NRNP 6630 MIDTERM EXAM QUESTIONS COMPLETE
WITH 100% VERIFIED ANSWERS
1. A patient with schizophrenia is prescribed an antipsychotic that acts
as a potent D2 antagonist with 5HT2A antagonist properties. The
PMHNP explains that this medication profile is associated with which
benefit?
A. Increased risk of extrapyramidal symptoms
B. Reduced risk of extrapyramidal symptoms
C. Higher efficacy for negative symptoms only
D. Faster onset of action for positive symptoms
Correct Answer: B
Rationale: Antipsychotics that combine potent D2 antagonism with
5HT2A antagonism have a lower risk of EPS. The 5HT2A antagonism
modulates dopamine release in the nigrostriatal pathway, reducing the
motor side effects typically caused by D2 receptor blockade alone .
2. The PMHNP is treating a patient with bipolar depression who is
breastfeeding her 2-month-old infant. Which medication would be
contraindicated for this patient?
A. Lamotrigine
B. Quetiapine
,C. Lithium
D. Valproic acid
Correct Answer: C
Rationale: Lithium is contraindicated in breastfeeding mothers due to its
excretion in breast milk and potential for toxicity in the infant, including
effects on the thyroid and kidneys. It is known to pass into breast milk in
significant amounts .
3. During gene expression, what must occur prior to a gene being
expressed?
A. RNA must be converted to mRNA
B. Transcription factor must bind to the regulatory region within the
cell's nucleus
C. The coding region must separate from the regulatory region
D. RNA polymerase must inhibit the process of changing RNA to mRNA
Correct Answer: B
Rationale: For gene expression to occur, transcription factors must first
bind to regulatory regions (promoters) in the cell's nucleus, initiating the
transcription process .
4. The PMHNP understands that neurotransmission along the axon is
unidirectional. Which of the following best characterizes the order of
signal conduction through a neuron?
A. Dendrites, cell body, axon, axon terminals
B. Cell body, dendrites, axon, axon terminals
,C. Axon terminals, axon, cell body, dendrites
D. Dendrites, axon, cell body, axon terminals
Correct Answer: A
Rationale: Signal conduction through a neuron follows a specific
unidirectional path: dendrites receive the signal, which travels to the cell
body (soma), then down the axon, and finally to the axon terminals for
neurotransmitter release .
5. A patient presents with frequent episodes of mania. Which
approach would be most appropriate for this patient?
A. Initiating a monoamine oxidase inhibitor
B. Prescribing an anticonvulsant mood stabilizer
C. Starting a selective serotonin reuptake inhibitor
D. Administering a benzodiazepine alone
Correct Answer: B
Rationale: Anticonvulsants such as valproate, carbamazepine, and
lamotrigine are effective mood stabilizers for the treatment of mania in
bipolar disorder. Anticonvulsants work by modulating neurotransmitter
systems involved in mood regulation .
6. A patient taking an antipsychotic develops extrapyramidal
symptoms. Which pathway is most likely affected by dopamine D2
receptor blockade?
A. Mesolimbic pathway
B. Mesocortical pathway
, C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Correct Answer: C
Rationale: EPS results from dopamine D2 receptor blockade in the
nigrostriatal pathway, which is responsible for motor control. Blockade
in this pathway leads to symptoms such as parkinsonism, dystonia, and
akathisia .
7. The PMHNP is caring for a patient who is prescribed a medication
that acts on ionotropic receptors. Which statement accurately
describes this receptor type?
A. The drug will have a delayed effect lasting several hours
B. The drug will have an almost immediate effect
C. The drug will work through second messenger systems
D. The drug will require several days to achieve therapeutic effect
Correct Answer: B
Rationale: Ionotropic receptors are ligand-gated ion channels that
produce rapid, direct effects when activated. Medications acting on
these receptors produce almost immediate effects due to direct ion flux
across the membrane .
8. Which neurotransmitter is considered the major excitatory
neurotransmitter in the central nervous system?
