1
NURS 660 Exam 1 LATEST UPDATE 2026
QUESTIONS AND EXPLAINED ANSWERS
|AGRADE DO NOT PROVIDE RATIONALE BUT
PROVIDE 100 LONG HIGH YIELD QUESTIONS
1.
A 24-year-old graduate student is evaluated after several months of
increasingly disorganized behavior, social withdrawal, diminished
emotional expression, and declining academic performance. His family
reports that he previously functioned well but recently began expressing
the belief that classmates were secretly monitoring his activities. During
the interview, he demonstrates tangential speech and appears internally
preoccupied. Which neurotransmitter abnormality is most strongly
associated with the pathophysiology of schizophrenia and is particularly
relevant to the positive symptoms described in this patient?
A. Excessive dopamine activity in the mesocortical pathway
B. Excessive dopamine activity in the mesolimbic pathway
C. Reduced serotonin activity in the tuberoinfundibular pathway
D. Increased acetylcholine activity in the nigrostriatal pathway
Answer: B
2.
A patient newly diagnosed with schizophrenia is being educated about
the neurobiology of psychotic symptoms. The psychiatric mental health
nurse practitioner explains that different dopamine pathways are
associated with different clinical manifestations and medication adverse
effects. Which dopamine pathway is most directly associated with
positive symptoms such as hallucinations, delusions, and disorganized
thinking when dopamine activity is excessive?
,2
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: A
3.
A 29-year-old patient with schizophrenia continues to experience social
withdrawal, diminished motivation, reduced speech, and decreased
emotional expression despite improvement in auditory hallucinations.
The clinician explains that these symptoms are categorized differently
from hallucinations and delusions and may be associated with reduced
dopaminergic activity in a particular pathway. Which pathway is most
closely associated with these negative symptoms?
A. Mesolimbic
B. Mesocortical
C. Nigrostriatal
D. Tuberoinfundibular
Answer: B
4.
A patient taking a dopamine-receptor-blocking antipsychotic develops
rigidity, bradykinesia, and a shuffling gait several weeks after treatment
begins. The patient asks why a medication intended to treat
hallucinations has caused movement problems. The clinician explains
that dopamine blockade in a pathway involved in motor control can
produce extrapyramidal symptoms. Which pathway is responsible?
A. Mesolimbic
B. Mesocortical
C. Nigrostriatal
D. Tuberoinfundibular
,3
Answer: C
5.
A 35-year-old woman receiving an antipsychotic medication reports new
breast tenderness and spontaneous milk production despite not being
pregnant or breastfeeding. Laboratory testing demonstrates an elevated
prolactin concentration. The clinician explains that dopamine normally
suppresses prolactin release through a specific pathway and that
dopamine receptor blockade interferes with this process. Which pathway
is involved?
A. Mesolimbic
B. Mesocortical
C. Nigrostriatal
D. Tuberoinfundibular
Answer: D
6.
A 31-year-old patient with schizophrenia has been treated with an
atypical antipsychotic for several months. The patient reports increased
appetite and has gained 9 kg since beginning therapy. Laboratory testing
demonstrates elevated triglycerides and fasting glucose. Which adverse-
effect profile is most characteristic of several second-generation
antipsychotics and should be monitored during long-term treatment?
A. Severe nephrotoxicity and hearing loss
B. Metabolic abnormalities including weight gain, dyslipidemia, and
glucose intolerance
C. Profound bone marrow suppression occurring in nearly all patients
D. Permanent renal failure caused by dopamine receptor blockade
Answer: B
7.
, 4
A patient with schizophrenia is started on an antipsychotic that requires
regular laboratory monitoring because of a potentially serious
hematologic adverse effect. The clinician explains that the medication
can rarely produce severe neutropenia or agranulocytosis and that
patients must undergo appropriate blood-count monitoring. Which
medication is being described?
A. Clozapine
B. Aripiprazole
C. Haloperidol
D. Lurasidone
Answer: A
8.
A 42-year-old patient with treatment-resistant schizophrenia has failed
adequate trials of two different antipsychotic medications. The clinician
considers initiating clozapine because persistent psychotic symptoms
have significantly impaired the patient's functioning. Before and during
treatment, the patient must receive appropriate hematologic monitoring.
Which laboratory parameter is particularly important?
A. Serum amylase
B. Absolute neutrophil count
C. Serum calcium
D. Creatine kinase only
Answer: B
9.
A patient taking clozapine presents to an outpatient psychiatric clinic
reporting fever, severe sore throat, and generalized weakness. The nurse
practitioner recognizes that these symptoms could represent a potentially
serious medication-related complication. Which laboratory evaluation is
most important to obtain promptly?
