,NSG 2510 Exam 2 Mental Health Nursing Questions And Answers
2026/2027 South College
Q1. A client develops a resting tremor, muscle rigidity, and slowed
movement after starting an antipsychotic medication with strong
dopamine D2 receptor-blocking effects. Which neurological pathway
is most directly associated with these manifestations?
A) Mesocortical pathway
B) Nigrostriatal pathway
C) Tuberoinfundibular pathway
D) Reticulospinal pathway
Correct Answer: B) Nigrostriatal pathway
Rationale: Dopamine blockade in the nigrostriatal pathway can produce drug-
induced parkinsonism, including rigidity, tremor, and bradykinesia. These are
extrapyramidal adverse effects. Assessment should distinguish medication-
induced symptoms from other neurological conditions and guide treatment
adjustments.
Q2. A client receiving a dopamine-blocking antipsychotic develops
menstrual irregularities, breast enlargement, and galactorrhea.
Which physiological mechanism best explains these findings?
A) Increased norepinephrine release from the adrenal medulla
B) Reduced serotonin activity in the spinal cord
C) Increased acetylcholine activity in skeletal muscle
D) Dopamine blockade in the tuberoinfundibular pathway, resulting in
elevated prolactin secretion
Correct Answer: D) Dopamine blockade in the tuberoinfundibular pathway,
resulting in elevated prolactin secretion
Rationale: Dopamine normally inhibits prolactin secretion. Blocking dopamine
receptors in the tuberoinfundibular pathway can increase prolactin
concentrations, causing reproductive and endocrine effects. Persistent
symptoms require medication review and appropriate clinical evaluation.
,Q3. A client with depression asks how selective serotonin reuptake
inhibitors increase serotonin availability. Which explanation is most
accurate?
A) They inhibit serotonin reuptake into presynaptic neurons, increasing its
availability in the synaptic space.
B) They permanently destroy serotonin receptors.
C) They inhibit all dopamine production in the brain.
D) They directly replace deficient thyroid hormones.
Correct Answer: A) They inhibit serotonin reuptake into presynaptic neurons,
increasing its availability in the synaptic space.
Rationale: Selective serotonin reuptake inhibitors block the serotonin
transporter, increasing serotonin availability for neurotransmission. Clinical
improvement generally develops over several weeks as downstream
neurobiological adaptations occur.
Q4. A client is prescribed lorazepam for severe acute anxiety. Which
mechanism primarily produces its anxiolytic effects?
A) Direct stimulation of dopamine D2 receptors
B) Inhibition of glutamate synthesis in skeletal muscle
C) Enhancement of gamma-aminobutyric acid activity at GABA-A receptors
D) Selective blockade of serotonin reuptake
Correct Answer: C) Enhancement of gamma-aminobutyric acid activity at
GABA-A receptors
Rationale: Benzodiazepines enhance the inhibitory effects of GABA at GABA-
A receptors, reducing neuronal excitability. They may provide rapid relief of
severe anxiety but can cause sedation, impaired coordination, dependence,
and respiratory depression, especially when combined with other central
nervous system depressants.
Q5. A client has been prescribed clonazepam for several months and
wants to discontinue it immediately. Which nursing response is most
appropriate?
A) Encourage abrupt discontinuation because withdrawal cannot occur.
, B) Explain that a clinician-directed gradual reduction is generally necessary
to limit withdrawal complications.
C) Recommend doubling the dose for several days before stopping.
D) Advise replacing the medication with alcohol.
Correct Answer: B) Explain that a clinician-directed gradual reduction is
generally necessary to limit withdrawal complications.
Rationale: Physiological dependence may develop during prolonged
benzodiazepine use. Abrupt discontinuation can produce rebound anxiety,
insomnia, autonomic symptoms, and potentially seizures. A supervised taper
accounts for dose, treatment duration, clinical condition, and withdrawal
response.
Q6. A client receiving haloperidol develops painful neck spasms,
forced upward eye deviation, and difficulty controlling facial
muscles several hours after an increased dose. Which adverse effect
should be suspected?
A) Tardive dyskinesia
B) Metabolic syndrome
C) Serotonin syndrome
D) Acute dystonia
Correct Answer: D) Acute dystonia
Rationale: Acute dystonia involves sudden sustained muscle contractions
that may affect the neck, jaw, eyes, or airway. It can occur after initiating or
increasing dopamine-blocking medications. Prompt treatment may include
prescribed anticholinergic medication such as benztropine or
diphenhydramine.
Q7. A client begins risperidone therapy and develops an intense
sensation of internal restlessness, repeatedly pacing despite stating
that anxiety is not the primary problem. Which adverse effect is
most likely?
