NR546 PSYCHOPHARMACOLOGY FOR
PMHNP EXAM STUDY GUIDE
1. Which dopamine pathway is primarily responsible for the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: The mesolimbic pathway is associated with reward and
pleasure; excessive dopamine in this pathway is linked to the positive symptoms of
schizophrenia.
2. A patient taking a first-generation antipsychotic develops muscle rigidity, high fever, and
autonomic instability. Which condition is most likely?
A. Serotonin Syndrome
B. Neuroleptic Malignant Syndrome (NMS)
,C. Akathisia
D. Tardive Dyskinesia
Answer: B
Conceptual Explanation: NMS is a life-threatening reaction to antipsychotics
characterized by lead-pipe rigidity, hyperpyrexia, and autonomic dysfunction.
3. Blocking dopamine in the tuberoinfundibular pathway leads to which side effect?
A. Hyperprolactinemia
B. Extrapyramidal symptoms
C. Cognitive impairment
D. Weight gain
Answer: A
Conceptual Explanation: Dopamine acts as a prolactin-inhibiting factor; blocking it in the
tuberoinfundibular pathway causes prolactin levels to rise.
4. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Fluoxetine
B. Venlafaxine
C. Bupropion
, D. Sertraline
Answer: C
Conceptual Explanation: Bupropion lowers the seizure threshold and is contraindicated
in individuals with seizure disorders or bulimia/anorexia due to electrolyte imbalance
risks.
5. What is the therapeutic serum range for Lithium in the maintenance phase of Bipolar
Disorder?
A. 0.1 - 0.5 mEq/L
B. 1.5 - 2.0 mEq/L
C. 0.6 - 1.2 mEq/L
D. 2.5 - 3.0 mEq/L
Answer: C
Conceptual Explanation: The standard therapeutic range for lithium maintenance is 0.6 to
1.2 mEq/L. Levels above 1.5 are considered toxic.
6. Which enzyme is responsible for the metabolism of many psychotropic drugs and is often
affected by genetic polymorphisms?
A. Monoamine oxidase
B. CYP450 2D6
C. Cholinesterase
PMHNP EXAM STUDY GUIDE
1. Which dopamine pathway is primarily responsible for the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: The mesolimbic pathway is associated with reward and
pleasure; excessive dopamine in this pathway is linked to the positive symptoms of
schizophrenia.
2. A patient taking a first-generation antipsychotic develops muscle rigidity, high fever, and
autonomic instability. Which condition is most likely?
A. Serotonin Syndrome
B. Neuroleptic Malignant Syndrome (NMS)
,C. Akathisia
D. Tardive Dyskinesia
Answer: B
Conceptual Explanation: NMS is a life-threatening reaction to antipsychotics
characterized by lead-pipe rigidity, hyperpyrexia, and autonomic dysfunction.
3. Blocking dopamine in the tuberoinfundibular pathway leads to which side effect?
A. Hyperprolactinemia
B. Extrapyramidal symptoms
C. Cognitive impairment
D. Weight gain
Answer: A
Conceptual Explanation: Dopamine acts as a prolactin-inhibiting factor; blocking it in the
tuberoinfundibular pathway causes prolactin levels to rise.
4. Which antidepressant is contraindicated in patients with a history of seizure disorders or
eating disorders?
A. Fluoxetine
B. Venlafaxine
C. Bupropion
, D. Sertraline
Answer: C
Conceptual Explanation: Bupropion lowers the seizure threshold and is contraindicated
in individuals with seizure disorders or bulimia/anorexia due to electrolyte imbalance
risks.
5. What is the therapeutic serum range for Lithium in the maintenance phase of Bipolar
Disorder?
A. 0.1 - 0.5 mEq/L
B. 1.5 - 2.0 mEq/L
C. 0.6 - 1.2 mEq/L
D. 2.5 - 3.0 mEq/L
Answer: C
Conceptual Explanation: The standard therapeutic range for lithium maintenance is 0.6 to
1.2 mEq/L. Levels above 1.5 are considered toxic.
6. Which enzyme is responsible for the metabolism of many psychotropic drugs and is often
affected by genetic polymorphisms?
A. Monoamine oxidase
B. CYP450 2D6
C. Cholinesterase
