NR 546 Week 3: Antipsychotics and Advanced Pharmacology Exam
2026 |Chamberlain
1. Which dopamine pathway is associated with the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Mesocortical pathway
B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: B
Rationale: Overactivity in the mesolimbic pathway is primarily responsible for the positive
symptoms of schizophrenia.
2. A deficiency of dopamine in which pathway is hypothesized to cause the
negative and cognitive symptoms of schizophrenia?
A. Tuberoinfundibular pathway
B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Mesocortical pathway
Answer: D
Rationale: The mesocortical pathway relates to cognitive function and emotional
regulation; a deficit here leads to negative symptoms.
,3. Blockade of dopamine D2 receptors in the nigrostriatal pathway leads to
which of the following side effects?
A. Extrapyramidal symptoms (EPS)
B. Improvement in negative symptoms
C. Hyperprolactinemia
D. Weight gain
Answer: A
Rationale: The nigrostriatal pathway controls motor movement; blockade here results in
EPS and tardive dyskinesia.
4. Which pathway is responsible for the regulation of prolactin secretion?
A. Tuberoinfundibular pathway
B. Mesolimbic pathway
C. Mesocortical pathway
D. Nigrostriatal pathway
Answer: A
Rationale: Dopamine inhibits prolactin in the tuberoinfundibular pathway; blocking D2
receptors here causes prolactin levels to rise.
5. What is the primary mechanism of action for First-Generation Antipsychotics
(FGAs)?
A. D2 receptor antagonism
B. 5-HT2A receptor antagonism
C. D2 receptor partial agonism
D. NMDA receptor agonism
Answer: A
Rationale: FGAs, also known as typical antipsychotics, primarily work by blocking D2
receptors throughout the brain.
, 6. Second-Generation Antipsychotics (SGAs) differ from FGAs primarily by their
added affinity for which receptor?
A. Alpha-1 adrenergic
B. 5-HT2A serotonin
C. Muscarinic M1
D. Histamine H1
Answer: B
Rationale: SGAs are defined by D2 antagonism plus 5-HT2A antagonism, which helps
reduce EPS and improve negative symptoms.
7. Which of the following is considered a high-potency First-Generation
Antipsychotic?
A. Chlorpromazine
B. Haloperidol
C. Thioridazine
D. Quetiapine
Answer: B
Rationale: Haloperidol is a classic high-potency FGA, meaning it has a high affinity for D2
receptors and requires low doses.
8. What is the FDA Black Box Warning associated with all antipsychotic
medications?
A. Increased mortality in elderly patients with dementia-related psychosis
B. Risk of agranulocytosis
C. Severe liver toxicity
D. Risk of Stevens-Johnson Syndrome
Answer: A
Rationale: All antipsychotics carry a warning regarding increased risk of death in elderly
patients with dementia.
2026 |Chamberlain
1. Which dopamine pathway is associated with the positive symptoms of
schizophrenia, such as hallucinations and delusions?
A. Mesocortical pathway
B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: B
Rationale: Overactivity in the mesolimbic pathway is primarily responsible for the positive
symptoms of schizophrenia.
2. A deficiency of dopamine in which pathway is hypothesized to cause the
negative and cognitive symptoms of schizophrenia?
A. Tuberoinfundibular pathway
B. Mesolimbic pathway
C. Nigrostriatal pathway
D. Mesocortical pathway
Answer: D
Rationale: The mesocortical pathway relates to cognitive function and emotional
regulation; a deficit here leads to negative symptoms.
,3. Blockade of dopamine D2 receptors in the nigrostriatal pathway leads to
which of the following side effects?
A. Extrapyramidal symptoms (EPS)
B. Improvement in negative symptoms
C. Hyperprolactinemia
D. Weight gain
Answer: A
Rationale: The nigrostriatal pathway controls motor movement; blockade here results in
EPS and tardive dyskinesia.
4. Which pathway is responsible for the regulation of prolactin secretion?
A. Tuberoinfundibular pathway
B. Mesolimbic pathway
C. Mesocortical pathway
D. Nigrostriatal pathway
Answer: A
Rationale: Dopamine inhibits prolactin in the tuberoinfundibular pathway; blocking D2
receptors here causes prolactin levels to rise.
5. What is the primary mechanism of action for First-Generation Antipsychotics
(FGAs)?
A. D2 receptor antagonism
B. 5-HT2A receptor antagonism
C. D2 receptor partial agonism
D. NMDA receptor agonism
Answer: A
Rationale: FGAs, also known as typical antipsychotics, primarily work by blocking D2
receptors throughout the brain.
, 6. Second-Generation Antipsychotics (SGAs) differ from FGAs primarily by their
added affinity for which receptor?
A. Alpha-1 adrenergic
B. 5-HT2A serotonin
C. Muscarinic M1
D. Histamine H1
Answer: B
Rationale: SGAs are defined by D2 antagonism plus 5-HT2A antagonism, which helps
reduce EPS and improve negative symptoms.
7. Which of the following is considered a high-potency First-Generation
Antipsychotic?
A. Chlorpromazine
B. Haloperidol
C. Thioridazine
D. Quetiapine
Answer: B
Rationale: Haloperidol is a classic high-potency FGA, meaning it has a high affinity for D2
receptors and requires low doses.
8. What is the FDA Black Box Warning associated with all antipsychotic
medications?
A. Increased mortality in elderly patients with dementia-related psychosis
B. Risk of agranulocytosis
C. Severe liver toxicity
D. Risk of Stevens-Johnson Syndrome
Answer: A
Rationale: All antipsychotics carry a warning regarding increased risk of death in elderly
patients with dementia.
