NSG 552 Exam 1: Antipsychotics – Pharmacology, Side Effects, EPS,
NMS, Clozapine (Latest 2026/2027 Update) | Q&A | Grade A | 100%
Verified Answers – Nursing Program
Subject: NSG 552 Exam 1 – Antipsychotics (Typical/FGA vs. Atypical/SGA), Dopamine
Pathways, Positive/Negative Symptoms, Extrapyramidal Symptoms (EPS), Neuroleptic
Malignant Syndrome (NMS), Tardive Dyskinesia, Clozapine REMS, Long-Acting Injectables,
Metabolic Monitoring
Format: Q&A Guide with Clinical & Pharmacological Rationale | 100% Verified
What are the 4 main dopamine (DA) pathways in the brain?
Correct Answer: Mesolimbic [+], Mesocortical [-], Nigrostriatal [EPS], Tuberoinfundibular
[hyperprolactinemia]
1. Mesolimbic pathway overactivity → positive symptoms; Mesocortical underactivity → negative
symptoms.
2. Nigrostriatal pathway blockade → EPS; Tuberoinfundibular pathway blockade →
hyperprolactinemia.
How are symptoms of schizophrenia divided?
Correct Answer: Positive and negative symptoms
1. Positive symptoms: delusions, hallucinations, disorganized speech/behavior.
2. Negative symptoms: alogia, anhedonia, avolition, flat affect, social withdrawal.
What risks can increase with antipsychotic polypharmacy?
Correct Answer: Re-hospitalization, diabetes, EPS, sedation, seizures, metabolic effects, mortality,
sudden cardiac death (due to blockade of DA)
1. Polypharmacy increases adverse effect burden and drug interactions.
2. Monotherapy is preferred unless clinically necessary.
What are negative symptoms of schizophrenia?
Correct Answer: Alogia, anhedonia, avolition and cognitive symptoms
1. Negative symptoms represent a loss of normal functioning.
2. More difficult to treat than positive symptoms.
What are positive symptoms of schizophrenia?
Correct Answer: Delusions, hallucinations, hostility, grandiosity
1. Positive symptoms represent an excess or distortion of normal functions.
2. Generally respond better to antipsychotic treatment.
What is another name for first-generation antipsychotics?
Correct Answer: Typical antipsychotics, FGA (first-generation antipsychotics)
1. First-generation antipsychotics are dopamine D2 receptor antagonists.
2. Examples include haloperidol, chlorpromazine, fluphenazine.
, What is another name for second-generation antipsychotics?
Correct Answer: Atypical antipsychotics, SGA (second-generation antipsychotics)
1. Second-generation antipsychotics block both dopamine and serotonin (5HT2A) receptors.
2. Associated with lower risk of EPS but higher metabolic side effects.
What is the first-line treatment for schizophrenia?
Correct Answer: Atypical antipsychotics (second-generation antipsychotics)
1. Atypical antipsychotics are first-line due to efficacy for both positive and negative symptoms.
2. Lower risk of extrapyramidal symptoms compared to typical antipsychotics.
Which medications are classified as atypical antipsychotics (SGAs)?
Correct Answer: Aripiprazole, brexpiprazole, clozapine, olanzapine, quetiapine, risperidone,
ziprasidone, lurasidone, pimavanserin
1. Each SGA has a unique receptor binding profile and side effect profile.
2. Clozapine is reserved for treatment-resistant schizophrenia.
Which medications are classified as typical antipsychotics (FGAs)?
Correct Answer: Chlorpromazine, fluphenazine, haloperidol, perphenazine, thiothixene, thioridazine,
loxapine, molindone
1. FGAs are effective primarily for positive symptoms.
2. High risk of extrapyramidal symptoms and tardive dyskinesia.
Which class of antipsychotics is associated with fewer neurological side effects and effects
for both positive and negative symptoms?
Correct Answer: Atypical antipsychotics (second-generation antipsychotics)
1. SGAs have lower D2 occupancy and 5HT2A antagonism, reducing EPS.
2. Effective for negative symptoms via mesocortical dopamine enhancement.
Which class of antipsychotics is effective for ONLY positive symptoms and can in fact
worsen negative symptoms due to decreased dopamine in the mesocortical pathway?
Correct Answer: Typical antipsychotics (first-generation antipsychotics)
1. FGAs block dopamine in the mesocortical pathway, potentially worsening negative symptoms.
2. Primarily target positive symptoms.
Which class of antipsychotics is associated with metabolic side effects?
Correct Answer: Atypical antipsychotics (second-generation antipsychotics)
1. SGAs cause weight gain, dyslipidemia, and hyperglycemia via H1, 5HT2C, and M3 receptor
blockade.
2. Olanzapine and clozapine have highest metabolic risk.
What are the metabolic side effects associated with atypical antipsychotics?
