Page 1 of 151
NSG 552 PSYCHOPHARMACOLOGY FINAL
EDITION | WILKES UNIVERSITY ALIGNED |
TABLE OF CONTENTS
| Section | Topic Area | Question Range
|---------|-------------|----------------|------|
| **I** | **Neurobiology & Neurotransmitter Systems** | **Q1–Q20** |
| **II** | **Pharmacokinetics & Pharmacodynamics** | **Q21–Q40** |
| **III** | **CYP450 Enzyme System & Drug Interactions** | **Q41–Q60** |
| **IV** | **Antidepressant Pharmacotherapy** | **Q61–Q90** |
| **V** | **Anxiolytics & Hypnotics** | **Q91–Q110** |
| **VI** | **Antipsychotic Pharmacotherapy** | **Q111–Q140** |
| **VII** | **Mood Stabilizers & Bipolar Disorder** | **Q141–Q165** |
| **VIII** | **ADHD Pharmacotherapy** | **Q166–Q180** |
| **IX** | **Dementia & Geriatric Psychopharmacology** | **Q181–Q200** |
| **X** | **Substance Use Disorders & Pharmacotherapy** | **Q201–Q215** |
| **XI** | **Special Populations: Pregnancy, Lactation & Pediatrics** | **Q216–Q225** |
| **XII** | **NGN Case Scenarios & Integrated Clinical Reasoning** | **Q226–Q235** |
---
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SECTION I: NEUROBIOLOGY & NEUROTRANSMITTER SYSTEMS
### Question 1
**Which brain region is primarily responsible for executive function, decision-making, and is
implicated in the negative symptoms of schizophrenia?**
A) Amygdala
B) Prefrontal cortex
C) Basal ganglia
D) Hippocampus
**CorreCt Answer: B**
**Rationale:** The prefrontal cortex (PFC) is critical for executive functioning,
including decision-making, planning, working memory, and impulse control. Hypofrontality
(decreased PFC activity) is strongly associated with negative symptoms of schizophrenia (e.g.,
avolition, flat affect, poverty of speech) and cognitive deficits. The amygdala mediates fear and
emotional processing; the basal ganglia are involved in motor control and procedural learning;
the hippocampus is critical for memory consolidation.
---
### Question 2
**A PMHNP is reviewing the neurobiology of depression. Which monoamine neurotransmitter
is synthesized from tryptophan in the raphe nuclei?**
A) Norepinephrine
B) Dopamine
C) Serotonin
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D) Acetylcholine
**CorreCt Answer: C**
**Rationale:** Serotonin (5-HT) is synthesized from the essential amino acid tryptophan
via the enzyme tryptophan hydroxylase in the raphe nuclei of the brainstem. Norepinephrine is
synthesized from tyrosine and produced primarily in the locus ceruleus. Dopamine is also
derived from tyrosine and produced in the ventral tegmental area (VTA) and substantia nigra.
Acetylcholine is synthesized from choline and acetyl-CoA.
---
### Question 3
**Which dopamine pathway is most directly implicated in the positive symptoms of
schizophrenia?**
A) Nigrostriatal pathway
B) Mesocortical pathway
C) Mesolimbic pathway
D) Tuberoinfundibular pathway
**CorreCt Answer: C**
**Rationale:** Hyperactivity of dopamine in the mesolimbic pathway (projecting from
the VTA to limbic structures) is associated with positive symptoms such as hallucinations and
delusions. The mesocortical pathway (VTA to prefrontal cortex) is associated with negative
symptoms and cognitive deficits (hypodopaminergia). The nigrostriatal pathway is involved in
motor control (blockade causes EPS). The tuberoinfundibular pathway regulates prolactin
secretion.
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### Question 4
**Which of the following is the primary inhibitory neurotransmitter in the central nervous
system?**
A) Glutamate
B) GABA
C) Dopamine
D) Serotonin
**CorreCt Answer: B**
**Rationale:** Gamma-aminobutyric acid (GABA) is the primary inhibitory
neurotransmitter in the CNS, often described as the "off switch." It induces calmness and
relaxation by increasing chloride influx into neurons, hyperpolarizing them. Glutamate is the
primary excitatory neurotransmitter (the "on switch"). Dopamine and serotonin are modulatory
neurotransmitters with complex excitatory and inhibitory roles depending on the receptor
subtype.
