NURS 5359 Exam 1: Antipsychotic Medications
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Question 1
Which neurotransmitter system is most directly associated with the therapeutic effects of many
antipsychotic medications?
A. Dopamine
B. Acetylcholine
C. Glutamate
D. Glycine
Correct Answer: A. Dopamine
Rationale: Most antipsychotics exert important effects through dopamine receptors, particularly
D2 receptors. Dopamine dysregulation is strongly associated with psychotic symptoms, although
schizophrenia involves multiple neurotransmitter systems. NCBI
Question 2
A patient with schizophrenia reports hearing voices that others cannot hear. This symptom is
classified as:
A. Negative symptom
B. Positive symptom
C. Cognitive deficit
D. Somatic symptom
Correct Answer: B. Positive symptom
Rationale: Hallucinations are positive symptoms because they represent an addition to normal
experience. Other positive symptoms include delusions and disorganized speech or behavior.
Question 3
Which dopamine pathway is most closely associated with positive symptoms of schizophrenia?
A. Nigrostriatal
B. Mesocortical
,C. Mesolimbic
D. Tuberoinfundibular
Correct Answer: C. Mesolimbic
Rationale: Increased dopaminergic activity in the mesolimbic pathway is associated with
positive psychotic symptoms such as hallucinations and delusions.
Question 4
Blocking dopamine D2 receptors in the nigrostriatal pathway increases the risk of:
A. Hyperprolactinemia
B. Extrapyramidal symptoms
C. Hyperglycemia
D. Agranulocytosis
Correct Answer: B. Extrapyramidal symptoms
Rationale: Dopamine signaling in the nigrostriatal pathway contributes to motor control. D2
blockade can produce dystonia, akathisia, parkinsonism and other extrapyramidal effects.
Question 5
A patient taking haloperidol develops a painful sustained contraction of the neck muscles
shortly after treatment begins. Which adverse effect is most likely?
A. Tardive dyskinesia
B. Acute dystonia
C. Akathisia
D. Neuroleptic malignant syndrome
Correct Answer: B. Acute dystonia
Rationale: Acute dystonia involves sustained involuntary muscle contractions and can occur
relatively soon after starting or increasing an antipsychotic. Severe laryngeal dystonia can
threaten the airway and requires urgent treatment.
Question 6
Which medication is a first-generation antipsychotic?
,A. Risperidone
B. Olanzapine
C. Haloperidol
D. Quetiapine
Correct Answer: C. Haloperidol
Rationale: Haloperidol is a first-generation or typical antipsychotic. Risperidone, olanzapine and
quetiapine are second-generation antipsychotics.
Question 7
Which adverse effect is particularly associated with long-term dopamine receptor blockade?
A. Tardive dyskinesia
B. Acute diarrhea
C. Hypoglycemia
D. Alopecia
Correct Answer: A. Tardive dyskinesia
Rationale: Tardive dyskinesia is a potentially persistent movement disorder associated with
chronic exposure to dopamine receptor-blocking agents. Repetitive oral-facial movements are
characteristic.
Question 8
A patient taking an antipsychotic repeatedly paces the hallway and reports an intense feeling of
inner restlessness. Which condition is most likely?
A. Dystonia
B. Akathisia
C. Tardive dyskinesia
D. Catatonia
Correct Answer: B. Akathisia
Rationale: Akathisia is characterized by subjective inner restlessness accompanied by an
inability to remain still. It is an important antipsychotic-induced movement disorder.
, Question 9
Which finding is most concerning for neuroleptic malignant syndrome?
A. Mild dry mouth
B. Increased appetite
C. Severe rigidity, fever and autonomic instability
D. Mild headache
Correct Answer: C. Severe rigidity, fever and autonomic instability
Rationale: Neuroleptic malignant syndrome (NMS) is a potentially life-threatening reaction
associated with dopamine blockade. Classic findings include severe muscle rigidity,
hyperthermia, altered mental status and autonomic instability.
Question 10
A patient receiving an antipsychotic develops high fever, severe muscle rigidity, confusion and
tachycardia. What should the nurse suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Panic disorder
D. Acute dystonia
Correct Answer: B. Neuroleptic malignant syndrome
Rationale: The combination of hyperthermia, severe rigidity, altered mental status and
autonomic dysfunction is highly concerning for NMS. The offending medication should be
urgently evaluated and the patient medically stabilized.
Question 11
Which laboratory abnormality may be associated with neuroleptic malignant syndrome?
A. Elevated creatine kinase
B. Decreased sodium only
C. Low hemoglobin only
D. Decreased bilirubin
Correct Answer: A. Elevated creatine kinase
Questions with Answers| Updated| Pass
Guaranteed
Question 1
Which neurotransmitter system is most directly associated with the therapeutic effects of many
antipsychotic medications?
