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MIDTERM PRACTICE EXAM: NR 546
PSYCHOPHARMACOLOGY, 2025/
WITH CORRECT/ACCURATE ANSWERS
Which dopamine pathway is associated with galactorrhea and gynecomastia? A. Mesocortical pathway B. Mesolimbic pathway C. Tuberoinfundibular pathway D. NIgrostriatal pathway C. Tuberoinfundibular pathway An overactive mesolimbic pathway will result in A.dystonia and akanthesia. B. sexual dysfunction C. negative symtoms D. hallucinations and psychosis D. hallucinations and psychosis Decreased levels of dopamine in which pathway is responsible for negative symptoms of schizophrenia? A. Nigrostriatal pathway
B. Tuberoinfundibular pathway C. Mesolimbic pathway D. Mesocortical pathway D. Mesocortical pathway A patient on Haldol 10mg daily is noted to have and extreme form of slowness. The PMHNP understands which dopamine pathway is associated with this? A. Tuberoinfundibular pathway B. Mesocortical pathway C. Nigrostriatal pathway D. Mesolimbic pathway C. Nigrostriatal pathway Which neurotransmitter in considered the chief inhibitory neurotransmitter? A. Histamine B. Dopamine C. GABA D. Glutamate C. GABA Which of the following teaching provided by the PMHNP is correct when teaching a patient about EPS? A. EPS may cause dystonia which feels like inner restlessness that may lead to locking or finger tapping.
C. haloperidol D. mesoridazine B. aripiprazole Which of the following mediation is a first generation antipsychotic? A. risperidone B. olanzapine C. thiothixene D. cariprazine C. thiothixene Which second-generation antipsychotic requires routine absolute neutrophil count monitoring? A. Brexpiprazole B. Clozapine C. Risperidone D. Ziprasidone B. Clozapine What is the contraindication for ziprasidone? A. Daytime sedation B. Obseity due to high risk of weight gain C. Liver disease and hepatic failure D. QT, myocardial infarction, heart failure D. QT, myocardial infarction, heart failure
Which of the following second generation antipsychotics is available sublingually or as transdermal patch? A. Clazapine B. Quetiapine C. Asenapine D. Olanzapine C. Asenapine Which of the following is the most appropriate option for an obese patient? A. Clozapine B. Quetiapine C. Asenapine D. Olanzapine C. Asenapine Which medication is a better choice for a patient who is overweight? A. Aripiprazole B. Clozapine C. Olanzapine D. Lurasidone A. Aripiprazole Which medication should the PMHNP avoid prescribing for their schizophrenic elderly patient with a history of falls?
C. paroxetine D. fluoxetine C. paroxetine Which medication is best used to treat the somatic symptoms of anxiety? A. hydroxyzine B. propanolol C. citalopram D. buspirone B. propanolol Which of the following statements is false related to buspirone? A. Buspirone is habit forming and can cause withdrawal symptoms. B. Can be prescribed short term, alone or adjunct. C. Binds to serotonin and dopamine receptors. D. Usually presided BID or TID due to short 1/2 half. A. Buspirone is habit forming and can cause withdrawal symptoms. All of the following medications is an SNRI expect for: A. duloxetine B. venlafaxine C. desvenlafaxine D. sertaline D. sertaline
The patient reports a history of QT prolongation. Which medication is QT prolongation considered a contraindication? A. buspirone B. hydroxyzine C. gabapentin D. paroxetine B. hydroxyzine The patient reports a history of hypertension. Which medication should the PMHNP avoid prescribing in the treatment of anxiety for this patient? A. diazepam B. atenolol C. venlafaxine D. escitalopram C. venlafaxine A 22-year-old patient recently diagnosed with bipolar disorder and states "I'm not crazy" and is refusing to take his prescribed medication. Which type of factor is contributing to this patient's nonadherence? A. Client factors B. Clinician factors C. Structural factors D. Environmental factors
C. The patient's family voices a stigma against psychiatric medications D. The patient states they worry about the potential side effects of the medication B. The patient poses a risk to themself as they state they are experiencing very scary auditory and visual hallucinations What is the name of the lobe that controls visual processing? A. Gyrus B. Frontal Lobe C. Occipital Lobe D. Parietal Lobe C. Occipital Lobe The cerebellum, cerebrum, brain stem, and butterfly-shaped portion of the central spinal cord are comprised of _______________ which contains neural cell bodies, axon terminals, dendrites, and all nerve synapses. A. Frontal lobe B. White mater C. Grey mater D. Corpus callosum C. Grey mater What is the function of the central sulcus? A. Separates the temporal from the occipital lobe B. Separates the frontal from the parietal lobe
C. Involved in complex motor activities D. Keeps us alert to our environment B. Separates the frontal from the parietal lobe Which of the following is associated with motor coordination? A. Broca's Area B. Olfactory Nerves C. Frontal Cortex D. Thalamus D. Thalamus Which lobe of the brain is in charge of handling memory and anxiety? A. Frontal lobe B. Anxiety center C. Temporal lobe D. Central sulcus C. Temporal lobe Damage to the anterior portion of which lobe can cause asterogenesis? A. Frontal B. Temporal C. Parietal D. Occipital C. Parietal
B. Parietal lobe C. Temporal lobe D. Occipital lobe A. Hippocampus Which area of the brain is associated anxiety and perception of odors? A. Amygdala B. Basal ganglia C. Prefrontal cortex D. Wernicke's area A. Amygdala The limbic system is associated with which of the following? A. Executive function B. Emotion and learning C. Intelligence and movement D. Expressive speech B. Emotion and learning Which channel membrane protein is specifically important in the process of neurotransmitter release? A. voltage-sensitive sodium channels. B. voltage-dependent (gated) calcium channels. C. neurotransmitter receptor potassium channels. D. voltage-dependent (gated) chloride channels. B. voltage-dependent (gated) calcium channels.
