NR 546 Week 3 Antipsychotics Comprehensive Quiz 2026
|Chamberlain
1. Which dopaminergic pathway is responsible for the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Mesolimbic pathway
D. Tuberoinfundibular pathway
Answer: C
Rationale: Overactivity in the mesolimbic pathway is associated with positive symptoms
of schizophrenia.
2. What is the primary mechanism of action of First-Generation Antipsychotics
(FGAs)?
A. Dopamine D2 receptor antagonism
B. Serotonin-Dopamine antagonism
C. Dopamine D2 partial agonism
D. NMDA receptor modulation
Answer: A
Rationale: FGAs primarily work by blocking D2 receptors in all dopaminergic pathways.
,3. Which pathway is associated with the development of Extrapyramidal
Symptoms (EPS) when D2 receptors are blocked?
A. Tuberinfundibular
B. Mesolimbic
C. Mesocortical
D. Nigrostriatal
Answer: D
Rationale: The nigrostriatal pathway controls motor movements; blocking D2 receptors
here leads to EPS.
4. Antagonism of D2 receptors in the tuberoinfundibular pathway leads to
which side effect?
A. Weight gain
B. Orthostatic hypotension
C. Sedation
D. Hyperprolactinemia
Answer: D
Rationale: Dopamine inhibits prolactin release; blocking D2 receptors in this pathway
increases prolactin levels.
5. Second-generation antipsychotics (SGAs) differ from FGAs primarily due to
their affinity for which receptor?
A. Alpha-1 adrenergic
B. Muscarinic M1
C. Serotonin 5HT2A
D. Histamine H1
Answer: C
Rationale: SGAs are defined by their 5HT2A antagonism, which modulates dopamine
release and reduces EPS risk.
, 6. Which of the following is considered a ‘High Potency’ First-Generation
Antipsychotic?
A. Haloperidol
B. Chlorpromazine
C. Thioridazine
D. Quetiapine
Answer: A
Rationale: Haloperidol is a high-potency FGA, meaning it has a high affinity for D2
receptors at low doses.
7. Which SGA is most notoriously associated with the risk of agranulocytosis?
A. Olanzapine
B. Risperidone
C. Ziprasidone
D. Clozapine
Answer: D
Rationale: Clozapine requires strict WBC and ANC monitoring due to the risk of life-
threatening agranulocytosis.
8. What is the Absolute Neutrophil Count (ANC) threshold to initiate Clozapine
in a general population patient?
A. Greater than or equal to 1,000/mm3
B. Greater than or equal to 2,000/mm3
C. Greater than or equal to 1,500/mm3
D. Greater than or equal to 500/mm3
Answer: C
Rationale: Clozapine therapy requires an initial ANC of at least 1,500/mm3 (except for
patients with Benign Ethnic Neutropenia).
|Chamberlain
1. Which dopaminergic pathway is responsible for the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Mesocortical pathway
B. Nigrostriatal pathway
C. Mesolimbic pathway
D. Tuberoinfundibular pathway
Answer: C
Rationale: Overactivity in the mesolimbic pathway is associated with positive symptoms
of schizophrenia.
2. What is the primary mechanism of action of First-Generation Antipsychotics
(FGAs)?
A. Dopamine D2 receptor antagonism
B. Serotonin-Dopamine antagonism
C. Dopamine D2 partial agonism
D. NMDA receptor modulation
Answer: A
Rationale: FGAs primarily work by blocking D2 receptors in all dopaminergic pathways.
,3. Which pathway is associated with the development of Extrapyramidal
Symptoms (EPS) when D2 receptors are blocked?
A. Tuberinfundibular
B. Mesolimbic
C. Mesocortical
D. Nigrostriatal
Answer: D
Rationale: The nigrostriatal pathway controls motor movements; blocking D2 receptors
here leads to EPS.
4. Antagonism of D2 receptors in the tuberoinfundibular pathway leads to
which side effect?
A. Weight gain
B. Orthostatic hypotension
C. Sedation
D. Hyperprolactinemia
Answer: D
Rationale: Dopamine inhibits prolactin release; blocking D2 receptors in this pathway
increases prolactin levels.
5. Second-generation antipsychotics (SGAs) differ from FGAs primarily due to
their affinity for which receptor?
A. Alpha-1 adrenergic
B. Muscarinic M1
C. Serotonin 5HT2A
D. Histamine H1
Answer: C
Rationale: SGAs are defined by their 5HT2A antagonism, which modulates dopamine
release and reduces EPS risk.
, 6. Which of the following is considered a ‘High Potency’ First-Generation
Antipsychotic?
A. Haloperidol
B. Chlorpromazine
C. Thioridazine
D. Quetiapine
Answer: A
Rationale: Haloperidol is a high-potency FGA, meaning it has a high affinity for D2
receptors at low doses.
7. Which SGA is most notoriously associated with the risk of agranulocytosis?
A. Olanzapine
B. Risperidone
C. Ziprasidone
D. Clozapine
Answer: D
Rationale: Clozapine requires strict WBC and ANC monitoring due to the risk of life-
threatening agranulocytosis.
8. What is the Absolute Neutrophil Count (ANC) threshold to initiate Clozapine
in a general population patient?
A. Greater than or equal to 1,000/mm3
B. Greater than or equal to 2,000/mm3
C. Greater than or equal to 1,500/mm3
D. Greater than or equal to 500/mm3
Answer: C
Rationale: Clozapine therapy requires an initial ANC of at least 1,500/mm3 (except for
patients with Benign Ethnic Neutropenia).
