NUR 318 Exam 2: psychopharmacology – UPDATED Questions with 100% Verified Answers
NUR 318 Exam 2: psychopharmacology –
UPDATED Questions with 100% Verified Answers
Section 1: Antipsychotics, Cause, Epse'S (Q1–Q13)
Question & Answer
Q1 What are the characteristics of a normal extrapyramidal system?
A It is the normal coordination of involuntary movement to support voluntary movement - dopamine
and acetylcholine are balanced
Q2 What is the cause of EPSE's vs the cause of Parkinson's?
A EPSE's are caused from a blockage of dopamine receptors in basal ganglia at the end of the
dopamine tracts Parkinson S/S are caused from an imbalance of ACh and dopamine related to
neurodegeneration of substantia nigra at the beginning of the dopamine tracts
Q3 What is the treatment of EPSE's vs the treatment of Parkinson's?
A EPSE's are treated only with anticholinergics Parkinson's is treated with antiparkinsonian agents
that increase dopamine levels
Q4 What is TD, it's cause, S/S, and what are the available treatments?
A TD occurs when the dopamine receptors in the basal ganglia become hypersensitive Caused by
long term use of antipsychotics S/S: lip smacking, teeth grinding, tongue thrusting - symptoms stop
when sleeping and is irreversible Treatment: Deutetrabenze and Valbenazine
Q5 What is neuroleptic malignant syndrome, S/S, available treatments and nursing actions?
A NMS is a potentially lethal side effect to certain antipsychotics caused by a sudden drop in
dopamine S/S: hyperthermia (101-108 degrees), rigidity, autonomic dysfunction Treatment:
dantrolene (muscle relaxant) and bromocriptine (central acting-dopaminergic) Nurses should
routinely take patients temperature and access for symptoms
Q6 What are anticholinergic drugs that can be used to manage EPSE's?
A Benztropine Trihexyphenidyl
Q7 What can antipsychotic drugs treat, including off-label uses?
A Schizophrenia Schizoaffective disorder Bipolar disorder Psychotic depression Off label uses:
insomnia, tics, delirium, stuttering
Q8 What are first generation antipsychotics?
A Haloperidol: high potency that has more action on dopamine receptors Chlorpromazine: lower
potency
Q9 What are second generation antipsychotics?
A Antipsychotics that are more specific to D2 receptors and serotonin receptors and can act as a
partial dopamine agonist to control negative S/S Risperidone: parent drug for paliperidone
Paliperidone
Page 1 of 11
, NUR 318 Exam 2: psychopharmacology – UPDATED Questions with 100% Verified Answers
Question & Answer
Q10 What is an example of a third generation antipsychotic?
A Aripiprazole
Q11 What is the difference between typical and atypical antipsychotics?
A Typical antipsychotics (1st generation): have a higher potency so are more like to cause EPSE's and
prolactin elevation - prolactin elevation can cause galactorrhea, and gynecomastia Atypical
antipsychotics (2nd generation): have a lower potency so that cause more intense anticholinergic
effects and antiadrenergic effects - has a reduced risk of EPSE's and elevated prolactin - more
profound effect at treating negative symptoms with minimal TD risk
Q12 What are the pharmacological effects of antipsychotics?
A Tranquilizing within an hour after ingestion Antipsychotic effects are seen within a few weeks and
improvement continues for 6-8 weeks Most effective in treating positive symptoms
Q13 What psychiatric S/S are modified by antipsychotic drugs?
A Reduces alterations in perception (hallucinations and illusions) Improved reasoning, decreased
ambivalence, and decreased delusions Slows psychomotor activity Decreases confusion and mental
clouding Promotes less focus on self and more focus on others to decrease inner turmoil from
self-absorbed thinking Can cause a flat affect
Section 2: Antipsychotic, Effects, Side (Q14–Q26)
Question & Answer
Q14 What are the common side effects of antipsychotic use?
A Anticholinergic: sympathetic nervous system dominants Antiadrenergic: orthostatic hypotension
(measure BP before dosing and encourage changing positions slowly) Can cause possible
arrhythmias EPSE's: most common in high potency agents - akathisia - akinesia and bradykinesia -
dystonia - parkinsonism/TD Pisa syndrome: leaning to one side NMS: high fever with rigidity leading
to tremors, impaired ventilation, altered consciousness and autonomic hyperactivity
Hyperprolactinemia Metabolic syndrome Sexual effects GI effects
Q15 What are the indicators that a antipsychotic med has to high of a doses?
A Patient with be restless, with agitation, convulsions, have hyperthermia, have increased
anticholinergic effects, and can have arrhythmias
Q16 What is the nursing implications for antipsychotic use during pregnancy?
A Antipsychotics should be avoided in first trimester EPSE's can be caused in some newborns Can
cause glucose intolerance in the newborn
Q17 What is the nursing implications for antipsychotic drug use in older adults?
A Heightened risk for anticholinergic and antiadrenergic effects, and CNS EPSE's Higher risk for TD
Should not be given to older adults with dementia related psychosis
Q18 What are important teaching points to educate a patient taking antipsychotics?