---
### Question 5
**The locus ceruleus is the primary site of synthesis for which neurotransmitter?**
A) Serotonin
B) Dopamine
C) Norepinephrine
D) GABA
NSG 552 PSYCHOPHARMACOLOGY FINAL
EDITION | WILKES UNIVERSITY ALIGNED |
TABLE OF CONTENTS
| Section | Topic Area | Question Range
|---------|-------------|----------------|------|
| **I** | **Neurobiology & Neurotransmitter Systems** | **Q1–Q20** |
| **II** | **Pharmacokinetics & Pharmacodynamics** | **Q21–Q40** |
| **III** | **CYP450 Enzyme System & Drug Interactions** | **Q41–Q60** |
| **IV** | **Antidepressant Pharmacotherapy** | **Q61–Q90** |
| **V** | **Anxiolytics & Hypnotics** | **Q91–Q110** |
| **VI** | **Antipsychotic Pharmacotherapy** | **Q111–Q140** |
| **VII** | **Mood Stabilizers & Bipolar Disorder** | **Q141–Q165** |
| **VIII** | **ADHD Pharmacotherapy** | **Q166–Q180** |
| **IX** | **Dementia & Geriatric Psychopharmacology** | **Q181–Q200** |
| **X** | **Substance Use Disorders & Pharmacotherapy** | **Q201–Q215** |
| **XI** | **Special Populations: Pregnancy, Lactation & Pediatrics** | **Q216–Q225** |
| **XII** | **NGN Case Scenarios & Integrated Clinical Reasoning** | **Q226–Q235** |
---
,Page 2 of 151
SECTION I: NEUROBIOLOGY & NEUROTRANSMITTER SYSTEMS
### Question 1
**Which brain region is primarily responsible for executive function, decision-making, and is
implicated in the negative symptoms of schizophrenia?**
A) Amygdala
B) Prefrontal cortex
C) Basal ganglia
D) Hippocampus
**CorreCt Answer: B**
**Rationale:** The prefrontal cortex (PFC) is critical for executive functioning,
including decision-making, planning, working memory, and impulse control. Hypofrontality
(decreased PFC activity) is strongly associated with negative symptoms of schizophrenia (e.g.,
avolition, flat affect, poverty of speech) and cognitive deficits. The amygdala mediates fear and
emotional processing; the basal ganglia are involved in motor control and procedural learning;
the hippocampus is critical for memory consolidation.
---
### Question 2
**A PMHNP is reviewing the neurobiology of depression. Which monoamine neurotransmitter
is synthesized from tryptophan in the raphe nuclei?**
A) Norepinephrine
B) Dopamine
C) Serotonin
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D) Acetylcholine
**CorreCt Answer: C**
**Rationale:** Serotonin (5-HT) is synthesized from the essential amino acid tryptophan
via the enzyme tryptophan hydroxylase in the raphe nuclei of the brainstem. Norepinephrine is
synthesized from tyrosine and produced primarily in the locus ceruleus. Dopamine is also
derived from tyrosine and produced in the ventral tegmental area (VTA) and substantia nigra.
Acetylcholine is synthesized from choline and acetyl-CoA.
---
### Question 3
**Which dopamine pathway is most directly implicated in the positive symptoms of
schizophrenia?**
A) Nigrostriatal pathway
B) Mesocortical pathway
C) Mesolimbic pathway
D) Tuberoinfundibular pathway
**CorreCt Answer: C**
**Rationale:** Hyperactivity of dopamine in the mesolimbic pathway (projecting from
the VTA to limbic structures) is associated with positive symptoms such as hallucinations and
delusions. The mesocortical pathway (VTA to prefrontal cortex) is associated with negative
symptoms and cognitive deficits (hypodopaminergia). The nigrostriatal pathway is involved in
motor control (blockade causes EPS). The tuberoinfundibular pathway regulates prolactin
secretion.
, Page 4 of 151
### Question 4
**Which of the following is the primary inhibitory neurotransmitter in the central nervous
system?**
A) Glutamate
B) GABA
C) Dopamine
D) Serotonin
**CorreCt Answer: B**
**Rationale:** Gamma-aminobutyric acid (GABA) is the primary inhibitory
neurotransmitter in the CNS, often described as the "off switch." It induces calmness and
relaxation by increasing chloride influx into neurons, hyperpolarizing them. Glutamate is the
primary excitatory neurotransmitter (the "on switch"). Dopamine and serotonin are modulatory
neurotransmitters with complex excitatory and inhibitory roles depending on the receptor
subtype.
---
### Question 5
**The locus ceruleus is the primary site of synthesis for which neurotransmitter?**
A) Serotonin
B) Dopamine
C) Norepinephrine
D) GABA
