, NURS 5357: Neurobiology & Advanced
Psychopharmacology Across the Lifespan
Comprehensive Final Examination & Rationales (50 Questions)
_________________________________________________________________________________
PART I: EXAMINATION QUESTIONS
Instructions: Select the single best answer for each of the following 50 multiple-choice questions.
Rationales for each correct answer are provided in Part II at the end of the exam.
1. A 34-year-old female with major depressive disorder (MDD) is started on a medication
that selectively inhibits the serotonin transporter (SERT) and acts as a 5-HT1A receptor
partial agonist. Which of the following best describes the pharmacological mechanism and
clinical advantage of this agent?
A. Vilazodone; reduces sexual dysfunction and offers rapid 5-HT1A desensitization.
B. Vortioxetine; acts as a 5-HT7 antagonist to improve cognitive symptoms.
C. Trazodone; provides potent 5-HT2A blockade and hypnotic effects.
D. Buspirone; serves as a monotherapy option for severe major depression.
2. Which brain region and dopaminergic pathway are primarily responsible for the
hyperprolactinemia observed during treatment with high-potency first-generation
antipsychotics (FGAs)?
A. Mesolimbic pathway originating in the ventral tegmental area (VTA).
B. Mesocortical pathway projecting to the dorsolateral prefrontal cortex.
C. Nigrostriatal pathway projecting from the substantia nigra to the caudate/putamen.
D. Tuberoinfundibular pathway projecting from the hypothalamus to the anterior pituitary.
3. A 22-year-old male with schizophrenia exhibits prominent negative symptoms, including
avolition, alogia, and affective flattening. Hypoactivity in which dopaminergic pathway is
pathophysiologically linked to these specific symptoms?
A. Tuberoinfundibular pathway.
, B. Mesocortical pathway.
C. Mesolimbic pathway.
D. Nigrostriatal pathway.
4. What receptor binding profile distinguishes Second-Generation Antipsychotics (SGAs)
from First-Generation Antipsychotics (FGAs) and accounts for their reduced risk of
Extrapyramidal Symptoms (EPS)?
A. 5-HT1A receptor antagonism combined with D1 receptor agonism.
B. 5-HT2A receptor antagonism combined with D2 receptor antagonism.
C. Alpha-1 adrenergic antagonism combined with H1 histamine agonism.
D. M1 muscarinic receptor antagonism combined with D3 receptor partial agonism.
5. Which excitatory neurotransmitter receptor requires both glutamate binding and
membrane depolarization (to remove a voltage-dependent Magnesium ion plug) for calcium
influx to occur?
A. AMPA receptor.
B. NMDA receptor.
C. Kainate receptor.
D. Metabotropic glutamate receptor (mGluR1).
6. A patient with severe generalized anxiety disorder is prescribed a medication that binds
to the alpha-2-delta (α2δ) subunit of voltage-gated calcium channels in the central nervous
system. Which drug acts via this mechanism?
A. Buspirone.
B. Pregabalin.
C. Clonazepam.
D. Propranolol.
Psychopharmacology Across the Lifespan
Comprehensive Final Examination & Rationales (50 Questions)
_________________________________________________________________________________
PART I: EXAMINATION QUESTIONS
Instructions: Select the single best answer for each of the following 50 multiple-choice questions.
Rationales for each correct answer are provided in Part II at the end of the exam.
1. A 34-year-old female with major depressive disorder (MDD) is started on a medication
that selectively inhibits the serotonin transporter (SERT) and acts as a 5-HT1A receptor
partial agonist. Which of the following best describes the pharmacological mechanism and
clinical advantage of this agent?
A. Vilazodone; reduces sexual dysfunction and offers rapid 5-HT1A desensitization.
B. Vortioxetine; acts as a 5-HT7 antagonist to improve cognitive symptoms.
C. Trazodone; provides potent 5-HT2A blockade and hypnotic effects.
D. Buspirone; serves as a monotherapy option for severe major depression.
2. Which brain region and dopaminergic pathway are primarily responsible for the
hyperprolactinemia observed during treatment with high-potency first-generation
antipsychotics (FGAs)?
A. Mesolimbic pathway originating in the ventral tegmental area (VTA).
B. Mesocortical pathway projecting to the dorsolateral prefrontal cortex.
C. Nigrostriatal pathway projecting from the substantia nigra to the caudate/putamen.
D. Tuberoinfundibular pathway projecting from the hypothalamus to the anterior pituitary.
3. A 22-year-old male with schizophrenia exhibits prominent negative symptoms, including
avolition, alogia, and affective flattening. Hypoactivity in which dopaminergic pathway is
pathophysiologically linked to these specific symptoms?
A. Tuberoinfundibular pathway.
, B. Mesocortical pathway.
C. Mesolimbic pathway.
D. Nigrostriatal pathway.
4. What receptor binding profile distinguishes Second-Generation Antipsychotics (SGAs)
from First-Generation Antipsychotics (FGAs) and accounts for their reduced risk of
Extrapyramidal Symptoms (EPS)?
A. 5-HT1A receptor antagonism combined with D1 receptor agonism.
B. 5-HT2A receptor antagonism combined with D2 receptor antagonism.
C. Alpha-1 adrenergic antagonism combined with H1 histamine agonism.
D. M1 muscarinic receptor antagonism combined with D3 receptor partial agonism.
5. Which excitatory neurotransmitter receptor requires both glutamate binding and
membrane depolarization (to remove a voltage-dependent Magnesium ion plug) for calcium
influx to occur?
A. AMPA receptor.
B. NMDA receptor.
C. Kainate receptor.
D. Metabotropic glutamate receptor (mGluR1).
6. A patient with severe generalized anxiety disorder is prescribed a medication that binds
to the alpha-2-delta (α2δ) subunit of voltage-gated calcium channels in the central nervous
system. Which drug acts via this mechanism?
A. Buspirone.
B. Pregabalin.
C. Clonazepam.
D. Propranolol.
