NUR 5461 EXAM 4: ADVANCED
PSYCHOPHARMACOLOGY QUESTIONS
AND CORRECT ANSWERS 2026/2027
1. A patient with schizophrenia is experiencing auditory hallucinations and delusions. Which
dopamine pathway is primarily associated with these positive symptoms?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: The mesolimbic pathway, projecting from the ventral tegmental
area to the nucleus accumbens, is responsible for the positive symptoms of schizophrenia
like hallucinations and delusions when dopamine is excessive.
2. Which dopamine pathway is associated with the development of Extrapyramidal
Symptoms (EPS) when D2 receptors are blocked?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Tuberoinfundibular pathway
,D. Nigrostriatal pathway
Answer: D
Conceptual Explanation: The nigrostriatal pathway controls motor function. Blockade of
D2 receptors in this pathway leads to EPS and tardive dyskinesia.
3. A patient taking Risperidone presents with a significantly elevated prolactin level. Which
pathway is responsible for this side effect?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesocortical pathway
Answer: C
Conceptual Explanation: Dopamine acts as a prolactin-inhibiting factor in the
tuberoinfundibular pathway. Blockade of D2 receptors here leads to hyperprolactinemia.
4. The ‘negative symptoms’ of schizophrenia, such as affective flattening and alogia, are
hypothesized to be caused by:
A. Dopamine deficit in the mesocortical pathway
B. Dopamine excess in the mesolimbic pathway
C. Dopamine excess in the nigrostriatal pathway
D. Dopamine deficit in the tuberoinfundibular pathway
, Answer: A
Conceptual Explanation: Negative and cognitive symptoms are associated with a deficit of
dopamine in the mesocortical pathway, particularly the prefrontal cortex.
5. Which of the following medications is a partial D2 agonist?
A. Haloperidol
B. Quetiapine
C. Olanzapine
D. Aripiprazole
Answer: D
Conceptual Explanation: Aripiprazole, Brexpiprazole, and Cariprazine are D2 partial
agonists, meaning they modulate dopamine levels rather than completely blocking them.
6. A patient is being switched to Clozapine due to treatment-resistant schizophrenia. Which
lab parameter must be monitored via the REMS program?
A. Serum Potassium
B. Absolute Neutrophil Count (ANC)
C. Liver Function Tests (LFTs)
D. Thyroid Stimulating Hormone (TSH)
Answer: B
PSYCHOPHARMACOLOGY QUESTIONS
AND CORRECT ANSWERS 2026/2027
1. A patient with schizophrenia is experiencing auditory hallucinations and delusions. Which
dopamine pathway is primarily associated with these positive symptoms?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: The mesolimbic pathway, projecting from the ventral tegmental
area to the nucleus accumbens, is responsible for the positive symptoms of schizophrenia
like hallucinations and delusions when dopamine is excessive.
2. Which dopamine pathway is associated with the development of Extrapyramidal
Symptoms (EPS) when D2 receptors are blocked?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Tuberoinfundibular pathway
,D. Nigrostriatal pathway
Answer: D
Conceptual Explanation: The nigrostriatal pathway controls motor function. Blockade of
D2 receptors in this pathway leads to EPS and tardive dyskinesia.
3. A patient taking Risperidone presents with a significantly elevated prolactin level. Which
pathway is responsible for this side effect?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesocortical pathway
Answer: C
Conceptual Explanation: Dopamine acts as a prolactin-inhibiting factor in the
tuberoinfundibular pathway. Blockade of D2 receptors here leads to hyperprolactinemia.
4. The ‘negative symptoms’ of schizophrenia, such as affective flattening and alogia, are
hypothesized to be caused by:
A. Dopamine deficit in the mesocortical pathway
B. Dopamine excess in the mesolimbic pathway
C. Dopamine excess in the nigrostriatal pathway
D. Dopamine deficit in the tuberoinfundibular pathway
, Answer: A
Conceptual Explanation: Negative and cognitive symptoms are associated with a deficit of
dopamine in the mesocortical pathway, particularly the prefrontal cortex.
5. Which of the following medications is a partial D2 agonist?
A. Haloperidol
B. Quetiapine
C. Olanzapine
D. Aripiprazole
Answer: D
Conceptual Explanation: Aripiprazole, Brexpiprazole, and Cariprazine are D2 partial
agonists, meaning they modulate dopamine levels rather than completely blocking them.
6. A patient is being switched to Clozapine due to treatment-resistant schizophrenia. Which
lab parameter must be monitored via the REMS program?
A. Serum Potassium
B. Absolute Neutrophil Count (ANC)
C. Liver Function Tests (LFTs)
D. Thyroid Stimulating Hormone (TSH)
Answer: B
