigine
C. Valproate
D. Topiramate
Answer: B
Conceptual Explanation: Lamotrigine requires slow titration to minimize the risk of
developing a life-threatening rash, including Stevens-Johnson Syndrome.
6. A patient presents with hyperreflexia, tremors, diaphoresis, and mental status changes
after adding a second SSRI to their regimen. What is the most likely diagnosis?
A. Neuroleptic Malignant Syndrome
B. Serotonin Syndrome
FINAL EXAM REVIEW 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 in this pathway is linked to
positive symptoms of schizophrenia.
2. Second-generation antipsychotics (SGAs) differ from first-generation antipsychotics (FGAs)
primarily due to their antagonism of which receptor?
A. 5-HT2A receptors
,B. D1 receptors
C. GABA-A receptors
D. Alpha-2 receptors
Answer: A
Conceptual Explanation: SGAs are defined by their dual antagonism of D2 and 5-HT2A
receptors, which helps reduce EPS and improve negative symptoms compared to FGAs.
3. A patient taking Clozapine must have their Absolute Neutrophil Count (ANC) monitored
regularly to screen for which life-threatening condition?
A. Agranulocytosis
B. Metabolic syndrome
C. Neuroleptic malignant syndrome
D. Tardive dyskinesia
Answer: A
Conceptual Explanation: Clozapine carries a risk of agranulocytosis (severe low white
blood cell count), necessitating strict ANC monitoring via the REMS program.
4. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Bupropion
B. Fluoxetine
, C. Sertraline
D. Venlafaxine
Answer: A
Conceptual Explanation: Bupropion lowers the seizure threshold and is specifically
contraindicated in patients with bulimia or anorexia due to increased seizure risk from
electrolyte imbalances.
5. Which mood stabilizer is most strongly associated with the rare but severe risk of Stevens-
Johnson Syndrome (SJS)?
A. Lithium
B. Lamotrigine
C. Valproate
D. Topiramate
Answer: B
Conceptual Explanation: Lamotrigine requires slow titration to minimize the risk of
developing a life-threatening rash, including Stevens-Johnson Syndrome.
6. A patient presents with hyperreflexia, tremors, diaphoresis, and mental status changes
after adding a second SSRI to their regimen. What is the most likely diagnosis?
A. Neuroleptic Malignant Syndrome
B. Serotonin Syndrome
