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NRNP 6675 Midterm Exam PMHNP
2026/2027 Actual Test Bank with
Verified Answers and NGN Rationales
Question 1
Which of the following are risk factors for neuroleptic malignant
syndrome? Select all that apply.
• A. Age
• B. Rapid Dose Escalation
• C. Parental Route of Administration
• D. Higher Potency Typical Antipsychotics
Correct Answer: A. Age, B. Rapid Dose Escalation, C. Parental Route of
Administration, D. Higher Potency Typical Antipsychotics
Rationale:
1. Age is a risk factor, as older adults are more vulnerable to NMS.
2. Rapid dose escalation increases the risk of developing NMS.
3. Parenteral (injection) route of administration is associated with higher
NMS risk.
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4. Higher potency typical antipsychotics (e.g., haloperidol) have a greater
risk of causing NMS.
Question 2
Antipsychotic medication provides D2 blockage in the meso-cortical
pathway causing which of the following effects?
• A. reduces negative symptoms
• B. Increases EPS
• C. causes prolactinemia
• D. reduces positive symptoms
Correct Answer: A. reduces negative symptoms, B. Increases EPS, C. causes
prolactinemia, D. reduces positive symptoms
Rationale:
1. D2 blockade in the mesocortical pathway may reduce negative
symptoms.
2. D2 blockade in the nigrostriatal pathway increases extrapyramidal
symptoms (EPS).
3. D2 blockade in the tuberoinfundibular pathway causes prolactinemia.
4. D2 blockade in the mesolimbic pathway reduces positive symptoms.
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Question 3
Phencyclidine (PCP) and ketamine exert their unique behavioral effects
by blocking which of the following receptors?
• A. GABA
• B. serotonin
• C. dopamine receptors
• D. NMDA type receptors
Correct Answer: D. NMDA type receptors
Rationale:
1. PCP and ketamine are non-competitive NMDA receptor antagonists.
2. NMDA receptor blockade produces dissociative anesthetic effects.
3. This mechanism differs from GABA, serotonin, or dopamine receptor
actions.
4. Ketamine's rapid antidepressant effects are also mediated through
NMDA antagonism.
Question 4
The diagnosis used to describe a syndrome characterized by specific s/s
resulting from recent ingestion or exposure to a substance is known as
which of the following?
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• A. substance intoxication
• B. substance withdrawal
• C. substance use disorder
• D. all of the above
Correct Answer: A. substance intoxication
Rationale:
1. Substance intoxication is a reversible syndrome caused by recent
substance ingestion.
2. Symptoms are directly related to the pharmacological effects of the
substance.
3. Withdrawal occurs upon cessation, not ingestion.
4. Substance use disorder is a chronic pattern, not acute ingestion.
Question 5
Abnormal involuntary movements in a rhythmic pattern affecting the
face, mouth, tongue, and jaw is known as which of the following?
• A. akathisia
• B. dystonia
• C. tardive dyskinesia
• D. EPS
NRNP 6675 Midterm Exam PMHNP
2026/2027 Actual Test Bank with
Verified Answers and NGN Rationales
Question 1
Which of the following are risk factors for neuroleptic malignant
syndrome? Select all that apply.
• A. Age
• B. Rapid Dose Escalation
• C. Parental Route of Administration
• D. Higher Potency Typical Antipsychotics
Correct Answer: A. Age, B. Rapid Dose Escalation, C. Parental Route of
Administration, D. Higher Potency Typical Antipsychotics
Rationale:
1. Age is a risk factor, as older adults are more vulnerable to NMS.
2. Rapid dose escalation increases the risk of developing NMS.
3. Parenteral (injection) route of administration is associated with higher
NMS risk.
,2|Page
4. Higher potency typical antipsychotics (e.g., haloperidol) have a greater
risk of causing NMS.
Question 2
Antipsychotic medication provides D2 blockage in the meso-cortical
pathway causing which of the following effects?
• A. reduces negative symptoms
• B. Increases EPS
• C. causes prolactinemia
• D. reduces positive symptoms
Correct Answer: A. reduces negative symptoms, B. Increases EPS, C. causes
prolactinemia, D. reduces positive symptoms
Rationale:
1. D2 blockade in the mesocortical pathway may reduce negative
symptoms.
2. D2 blockade in the nigrostriatal pathway increases extrapyramidal
symptoms (EPS).
3. D2 blockade in the tuberoinfundibular pathway causes prolactinemia.
4. D2 blockade in the mesolimbic pathway reduces positive symptoms.
,3|Page
Question 3
Phencyclidine (PCP) and ketamine exert their unique behavioral effects
by blocking which of the following receptors?
• A. GABA
• B. serotonin
• C. dopamine receptors
• D. NMDA type receptors
Correct Answer: D. NMDA type receptors
Rationale:
1. PCP and ketamine are non-competitive NMDA receptor antagonists.
2. NMDA receptor blockade produces dissociative anesthetic effects.
3. This mechanism differs from GABA, serotonin, or dopamine receptor
actions.
4. Ketamine's rapid antidepressant effects are also mediated through
NMDA antagonism.
Question 4
The diagnosis used to describe a syndrome characterized by specific s/s
resulting from recent ingestion or exposure to a substance is known as
which of the following?
, 4|Page
• A. substance intoxication
• B. substance withdrawal
• C. substance use disorder
• D. all of the above
Correct Answer: A. substance intoxication
Rationale:
1. Substance intoxication is a reversible syndrome caused by recent
substance ingestion.
2. Symptoms are directly related to the pharmacological effects of the
substance.
3. Withdrawal occurs upon cessation, not ingestion.
4. Substance use disorder is a chronic pattern, not acute ingestion.
Question 5
Abnormal involuntary movements in a rhythmic pattern affecting the
face, mouth, tongue, and jaw is known as which of the following?
• A. akathisia
• B. dystonia
• C. tardive dyskinesia
• D. EPS