A 76-year-old patient who is determined to be a poor 2D6 metabolizer is being prescribed vortioxetine for his depression. What does the PMHNP need to remember when prescribing this drug? A. The dosage of the drug will need to be increased B. The dosage needs to begin at half then increase over a 2-week period C. The dosage should not exceed ½ of the usual recommended dose D. An adjunct medication will need to be prescribed until the dosage can be reduced C. The dosage should not exceed ½ of the usual recommended dose Which of the following mechanisms would you associate with an antagonist drug action? A. A drug that binds postsynaptic receptors and mimics the effect of the neurotransmitter. B. A drug that binds and blocks normal auto receptor function. C. A drug that increases the enzymatic synthesis of neurotransmitters. D. A drug that binds postsynaptic receptors and blocks the normal action of the neurotransmitter. D. A drug that binds postsynaptic receptors and blocks the normal action of the neurotransmitter. A court order inpatient hospitalization was ordered for a patient who is considered a danger to themselves and other. Which ethical issue is being addressed? A. Informed consent
C. Amygdala D. Limbic system A. Basal ganglia Obtaining consent from from a the guardian of a patient who has limited cognitive capabilities or are incompetent to make decisions represents which ethical principle? A. Informed consent B. Compliance C. Off label prescribing D. Confidentiality B. Compliance Lack of medication access and the increasing costs of medication is which type of factor contributing to medication non adherence? A. Provider B. Environmental C. Structural D. Client C. Structural Which of the following is an enzyme inhibitor? A. Sulfaurea B. Smoking C. Rifampin D. Sulfamide
D. Sulfamide Which of the following is an enzyme inducer? A. Quinidine B. Ketoconazole C. Amiodarone D. Carbamezpine D. Carbamezpine Which of the following definitions are correct? A. Partial agonist- drug fully activates receptors B. Antagonist- drug binds to receptor and activates a response C. Inverse agonist- drug causes an opposite effect of the agonist D. Agonist- drug binds to the receptor and does not activate a biological response C. Inverse agonist- drug causes an opposite effect of the agonist Ethical issues within mental health include which of the following? A. Patient unable to afford medication B. Patient unable to self-determine care C. Patient's ethnic culture D. Patients wanting to include family in treatment plan B. Patient unable to self-determine care A patient presents to the PMHNP with report of having anxiety, frequent occurrences of feeling frozen in place and like his heart is pounding out of his chest, as well as having difficulty sleeping. The
Which neurotransmitter is responsible for the regulation of the "fight or flight" response? A. Dopamine B. Norepinephrine C. GABA D. Histamine B. Norepinephrine An increase of which neurotransmitter can result in hallucinations and/or psychosis? A. Serotonin B. Acetycholine C. Dopamine D. GABA C. Dopamine Which of the following neurotransmitters is considered the chief inbibitory neurotransmitter? A. Serotonin B. Histamine C. Glutamate D. GABA D. GABA Increased levels of acetycholine result in
A. hallucinations B. alhenizmers C. depression D. parkinson's C. depression SSRIs, SNRIs, and tricyclic antidepressants increase levels of which neurotransmitter? A. Dopamine B. Serotonin C. GABA D. Glutamate B. Serotonin Which medication class does not affect serotonin? A. Benzodiazepines B. MOAIs C. SSRIs D. Tricyclic antidepressants A. Benzodiazepines Which of the following is the best medication class for the PMHNP to prescribe to address elevated norepinephrine levels? A. SSRI B. MAOI