Correct Answer: Increased BP, increased weight, hyperlipidemia (HLD), hyperglycemia
1. Regular monitoring of weight, BMI, fasting glucose, and lipids is recommended.
2. Lifestyle modifications and medication adjustments may be needed.
NMS, Clozapine (Latest 2026/2027 Update) | Q&A | Grade A | 100%
Verified Answers – Nursing Program
Subject: NSG 552 Exam 1 – Antipsychotics (Typical/FGA vs. Atypical/SGA), Dopamine
Pathways, Positive/Negative Symptoms, Extrapyramidal Symptoms (EPS), Neuroleptic
Malignant Syndrome (NMS), Tardive Dyskinesia, Clozapine REMS, Long-Acting Injectables,
Metabolic Monitoring
Format: Q&A Guide with Clinical & Pharmacological Rationale | 100% Verified
What are the 4 main dopamine (DA) pathways in the brain?
Correct Answer: Mesolimbic [+], Mesocortical [-], Nigrostriatal [EPS], Tuberoinfundibular
[hyperprolactinemia]
1. Mesolimbic pathway overactivity → positive symptoms; Mesocortical underactivity → negative
symptoms.
2. Nigrostriatal pathway blockade → EPS; Tuberoinfundibular pathway blockade →
hyperprolactinemia.
How are symptoms of schizophrenia divided?
Correct Answer: Positive and negative symptoms
1. Positive symptoms: delusions, hallucinations, disorganized speech/behavior.
2. Negative symptoms: alogia, anhedonia, avolition, flat affect, social withdrawal.
What risks can increase with antipsychotic polypharmacy?
Correct Answer: Re-hospitalization, diabetes, EPS, sedation, seizures, metabolic effects, mortality,
sudden cardiac death (due to blockade of DA)
1. Polypharmacy increases adverse effect burden and drug interactions.
2. Monotherapy is preferred unless clinically necessary.
What are negative symptoms of schizophrenia?
Correct Answer: Alogia, anhedonia, avolition and cognitive symptoms
1. Negative symptoms represent a loss of normal functioning.
2. More difficult to treat than positive symptoms.
What are positive symptoms of schizophrenia?
Correct Answer: Delusions, hallucinations, hostility, grandiosity
1. Positive symptoms represent an excess or distortion of normal functions.
2. Generally respond better to antipsychotic treatment.
What is another name for first-generation antipsychotics?
Correct Answer: Typical antipsychotics, FGA (first-generation antipsychotics)
1. First-generation antipsychotics are dopamine D2 receptor antagonists.
2. Examples include haloperidol, chlorpromazine, fluphenazine.
, What is another name for second-generation antipsychotics?
Correct Answer: Atypical antipsychotics, SGA (second-generation antipsychotics)
1. Second-generation antipsychotics block both dopamine and serotonin (5HT2A) receptors.
2. Associated with lower risk of EPS but higher metabolic side effects.
What is the first-line treatment for schizophrenia?
Correct Answer: Atypical antipsychotics (second-generation antipsychotics)
1. Atypical antipsychotics are first-line due to efficacy for both positive and negative symptoms.
2. Lower risk of extrapyramidal symptoms compared to typical antipsychotics.
Which medications are classified as atypical antipsychotics (SGAs)?
Correct Answer: Aripiprazole, brexpiprazole, clozapine, olanzapine, quetiapine, risperidone,
ziprasidone, lurasidone, pimavanserin
1. Each SGA has a unique receptor binding profile and side effect profile.
2. Clozapine is reserved for treatment-resistant schizophrenia.
Which medications are classified as typical antipsychotics (FGAs)?
Correct Answer: Chlorpromazine, fluphenazine, haloperidol, perphenazine, thiothixene, thioridazine,
loxapine, molindone
1. FGAs are effective primarily for positive symptoms.
2. High risk of extrapyramidal symptoms and tardive dyskinesia.
Which class of antipsychotics is associated with fewer neurological side effects and effects
for both positive and negative symptoms?
Correct Answer: Atypical antipsychotics (second-generation antipsychotics)
1. SGAs have lower D2 occupancy and 5HT2A antagonism, reducing EPS.
2. Effective for negative symptoms via mesocortical dopamine enhancement.
Which class of antipsychotics is effective for ONLY positive symptoms and can in fact
worsen negative symptoms due to decreased dopamine in the mesocortical pathway?
Correct Answer: Typical antipsychotics (first-generation antipsychotics)
1. FGAs block dopamine in the mesocortical pathway, potentially worsening negative symptoms.
2. Primarily target positive symptoms.
Which class of antipsychotics is associated with metabolic side effects?
Correct Answer: Atypical antipsychotics (second-generation antipsychotics)
1. SGAs cause weight gain, dyslipidemia, and hyperglycemia via H1, 5HT2C, and M3 receptor
blockade.
2. Olanzapine and clozapine have highest metabolic risk.
What are the metabolic side effects associated with atypical antipsychotics?
Correct Answer: Increased BP, increased weight, hyperlipidemia (HLD), hyperglycemia
1. Regular monitoring of weight, BMI, fasting glucose, and lipids is recommended.
2. Lifestyle modifications and medication adjustments may be needed.
