NRNP 6675 Week 6 Midterm
Solution — Master Review &
Preparation Guide 2025/2026
<Latest Version>
1. The primary excitatory neurotransmitter in the brain, crucial for learning and memory, but
implicated in excitotoxicity, is:
A) GABA
B) Dopamine
C) Glutamate ✓
D) Acetylcholine
2. A patient experiencing extrapyramidal symptoms (EPS) such as muscle stiffness and tremor
is likely having an adverse reaction to a medication that blocks which receptor?
A) Histamine (H1)
B) Dopamine (D2) ✓
C) Muscarinic (M1)
D) Serotonin (5-HT2A)
3. The therapeutic effect of SSRIs is primarily attributed to their initial action of:
A) Blocking serotonin reuptake, increasing synaptic serotonin levels. ✓
B) Directly stimulating serotonin receptors.
C) Increasing the production of serotonin precursors.
D) Blocking the enzymatic breakdown of serotonin.
4. Which of the following is a crucial baseline assessment before initiating treatment with a
typical (first-generation) antipsychotic like Haloperidol?
A) Liver Function Tests (LFTs)
B) Thyroid Stimulating Hormone (TSH)
C) Electrocardiogram (ECG)
D) Abnormal Involuntary Movement Scale (AIMS) ✓
,5. The "kindling hypothesis" is most associated with which psychiatric disorder?
A) Schizophrenia
B) Bipolar Disorder ✓
C) Generalized Anxiety Disorder
D) Obsessive-Compulsive Disorder
6. Tardive Dyskinesia (TD) is a potentially irreversible movement disorder associated with
long-term use of:
A) Benzodiazepines
B) SSRIs
C) Antipsychotics ✓
D) Mood Stabilizers
7. Which lab value is MOST critical to monitor for a patient taking Lithium?
A) Serum Sodium
B) Serum Lithium level ✓
C) Serum Potassium
D) White Blood Cell Count
8. The mechanism of action of Benzodiazepines involves enhancing the effects of which
neurotransmitter?
A) Norepinephrine
B) Dopamine
C) GABA ✓
D) Serotonin
9. Akathisia, a subjective feeling of inner restlessness and inability to sit still, is a side effect of
medications that antagonize which receptor?
A) Serotonin
B) Dopamine ✓
C) Muscarinic
D) Adrenergic
10. Which antidepressant is considered the safest in overdose and is often a first-line
treatment for depression?
A) Amitriptyline
B) Phenelzine
C) Sertraline ✓
D) Bupropion
,11. The risk of Serotonin Syndrome is increased when which two medications are combined?
A) Lithium and Valproate
B) Sertraline and St. John's Wort ✓
C) Haloperidol and Benztropine
D) Clonidine and Lisinopril
12. Which part of the brain is primarily responsible for fear responses and emotional
memory?
A) Prefrontal Cortex
B) Hippocampus
C) Amygdala ✓
D) Cerebellum
13. A patient taking Clozapine must have absolute baseline and weekly monitoring for the
first six months due to the risk of:
A) Agranulocytosis ✓
B) Hepatotoxicity
C) Nephrotoxicity
D) Hypertensive Crisis
14. Which medication requires strict dietary avoidance of tyramine-rich foods to prevent a
hypertensive crisis?
A) TCAs (Tricyclic Antidepressants)
B) SSRIs (Selective Serotonin Reuptake Inhibitors)
C) MAOIs (Monoamine Oxidase Inhibitors) ✓
D) SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)
15. The proposed "dopamine hypothesis" is a pathophysiological theory for:
A) Major Depressive Disorder
B) Schizophrenia ✓
C) Panic Disorder
D) Alzheimer's Disease
16. Which anticonvulsant is also used as a mood stabilizer and requires monitoring of liver
enzymes and CBC?
A) Topiramate
B) Lamotrigine ✓
C) Gabapentin
D) Pregabalin
, 17. Neuroleptic Malignant Syndrome (NMS) is a medical emergency characterized by:
A) Hyperthermia, muscle rigidity, altered mental status, and autonomic instability. ✓
B) Severe muscle spasms in the neck and jaw.
C) A fine, resting tremor and bradykinesia.
D) Skin hyperpigmentation and corneal deposits.
18. Which symptom is a core negative symptom of schizophrenia?
A) Auditory Hallucinations
B) Disorganized Speech
C) Avolition ✓
D) Paranoid Delusions
19. Bupropion (Wellbutrin) is unique among antidepressants because it primarily affects
which neurotransmitters?
A) Serotonin only
B) Norepinephrine and Dopamine ✓
C) Serotonin and Norepinephrine
D) GABA and Glutamate
20. The therapeutic window for Lithium is typically:
A) 0.2-0.5 mEq/L
B) 0.6-1.2 mEq/L ✓
C) 1.5-2.0 mEq/L
D) 2.5-3.5 mEq/L
21. Which medication is an example of an SNRI?
A) Escitalopram
B) Duloxetine ✓
C) Mirtazapine
D) Trazodone
22. A common side effect of SSRIs that often leads to discontinuation, particularly in younger
patients, is:
A) Weight Gain
B) Sexual Dysfunction ✓
C) Orthostatic Hypotension
D) Dry Mouth
23. Valproic Acid (Depakote) is contraindicated in which patient population due to high
teratogenic risk?