A. Dopamine
B. Acetylcholine
C. Glutamate
D. Glycine
Correct Answer: A. Dopamine
Rationale: Most antipsychotics exert important effects through dopamine receptors, particularly
D2 receptors. Dopamine dysregulation is strongly associated with psychotic symptoms, although
schizophrenia involves multiple neurotransmitter systems. NCBI
Question 2
A patient with schizophrenia reports hearing voices that others cannot hear. This symptom is
classified as:
A. Negative symptom
B. Positive symptom
C. Cognitive deficit
D. Somatic symptom
Correct Answer: B. Positive symptom
Rationale: Hallucinations are positive symptoms because they represent an addition to normal
experience. Other positive symptoms include delusions and disorganized speech or behavior.
Question 3
Which dopamine pathway is most closely associated with positive symptoms of schizophrenia?
A. Nigrostriatal
B. Mesocortical
,C. Mesolimbic
D. Tuberoinfundibular
Correct Answer: C. Mesolimbic
Rationale: Increased dopaminergic activity in the mesolimbic pathway is associated with
positive psychotic symptoms such as hallucinations and delusions.
Question 4
Blocking dopamine D2 receptors in the nigrostriatal pathway increases the risk of:
A. Hyperprolactinemia
B. Extrapyramidal symptoms
C. Hyperglycemia
D. Agranulocytosis
Correct Answer: B. Extrapyramidal symptoms
Rationale: Dopamine signaling in the nigrostriatal pathway contributes to motor control. D2
blockade can produce dystonia, akathisia, parkinsonism and other extrapyramidal effects.
Question 5
A patient taking haloperidol develops a painful sustained contraction of the neck muscles
shortly after treatment begins. Which adverse effect is most likely?
A. Tardive dyskinesia
B. Acute dystonia
C. Akathisia
D. Neuroleptic malignant syndrome
Correct Answer: B. Acute dystonia
Rationale: Acute dystonia involves sustained involuntary muscle contractions and can occur
relatively soon after starting or increasing an antipsychotic. Severe laryngeal dystonia can
threaten the airway and requires urgent treatment.
Question 6
Which medication is a first-generation antipsychotic?
,A. Risperidone
B. Olanzapine
C. Haloperidol
D. Quetiapine
Correct Answer: C. Haloperidol
Rationale: Haloperidol is a first-generation or typical antipsychotic. Risperidone, olanzapine and
quetiapine are second-generation antipsychotics.
Question 7
Which adverse effect is particularly associated with long-term dopamine receptor blockade?
A. Tardive dyskinesia
B. Acute diarrhea
C. Hypoglycemia
D. Alopecia
Correct Answer: A. Tardive dyskinesia
Rationale: Tardive dyskinesia is a potentially persistent movement disorder associated with
chronic exposure to dopamine receptor-blocking agents. Repetitive oral-facial movements are
characteristic.
Question 8
A patient taking an antipsychotic repeatedly paces the hallway and reports an intense feeling of
inner restlessness. Which condition is most likely?
A. Dystonia
B. Akathisia
C. Tardive dyskinesia
D. Catatonia
Correct Answer: B. Akathisia
Rationale: Akathisia is characterized by subjective inner restlessness accompanied by an
inability to remain still. It is an important antipsychotic-induced movement disorder.
, Question 9
Which finding is most concerning for neuroleptic malignant syndrome?
A. Mild dry mouth
B. Increased appetite
C. Severe rigidity, fever and autonomic instability
D. Mild headache
Correct Answer: C. Severe rigidity, fever and autonomic instability
Rationale: Neuroleptic malignant syndrome (NMS) is a potentially life-threatening reaction
associated with dopamine blockade. Classic findings include severe muscle rigidity,
hyperthermia, altered mental status and autonomic instability.
Question 10
A patient receiving an antipsychotic develops high fever, severe muscle rigidity, confusion and
tachycardia. What should the nurse suspect?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Panic disorder
D. Acute dystonia
Correct Answer: B. Neuroleptic malignant syndrome
Rationale: The combination of hyperthermia, severe rigidity, altered mental status and
autonomic dysfunction is highly concerning for NMS. The offending medication should be
urgently evaluated and the patient medically stabilized.
Question 11
Which laboratory abnormality may be associated with neuroleptic malignant syndrome?
A. Elevated creatine kinase
B. Decreased sodium only
C. Low hemoglobin only
D. Decreased bilirubin
Correct Answer: A. Elevated creatine kinase