A Avoid hot tubs, showers and baths to prevent hypotension and falls Do not abruptly discontinue
because EPSE's can occur Report sore throat, fever, malaise, and bleeding Drink plenty of water
Page 2 of 11
NUR 318 Exam 2: psychopharmacology –
UPDATED Questions with 100% Verified Answers
Section 1: Antipsychotics, Cause, Epse'S (Q1–Q13)
Question & Answer
Q1 What are the characteristics of a normal extrapyramidal system?
A It is the normal coordination of involuntary movement to support voluntary movement - dopamine
and acetylcholine are balanced
Q2 What is the cause of EPSE's vs the cause of Parkinson's?
A EPSE's are caused from a blockage of dopamine receptors in basal ganglia at the end of the
dopamine tracts Parkinson S/S are caused from an imbalance of ACh and dopamine related to
neurodegeneration of substantia nigra at the beginning of the dopamine tracts
Q3 What is the treatment of EPSE's vs the treatment of Parkinson's?
A EPSE's are treated only with anticholinergics Parkinson's is treated with antiparkinsonian agents
that increase dopamine levels
Q4 What is TD, it's cause, S/S, and what are the available treatments?
A TD occurs when the dopamine receptors in the basal ganglia become hypersensitive Caused by
long term use of antipsychotics S/S: lip smacking, teeth grinding, tongue thrusting - symptoms stop
when sleeping and is irreversible Treatment: Deutetrabenze and Valbenazine
Q5 What is neuroleptic malignant syndrome, S/S, available treatments and nursing actions?
A NMS is a potentially lethal side effect to certain antipsychotics caused by a sudden drop in
dopamine S/S: hyperthermia (101-108 degrees), rigidity, autonomic dysfunction Treatment:
dantrolene (muscle relaxant) and bromocriptine (central acting-dopaminergic) Nurses should
routinely take patients temperature and access for symptoms
Q6 What are anticholinergic drugs that can be used to manage EPSE's?
A Benztropine Trihexyphenidyl
Q7 What can antipsychotic drugs treat, including off-label uses?
A Schizophrenia Schizoaffective disorder Bipolar disorder Psychotic depression Off label uses:
insomnia, tics, delirium, stuttering
Q8 What are first generation antipsychotics?
A Haloperidol: high potency that has more action on dopamine receptors Chlorpromazine: lower
potency
Q9 What are second generation antipsychotics?
A Antipsychotics that are more specific to D2 receptors and serotonin receptors and can act as a
partial dopamine agonist to control negative S/S Risperidone: parent drug for paliperidone
Paliperidone
Page 1 of 11
, NUR 318 Exam 2: psychopharmacology – UPDATED Questions with 100% Verified Answers
Question & Answer
Q10 What is an example of a third generation antipsychotic?
A Aripiprazole
Q11 What is the difference between typical and atypical antipsychotics?
A Typical antipsychotics (1st generation): have a higher potency so are more like to cause EPSE's and
prolactin elevation - prolactin elevation can cause galactorrhea, and gynecomastia Atypical
antipsychotics (2nd generation): have a lower potency so that cause more intense anticholinergic
effects and antiadrenergic effects - has a reduced risk of EPSE's and elevated prolactin - more
profound effect at treating negative symptoms with minimal TD risk
Q12 What are the pharmacological effects of antipsychotics?
A Tranquilizing within an hour after ingestion Antipsychotic effects are seen within a few weeks and
improvement continues for 6-8 weeks Most effective in treating positive symptoms
Q13 What psychiatric S/S are modified by antipsychotic drugs?
A Reduces alterations in perception (hallucinations and illusions) Improved reasoning, decreased
ambivalence, and decreased delusions Slows psychomotor activity Decreases confusion and mental
clouding Promotes less focus on self and more focus on others to decrease inner turmoil from
self-absorbed thinking Can cause a flat affect
Section 2: Antipsychotic, Effects, Side (Q14–Q26)
Question & Answer
Q14 What are the common side effects of antipsychotic use?
A Anticholinergic: sympathetic nervous system dominants Antiadrenergic: orthostatic hypotension
(measure BP before dosing and encourage changing positions slowly) Can cause possible
arrhythmias EPSE's: most common in high potency agents - akathisia - akinesia and bradykinesia -
dystonia - parkinsonism/TD Pisa syndrome: leaning to one side NMS: high fever with rigidity leading
to tremors, impaired ventilation, altered consciousness and autonomic hyperactivity
Hyperprolactinemia Metabolic syndrome Sexual effects GI effects
Q15 What are the indicators that a antipsychotic med has to high of a doses?
A Patient with be restless, with agitation, convulsions, have hyperthermia, have increased
anticholinergic effects, and can have arrhythmias
Q16 What is the nursing implications for antipsychotic use during pregnancy?
A Antipsychotics should be avoided in first trimester EPSE's can be caused in some newborns Can
cause glucose intolerance in the newborn
Q17 What is the nursing implications for antipsychotic drug use in older adults?
A Heightened risk for anticholinergic and antiadrenergic effects, and CNS EPSE's Higher risk for TD
Should not be given to older adults with dementia related psychosis
Q18 What are important teaching points to educate a patient taking antipsychotics?
A Avoid hot tubs, showers and baths to prevent hypotension and falls Do not abruptly discontinue
because EPSE's can occur Report sore throat, fever, malaise, and bleeding Drink plenty of water
Page 2 of 11