Solution — Master Review &
Preparation Guide 2025/2026
<Latest Version>
1. The primary excitatory neurotransmitter in the brain, crucial for learning and memory, but
implicated in excitotoxicity, is:
A) GABA
B) Dopamine
C) Glutamate ✓
D) Acetylcholine
2. A patient experiencing extrapyramidal symptoms (EPS) such as muscle stiffness and tremor
is likely having an adverse reaction to a medication that blocks which receptor?
A) Histamine (H1)
B) Dopamine (D2) ✓
C) Muscarinic (M1)
D) Serotonin (5-HT2A)
3. The therapeutic effect of SSRIs is primarily attributed to their initial action of:
A) Blocking serotonin reuptake, increasing synaptic serotonin levels. ✓
B) Directly stimulating serotonin receptors.
C) Increasing the production of serotonin precursors.
D) Blocking the enzymatic breakdown of serotonin.
4. Which of the following is a crucial baseline assessment before initiating treatment with a
typical (first-generation) antipsychotic like Haloperidol?
A) Liver Function Tests (LFTs)
B) Thyroid Stimulating Hormone (TSH)
C) Electrocardiogram (ECG)
D) Abnormal Involuntary Movement Scale (AIMS) ✓
,5. The "kindling hypothesis" is most associated with which psychiatric disorder?
A) Schizophrenia
B) Bipolar Disorder ✓
C) Generalized Anxiety Disorder
D) Obsessive-Compulsive Disorder
6. Tardive Dyskinesia (TD) is a potentially irreversible movement disorder associated with
long-term use of:
A) Benzodiazepines
B) SSRIs
C) Antipsychotics ✓
D) Mood Stabilizers
7. Which lab value is MOST critical to monitor for a patient taking Lithium?
A) Serum Sodium
B) Serum Lithium level ✓
C) Serum Potassium
D) White Blood Cell Count
8. The mechanism of action of Benzodiazepines involves enhancing the effects of which
neurotransmitter?
A) Norepinephrine
B) Dopamine
C) GABA ✓
D) Serotonin
9. Akathisia, a subjective feeling of inner restlessness and inability to sit still, is a side effect of
medications that antagonize which receptor?
A) Serotonin
B) Dopamine ✓
C) Muscarinic
D) Adrenergic
10. Which antidepressant is considered the safest in overdose and is often a first-line
treatment for depression?
A) Amitriptyline
B) Phenelzine
C) Sertraline ✓
D) Bupropion
,11. The risk of Serotonin Syndrome is increased when which two medications are combined?
A) Lithium and Valproate
B) Sertraline and St. John's Wort ✓
C) Haloperidol and Benztropine
D) Clonidine and Lisinopril
12. Which part of the brain is primarily responsible for fear responses and emotional
memory?
A) Prefrontal Cortex
B) Hippocampus
C) Amygdala ✓
D) Cerebellum
13. A patient taking Clozapine must have absolute baseline and weekly monitoring for the
first six months due to the risk of:
A) Agranulocytosis ✓
B) Hepatotoxicity
C) Nephrotoxicity
D) Hypertensive Crisis
14. Which medication requires strict dietary avoidance of tyramine-rich foods to prevent a
hypertensive crisis?
A) TCAs (Tricyclic Antidepressants)
B) SSRIs (Selective Serotonin Reuptake Inhibitors)
C) MAOIs (Monoamine Oxidase Inhibitors) ✓
D) SNRIs (Serotonin-Norepinephrine Reuptake Inhibitors)
15. The proposed "dopamine hypothesis" is a pathophysiological theory for:
A) Major Depressive Disorder
B) Schizophrenia ✓
C) Panic Disorder
D) Alzheimer's Disease
16. Which anticonvulsant is also used as a mood stabilizer and requires monitoring of liver
enzymes and CBC?
A) Topiramate
B) Lamotrigine ✓
C) Gabapentin
D) Pregabalin
, 17. Neuroleptic Malignant Syndrome (NMS) is a medical emergency characterized by:
A) Hyperthermia, muscle rigidity, altered mental status, and autonomic instability. ✓
B) Severe muscle spasms in the neck and jaw.
C) A fine, resting tremor and bradykinesia.
D) Skin hyperpigmentation and corneal deposits.
18. Which symptom is a core negative symptom of schizophrenia?
A) Auditory Hallucinations
B) Disorganized Speech
C) Avolition ✓
D) Paranoid Delusions
19. Bupropion (Wellbutrin) is unique among antidepressants because it primarily affects
which neurotransmitters?
A) Serotonin only
B) Norepinephrine and Dopamine ✓
C) Serotonin and Norepinephrine
D) GABA and Glutamate
20. The therapeutic window for Lithium is typically:
A) 0.2-0.5 mEq/L
B) 0.6-1.2 mEq/L ✓
C) 1.5-2.0 mEq/L
D) 2.5-3.5 mEq/L
21. Which medication is an example of an SNRI?
A) Escitalopram
B) Duloxetine ✓
C) Mirtazapine
D) Trazodone
22. A common side effect of SSRIs that often leads to discontinuation, particularly in younger
patients, is:
A) Weight Gain
B) Sexual Dysfunction ✓
C) Orthostatic Hypotension
D) Dry Mouth
23. Valproic Acid (Depakote) is contraindicated in which patient population due to high
teratogenic risk?