NURS 660 Exam 1 LATEST UPDATE 2026
QUESTIONS AND EXPLAINED ANSWERS
|AGRADE DO NOT PROVIDE RATIONALE BUT
PROVIDE 100 LONG HIGH YIELD QUESTIONS
1.
A 24-year-old graduate student is evaluated after several months of
increasingly disorganized behavior, social withdrawal, diminished
emotional expression, and declining academic performance. His family
reports that he previously functioned well but recently began expressing
the belief that classmates were secretly monitoring his activities. During
the interview, he demonstrates tangential speech and appears internally
preoccupied. Which neurotransmitter abnormality is most strongly
associated with the pathophysiology of schizophrenia and is particularly
relevant to the positive symptoms described in this patient?
A. Excessive dopamine activity in the mesocortical pathway
B. Excessive dopamine activity in the mesolimbic pathway
C. Reduced serotonin activity in the tuberoinfundibular pathway
D. Increased acetylcholine activity in the nigrostriatal pathway
Answer: B
2.
A patient newly diagnosed with schizophrenia is being educated about
the neurobiology of psychotic symptoms. The psychiatric mental health
nurse practitioner explains that different dopamine pathways are
associated with different clinical manifestations and medication adverse
effects. Which dopamine pathway is most directly associated with
positive symptoms such as hallucinations, delusions, and disorganized
thinking when dopamine activity is excessive?
,2
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: A
3.
A 29-year-old patient with schizophrenia continues to experience social
withdrawal, diminished motivation, reduced speech, and decreased
emotional expression despite improvement in auditory hallucinations.
The clinician explains that these symptoms are categorized differently
from hallucinations and delusions and may be associated with reduced
dopaminergic activity in a particular pathway. Which pathway is most
closely associated with these negative symptoms?
A. Mesolimbic
B. Mesocortical
C. Nigrostriatal
D. Tuberoinfundibular
Answer: B
4.
A patient taking a dopamine-receptor-blocking antipsychotic develops
rigidity, bradykinesia, and a shuffling gait several weeks after treatment
begins. The patient asks why a medication intended to treat
hallucinations has caused movement problems. The clinician explains
that dopamine blockade in a pathway involved in motor control can
produce extrapyramidal symptoms. Which pathway is responsible?
A. Mesolimbic
B. Mesocortical
C. Nigrostriatal
D. Tuberoinfundibular
,3
Answer: C
5.
A 35-year-old woman receiving an antipsychotic medication reports new
breast tenderness and spontaneous milk production despite not being
pregnant or breastfeeding. Laboratory testing demonstrates an elevated
prolactin concentration. The clinician explains that dopamine normally
suppresses prolactin release through a specific pathway and that
dopamine receptor blockade interferes with this process. Which pathway
is involved?
A. Mesolimbic
B. Mesocortical
C. Nigrostriatal
D. Tuberoinfundibular
Answer: D
6.
A 31-year-old patient with schizophrenia has been treated with an
atypical antipsychotic for several months. The patient reports increased
appetite and has gained 9 kg since beginning therapy. Laboratory testing
demonstrates elevated triglycerides and fasting glucose. Which adverse-
effect profile is most characteristic of several second-generation
antipsychotics and should be monitored during long-term treatment?
A. Severe nephrotoxicity and hearing loss
B. Metabolic abnormalities including weight gain, dyslipidemia, and
glucose intolerance
C. Profound bone marrow suppression occurring in nearly all patients
D. Permanent renal failure caused by dopamine receptor blockade
Answer: B
7.
, 4
A patient with schizophrenia is started on an antipsychotic that requires
regular laboratory monitoring because of a potentially serious
hematologic adverse effect. The clinician explains that the medication
can rarely produce severe neutropenia or agranulocytosis and that
patients must undergo appropriate blood-count monitoring. Which
medication is being described?
A. Clozapine
B. Aripiprazole
C. Haloperidol
D. Lurasidone
Answer: A
8.
A 42-year-old patient with treatment-resistant schizophrenia has failed
adequate trials of two different antipsychotic medications. The clinician
considers initiating clozapine because persistent psychotic symptoms
have significantly impaired the patient's functioning. Before and during
treatment, the patient must receive appropriate hematologic monitoring.
Which laboratory parameter is particularly important?
A. Serum amylase
B. Absolute neutrophil count
C. Serum calcium
D. Creatine kinase only
Answer: B
9.
A patient taking clozapine presents to an outpatient psychiatric clinic
reporting fever, severe sore throat, and generalized weakness. The nurse
practitioner recognizes that these symptoms could represent a potentially
serious medication-related complication. Which laboratory evaluation is
most important to obtain promptly?