A) Akathisia
B) Neuroleptic malignant syndrome
C) Acute delirium
2026/2027 South College
Q1. A client develops a resting tremor, muscle rigidity, and slowed
movement after starting an antipsychotic medication with strong
dopamine D2 receptor-blocking effects. Which neurological pathway
is most directly associated with these manifestations?
A) Mesocortical pathway
B) Nigrostriatal pathway
C) Tuberoinfundibular pathway
D) Reticulospinal pathway
Correct Answer: B) Nigrostriatal pathway
Rationale: Dopamine blockade in the nigrostriatal pathway can produce drug-
induced parkinsonism, including rigidity, tremor, and bradykinesia. These are
extrapyramidal adverse effects. Assessment should distinguish medication-
induced symptoms from other neurological conditions and guide treatment
adjustments.
Q2. A client receiving a dopamine-blocking antipsychotic develops
menstrual irregularities, breast enlargement, and galactorrhea.
Which physiological mechanism best explains these findings?
A) Increased norepinephrine release from the adrenal medulla
B) Reduced serotonin activity in the spinal cord
C) Increased acetylcholine activity in skeletal muscle
D) Dopamine blockade in the tuberoinfundibular pathway, resulting in
elevated prolactin secretion
Correct Answer: D) Dopamine blockade in the tuberoinfundibular pathway,
resulting in elevated prolactin secretion
Rationale: Dopamine normally inhibits prolactin secretion. Blocking dopamine
receptors in the tuberoinfundibular pathway can increase prolactin
concentrations, causing reproductive and endocrine effects. Persistent
symptoms require medication review and appropriate clinical evaluation.
,Q3. A client with depression asks how selective serotonin reuptake
inhibitors increase serotonin availability. Which explanation is most
accurate?
A) They inhibit serotonin reuptake into presynaptic neurons, increasing its
availability in the synaptic space.
B) They permanently destroy serotonin receptors.
C) They inhibit all dopamine production in the brain.
D) They directly replace deficient thyroid hormones.
Correct Answer: A) They inhibit serotonin reuptake into presynaptic neurons,
increasing its availability in the synaptic space.
Rationale: Selective serotonin reuptake inhibitors block the serotonin
transporter, increasing serotonin availability for neurotransmission. Clinical
improvement generally develops over several weeks as downstream
neurobiological adaptations occur.
Q4. A client is prescribed lorazepam for severe acute anxiety. Which
mechanism primarily produces its anxiolytic effects?
A) Direct stimulation of dopamine D2 receptors
B) Inhibition of glutamate synthesis in skeletal muscle
C) Enhancement of gamma-aminobutyric acid activity at GABA-A receptors
D) Selective blockade of serotonin reuptake
Correct Answer: C) Enhancement of gamma-aminobutyric acid activity at
GABA-A receptors
Rationale: Benzodiazepines enhance the inhibitory effects of GABA at GABA-
A receptors, reducing neuronal excitability. They may provide rapid relief of
severe anxiety but can cause sedation, impaired coordination, dependence,
and respiratory depression, especially when combined with other central
nervous system depressants.
Q5. A client has been prescribed clonazepam for several months and
wants to discontinue it immediately. Which nursing response is most
appropriate?
A) Encourage abrupt discontinuation because withdrawal cannot occur.
, B) Explain that a clinician-directed gradual reduction is generally necessary
to limit withdrawal complications.
C) Recommend doubling the dose for several days before stopping.
D) Advise replacing the medication with alcohol.
Correct Answer: B) Explain that a clinician-directed gradual reduction is
generally necessary to limit withdrawal complications.
Rationale: Physiological dependence may develop during prolonged
benzodiazepine use. Abrupt discontinuation can produce rebound anxiety,
insomnia, autonomic symptoms, and potentially seizures. A supervised taper
accounts for dose, treatment duration, clinical condition, and withdrawal
response.
Q6. A client receiving haloperidol develops painful neck spasms,
forced upward eye deviation, and difficulty controlling facial
muscles several hours after an increased dose. Which adverse effect
should be suspected?
A) Tardive dyskinesia
B) Metabolic syndrome
C) Serotonin syndrome
D) Acute dystonia
Correct Answer: D) Acute dystonia
Rationale: Acute dystonia involves sudden sustained muscle contractions
that may affect the neck, jaw, eyes, or airway. It can occur after initiating or
increasing dopamine-blocking medications. Prompt treatment may include
prescribed anticholinergic medication such as benztropine or
diphenhydramine.
Q7. A client begins risperidone therapy and develops an intense
sensation of internal restlessness, repeatedly pacing despite stating
that anxiety is not the primary problem. Which adverse effect is
most likely?
A) Akathisia
B) Neuroleptic malignant syndrome
C) Acute delirium