A. GABA
B. Serotonin
WITH 100% VERIFIED ANSWERS
1. A patient with schizophrenia is prescribed an antipsychotic that acts
as a potent D2 antagonist with 5HT2A antagonist properties. The
PMHNP explains that this medication profile is associated with which
benefit?
A. Increased risk of extrapyramidal symptoms
B. Reduced risk of extrapyramidal symptoms
C. Higher efficacy for negative symptoms only
D. Faster onset of action for positive symptoms
Correct Answer: B
Rationale: Antipsychotics that combine potent D2 antagonism with
5HT2A antagonism have a lower risk of EPS. The 5HT2A antagonism
modulates dopamine release in the nigrostriatal pathway, reducing the
motor side effects typically caused by D2 receptor blockade alone .
2. The PMHNP is treating a patient with bipolar depression who is
breastfeeding her 2-month-old infant. Which medication would be
contraindicated for this patient?
A. Lamotrigine
B. Quetiapine
,C. Lithium
D. Valproic acid
Correct Answer: C
Rationale: Lithium is contraindicated in breastfeeding mothers due to its
excretion in breast milk and potential for toxicity in the infant, including
effects on the thyroid and kidneys. It is known to pass into breast milk in
significant amounts .
3. During gene expression, what must occur prior to a gene being
expressed?
A. RNA must be converted to mRNA
B. Transcription factor must bind to the regulatory region within the
cell's nucleus
C. The coding region must separate from the regulatory region
D. RNA polymerase must inhibit the process of changing RNA to mRNA
Correct Answer: B
Rationale: For gene expression to occur, transcription factors must first
bind to regulatory regions (promoters) in the cell's nucleus, initiating the
transcription process .
4. The PMHNP understands that neurotransmission along the axon is
unidirectional. Which of the following best characterizes the order of
signal conduction through a neuron?
A. Dendrites, cell body, axon, axon terminals
B. Cell body, dendrites, axon, axon terminals
,C. Axon terminals, axon, cell body, dendrites
D. Dendrites, axon, cell body, axon terminals
Correct Answer: A
Rationale: Signal conduction through a neuron follows a specific
unidirectional path: dendrites receive the signal, which travels to the cell
body (soma), then down the axon, and finally to the axon terminals for
neurotransmitter release .
5. A patient presents with frequent episodes of mania. Which
approach would be most appropriate for this patient?
A. Initiating a monoamine oxidase inhibitor
B. Prescribing an anticonvulsant mood stabilizer
C. Starting a selective serotonin reuptake inhibitor
D. Administering a benzodiazepine alone
Correct Answer: B
Rationale: Anticonvulsants such as valproate, carbamazepine, and
lamotrigine are effective mood stabilizers for the treatment of mania in
bipolar disorder. Anticonvulsants work by modulating neurotransmitter
systems involved in mood regulation .
6. A patient taking an antipsychotic develops extrapyramidal
symptoms. Which pathway is most likely affected by dopamine D2
receptor blockade?
A. Mesolimbic pathway
B. Mesocortical pathway
, C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Correct Answer: C
Rationale: EPS results from dopamine D2 receptor blockade in the
nigrostriatal pathway, which is responsible for motor control. Blockade
in this pathway leads to symptoms such as parkinsonism, dystonia, and
akathisia .
7. The PMHNP is caring for a patient who is prescribed a medication
that acts on ionotropic receptors. Which statement accurately
describes this receptor type?
A. The drug will have a delayed effect lasting several hours
B. The drug will have an almost immediate effect
C. The drug will work through second messenger systems
D. The drug will require several days to achieve therapeutic effect
Correct Answer: B
Rationale: Ionotropic receptors are ligand-gated ion channels that
produce rapid, direct effects when activated. Medications acting on
these receptors produce almost immediate effects due to direct ion flux
across the membrane .
8. Which neurotransmitter is considered the major excitatory
neurotransmitter in the central nervous system?
A. GABA
B. Serotonin
