NR546 Week 4 Midterm Complete Actual Exam
Questions 1- 75 NR546 Psychopharmacology
for the PMHNP NR 546 Midterm and Finals
Examplify Online Proctored Exam Questions
and Answers | 100% Pass Guaranteed | Graded
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Domain 1: Neurobiology & Receptor Pharmacology (Questions 1–10)
Question 1
A patient with schizophrenia has predominantly negative symptoms
(avolition, anhedonia). Which neurotransmitter pathway is most
implicated?
A) Mesolimbic dopamine (hyperactivity)
B) Mesocortical dopamine (hypoactivity)
C) Nigrostriatal dopamine
D) Tuberoinfundibular dopamine
Correct ,,answer,,,,: B
Rationale: Negative symptoms are linked to reduced dopamine activity in
the mesocortical pathway (prefrontal cortex). Mesolimbic hyperactivity
causes positive symptoms. Nigrostriatal mediates motor control.
Tuberoinfundibular regulates prolactin.
,Question 2
A patient on an antipsychotic develops galactorrhea. Which receptor
blockade is responsible?
A) 5‑HT2A
B) D2 (tuberoinfundibular pathway)
C) H1
D) α1
Correct ,,answer,,,,: B
Rationale: D2 blockade in the tuberoinfundibular pathway disinhibits
prolactin release, causing hyperprolactinemia → galactorrhea,
gynecomastia, sexual dysfunction.
Question 3
Which serotonin receptor is most closely associated with the therapeutic
effect of atypical antipsychotics on negative symptoms?
A) 5‑HT1A
B) 5‑HT2A
C) 5‑HT3
D) 5‑HT7
,Correct ,,answer,,,,: B
Rationale: 5‑HT2A antagonism by atypical antipsychotics is thought to
improve negative symptoms and reduce extrapyramidal side effects by
modulating dopamine release.
Question 4
A patient with major depression is started on an SSRI. The therapeutic
effect is delayed by 2‑4 weeks. This delay is best explained by:
A) Slow absorption from the gut
B) Time required for downregulation of postsynaptic 5‑HT2A receptors
and neuroplasticity changes
C) Slow distribution to the brain
D) Accumulation of an active metabolite
Correct ,,answer,,,,: B
Rationale: SSRIs increase synaptic serotonin within hours, but
therapeutic response requires downstream adaptive changes (receptor
desensitization, BDNF increase, neurogenesis), which take weeks.
Question 5
Which of the following is a presynaptic autoreceptor that, when
stimulated, inhibits serotonin release?
A) 5‑HT2A
, B) 5‑HT1A
C) 5‑HT3
D) 5‑HT7
Correct ,,answer,,,,: B
Rationale: 5‑HT1A autoreceptors on raphe nuclei cell bodies inhibit
serotonin neuronal firing. Antagonism or desensitization of these
autoreceptors is thought to contribute to antidepressant effect.
Question 6
A patient with bipolar disorder is started on valproate. Which
neurotransmitter system is primarily modulated by valproate?
A) Dopamine
B) Norepinephrine
C) GABA
D) Glutamate
Correct ,,answer,,,,: C
Rationale: Valproate increases GABA levels by inhibiting GABA
transaminase and enhancing GABA synthesis, leading to increased
inhibitory neurotransmission and mood stabilization.
Questions 1- 75 NR546 Psychopharmacology
for the PMHNP NR 546 Midterm and Finals
Examplify Online Proctored Exam Questions
and Answers | 100% Pass Guaranteed | Graded
A+ |
Domain 1: Neurobiology & Receptor Pharmacology (Questions 1–10)
Question 1
A patient with schizophrenia has predominantly negative symptoms
(avolition, anhedonia). Which neurotransmitter pathway is most
implicated?
A) Mesolimbic dopamine (hyperactivity)
B) Mesocortical dopamine (hypoactivity)
C) Nigrostriatal dopamine
D) Tuberoinfundibular dopamine
Correct ,,answer,,,,: B
Rationale: Negative symptoms are linked to reduced dopamine activity in
the mesocortical pathway (prefrontal cortex). Mesolimbic hyperactivity
causes positive symptoms. Nigrostriatal mediates motor control.
Tuberoinfundibular regulates prolactin.
,Question 2
A patient on an antipsychotic develops galactorrhea. Which receptor
blockade is responsible?
A) 5‑HT2A
B) D2 (tuberoinfundibular pathway)
C) H1
D) α1
Correct ,,answer,,,,: B
Rationale: D2 blockade in the tuberoinfundibular pathway disinhibits
prolactin release, causing hyperprolactinemia → galactorrhea,
gynecomastia, sexual dysfunction.
Question 3
Which serotonin receptor is most closely associated with the therapeutic
effect of atypical antipsychotics on negative symptoms?
A) 5‑HT1A
B) 5‑HT2A
C) 5‑HT3
D) 5‑HT7
,Correct ,,answer,,,,: B
Rationale: 5‑HT2A antagonism by atypical antipsychotics is thought to
improve negative symptoms and reduce extrapyramidal side effects by
modulating dopamine release.
Question 4
A patient with major depression is started on an SSRI. The therapeutic
effect is delayed by 2‑4 weeks. This delay is best explained by:
A) Slow absorption from the gut
B) Time required for downregulation of postsynaptic 5‑HT2A receptors
and neuroplasticity changes
C) Slow distribution to the brain
D) Accumulation of an active metabolite
Correct ,,answer,,,,: B
Rationale: SSRIs increase synaptic serotonin within hours, but
therapeutic response requires downstream adaptive changes (receptor
desensitization, BDNF increase, neurogenesis), which take weeks.
Question 5
Which of the following is a presynaptic autoreceptor that, when
stimulated, inhibits serotonin release?
A) 5‑HT2A
, B) 5‑HT1A
C) 5‑HT3
D) 5‑HT7
Correct ,,answer,,,,: B
Rationale: 5‑HT1A autoreceptors on raphe nuclei cell bodies inhibit
serotonin neuronal firing. Antagonism or desensitization of these
autoreceptors is thought to contribute to antidepressant effect.
Question 6
A patient with bipolar disorder is started on valproate. Which
neurotransmitter system is primarily modulated by valproate?
A) Dopamine
B) Norepinephrine
C) GABA
D) Glutamate
Correct ,,answer,,,,: C
Rationale: Valproate increases GABA levels by inhibiting GABA
transaminase and enhancing GABA synthesis, leading to increased
inhibitory neurotransmission and mood stabilization.
