NR 546 MIDTERM
PSYCHOPHARMACOLOGY
COMPREHENSIVE EXAM QUESTIONS
AND VERIFIED ANSWERS |GRADE A+|
JUST RELEASED CHAMBERLAIN
COLLEGE OF NURSING
1. A 24-year-old male patient with schizophrenia is started on Haloperidol. Two days later, he
presents with muscle spasms of the neck and his eyes are rolled back. Which of the following
is the most likely diagnosis and treatment?
A. Akathisia; treated with Propranolol
B. Acute Dystonia; treated with Benztropine
C. Tardive Dyskinesia; treated with Valbenazine
D. Pseudoparkinsonism; treated with Amantadine
Answer: B
Conceptual Explanation: Acute dystonia often occurs within hours to days of starting a
typical antipsychotic like Haloperidol. It involves involuntary muscle contractions (like
,torticollis or oculogyric crisis) and is treated with anticholinergic medications like
Benztropine or Diphenhydramine.
2. Smoking cigarettes is a known inducer of which cytochrome P450 enzyme, affecting the
metabolism of Clozapine?
A. CYP2D6
B. CYP1A2
C. CYP3A4
D. CYP2C19
Answer: B
Conceptual Explanation: Smoking induces CYP1A2. When a patient who smokes is
stabilized on Clozapine and then stops smoking, their Clozapine levels can rise to toxic
levels because the enzyme induction is removed.
3. Which dopamine pathway is associated with the negative symptoms of schizophrenia and
cognitive impairment?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesolimbic pathway
Answer: A
, Conceptual Explanation: The mesocortical pathway is thought to be responsible for
negative and cognitive symptoms due to a deficit of dopamine in this area. In contrast, the
mesolimbic pathway is associated with positive symptoms due to dopamine excess.
4. A patient taking Phenelzine (an MAOI) presents to the emergency room with a severe
headache, palpitations, and a blood pressure of 210/120 mmHg. Which dietary indiscretion
most likely caused this?
A. Drinking a glass of milk and eating an apple
B. Eating fresh fish and green beans
C. Eating a pepperoni pizza with aged cheese
D. Eating a turkey sandwich on white bread
Answer: C
Conceptual Explanation: MAOIs inhibit the breakdown of tyramine. Ingesting tyramine-
rich foods (aged cheeses, cured meats, fermented products) leads to massive release of
norepinephrine, causing a hypertensive crisis.
5. Which of the following antidepressants is strictly contraindicated in patients with a history
of seizures or eating disorders?
A. Fluoxetine
B. Venlafaxine
C. Bupropion
PSYCHOPHARMACOLOGY
COMPREHENSIVE EXAM QUESTIONS
AND VERIFIED ANSWERS |GRADE A+|
JUST RELEASED CHAMBERLAIN
COLLEGE OF NURSING
1. A 24-year-old male patient with schizophrenia is started on Haloperidol. Two days later, he
presents with muscle spasms of the neck and his eyes are rolled back. Which of the following
is the most likely diagnosis and treatment?
A. Akathisia; treated with Propranolol
B. Acute Dystonia; treated with Benztropine
C. Tardive Dyskinesia; treated with Valbenazine
D. Pseudoparkinsonism; treated with Amantadine
Answer: B
Conceptual Explanation: Acute dystonia often occurs within hours to days of starting a
typical antipsychotic like Haloperidol. It involves involuntary muscle contractions (like
,torticollis or oculogyric crisis) and is treated with anticholinergic medications like
Benztropine or Diphenhydramine.
2. Smoking cigarettes is a known inducer of which cytochrome P450 enzyme, affecting the
metabolism of Clozapine?
A. CYP2D6
B. CYP1A2
C. CYP3A4
D. CYP2C19
Answer: B
Conceptual Explanation: Smoking induces CYP1A2. When a patient who smokes is
stabilized on Clozapine and then stops smoking, their Clozapine levels can rise to toxic
levels because the enzyme induction is removed.
3. Which dopamine pathway is associated with the negative symptoms of schizophrenia and
cognitive impairment?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Tuberoinfundibular pathway
D. Mesolimbic pathway
Answer: A
, Conceptual Explanation: The mesocortical pathway is thought to be responsible for
negative and cognitive symptoms due to a deficit of dopamine in this area. In contrast, the
mesolimbic pathway is associated with positive symptoms due to dopamine excess.
4. A patient taking Phenelzine (an MAOI) presents to the emergency room with a severe
headache, palpitations, and a blood pressure of 210/120 mmHg. Which dietary indiscretion
most likely caused this?
A. Drinking a glass of milk and eating an apple
B. Eating fresh fish and green beans
C. Eating a pepperoni pizza with aged cheese
D. Eating a turkey sandwich on white bread
Answer: C
Conceptual Explanation: MAOIs inhibit the breakdown of tyramine. Ingesting tyramine-
rich foods (aged cheeses, cured meats, fermented products) leads to massive release of
norepinephrine, causing a hypertensive crisis.
5. Which of the following antidepressants is strictly contraindicated in patients with a history
of seizures or eating disorders?
A. Fluoxetine
B. Venlafaxine
C. Bupropion
