for the Psychiatric-Mental Health Nurse Practitioner
Midterm Exam
1. Which of the following is considered the pleasure center of the brain?
A. Cortico-striatal-thalamic-cortical loop
B. Mesolimbic dopamine pathway
C. Mesocortical dopamine pathway
D. None of the above
:Ans>> B. Mesolimbic dopamine pathway
2. A 35-year-old cigarette smoker would like to quit but is nervous because she
typically craves a cigarette approximately every 2 hrs. The craving and withdrawal
,are due to :Ans>>
A. Desensitization of nicotinic receptors
B. Resensitization of nicotinic receptors
C. Desensitization of muscarinic receptors
D. Resensitization of muscarinic receptors
:Ans>> D. Resensitization of muscarinicreceptors
3. The reactive reward system signals the immediate prospect of pleasure orpain
and triggers drug-seeking behavior.
A. True
B. False
:Ans>> True
4. What role does the amygdala play in substance abuse?
A. Releases phasic bursts of dopamine to the nucleus accumbens when drugsof abuse
are present
B. Communicates to the ventral tegmental area when cues related to drugs ofabuse
are present
C. Site of binding for most drugs of abuse
D. A and B
,E. A, B, and C
:Ans>> B. Communicates to the ventral tegmental area when cues relatedto drugs of
abuse are present
5. A 45-year-old patient has tried unsuccessfully to quit smoking several times over the
past ten years. Nicotine's actions at which receptors are considered primarily
responsible for its reinforcing effects?
A. Alpha 4 beta 2 postsynaptic receptors in the ventral tegmental area
B. Alpha 7 postsynaptic receptors in the prefrontal cortex C. A and B
D. Neither A nor B
:Ans>> A. Alpha 4 beta 2 postsynaptic receptors in the ventral tegmentalarea
6. A 35-year-old cigarette smoker would like to quit but is nervous because she
typically craves a cigarette approximately every 2 hrs. The craving and withdrawal
are due to
:Ans>>
A. Desensitization of nicotinic receptors
B. Resensitization of nicotinic receptors
C. Desensitization of muscarinic receptors
,D. Resensitization of muscarinic receptors
B. Resensitization of nicotinic receptor
:Ans>> B. Resensitization of nicotinic receptors
7. A 44-year-old patient has schizophrenia and comorbid alcohol abuse disor- der.
Alcohol has what effect on GABA and glutamate in the ventral tegmentalarea?
A. Increases GABA and decreases glutamate
B. Increases both GABA and glutamate
C. Decreases GABA and increases glutamate
D. Decreases both GABA and glutamate
:Ans>> A. Increases GABA and decreasesglutamate
8. A 26-year-old patient with ADHD has recently entered a drug rehabilitationcenter
following arrest for possession of cocaine. The cocaine use in this patient may be an
attempt at self-medication for ADHD symptoms because
it inhibits the dopamine transporter (but is not itself taken up into the neuron by the
transporter). Thus, cocaine has the same action at the dopamine trans- porter as
:Ans>>
A. Cocaine has the same actions at the dopamine transporter as amphetamine
B. Cocaine has the same actions at the dopamine transporter as
,methylphenidate
C. A and B
:Ans>> B. Cocaine has the same actions at the dopamine transporter as
methylphenidate
9. Patrick is a 22-year-old male who recently experienced a psychotic-like episode
after trying MDMA ("ecstasy") while at a party. A key binding site forhallucinogens is
the
:Ans>>
A. GABA-A receptor
B. Cannabinoid 1 receptor
C. Serotonin 2A receptor
D. Serotonin 2C receptor
:Ans>> C. Serotonin 2A receptor
10. 29-year-old patient is morbidly obese and reports that he is "addicted
to food". Hunger circuitry is connected to reward circuitry via dopaminergic
projections from the hypothalamus to the nucleus accumbens.
A. True
B. False
, :Ans>> A. True
11. Examples of neurotransmitters produced specifically as retrograde neu-
rotransmitters (i.e., those that communicate from postsynaptic neuron to
presynaptic neuron) include
:Ans>>
A. GABA
B. Galanin