PMHNP Study/practice questions
Which of the following statements does not reflect current understanding of neurotransmitter
pathways implicated in anxiery disorders?
A. Increase levels of CRF in amygdala, hippocampus and LC increase symptoms of anxiety.
B. Decreaseing GABA in the Mesolimbic cortex diminishes symptoms of anxiery.
C. Increasing serotoneric activity in the amygdala diminishes symptoms of anxiety.
D. Decreasing NE in the LC diminishes symptoms of anxiety. - ✔✔A, C & D are all correct so the
answer is B
As a PMHNP, you know anti-psychotic meds have side effects. Which side effects of antipsychotic
meds has an insidious delayed-onself of 1-2 after starting the medication? - ✔✔A. Dry Mouth
B. Tardive Dyskinesia
C. Wt gain
D. Sedation
We know that Dry mouth, drowsiness, dizziness, restlessness, wt gain, constipation & N/V are all SE
but, Tardive Dyskinesia does not start for 1-2 years.
My answer - B. *Tardive Dyskinesia (TD*)
** long standing blockage of DA2 in nigrostriatal pathway leads to TD
Which Serotonin receptor antagonism makes an antipsychotic "atypical"?
A. 5HT1A
B. 5HT3A
C. 5HT4A
D. 5HT2A - ✔✔Atypical antipsychotic drugs such as clozapine, olanzapine, quetiapine, risperidone,
sertindole, and ziprasidone are potent 5-HT2a receptor antagonists and relatively weaker dopamine
D2 antagonists.
Commonly Prescribed Typical and Atypical Antipsychotic Medications
Typical antipsychotics include:
Haldol (haloperidol); Loxitane (loxapine);
Mellaril (thioridazine); Geodon (ziprasidone)
Moban (molindone); Seroquel (quetiapine)
, Navane (thiothixene); Zyprexa (olanzapine)
Prolixin (fluphenazine); Serentil (mesoridazine)
Stelazine (trifluoperazine); Trilafon (perphenazine)
Thorazine (chlorpromazine)
Atypical antipsychotics include:
Abilify (aripiprazole); Clozaril (clozapine)
Geodon (ziprasidone); Seroquel (quetiapine)
Zyprexa (olanzapine)
Which medication inhibits both dopamine and norepinephrine?
A. Venlafaxine (effexor)
B. Duloxetine (Cymbalta)
C. Buproprion (Wellbutrin)
D. Imipramine (Tofranil) - ✔✔C. Buproprion (Wellbutrin)
Bupropion inhibits the presynaptic reuptake of both dopamine (DA) and noradrenaline (NA), leading
to increased levels of both of these neurotransmitters in the synaptic cleft
Current understanding of Dopamine (DA) pathways & clinical symptoms in schizophrenia is reflected
in which statement?
A. Neg symptoms are related to DA deficit in meslimbic system and pos (+) symptoms are related to
DA excess in the (SN) substanita nigra & (VTA) ventral tegmental area.
B. (-) symptoms are related to DA excess in the CC cerebral cortex; + symptoms are related to DA in
the (NA) nucleus accumbens and mesolimbic system
C. (-) related to DA in (MS) mesolimbic system; + are related to DA deficit in the SN and VTA
D. (-) related to DA deficit in the CC; (+) related to DA excess in the NA & MS - ✔✔ANS. D?
In the case of schizophrenia and other psychological disorders, a positive symptom is one that adds a
behavior, thought or feeling, whereas a negative symptom takes away a behavior, thought or feeling.
Dopamine pathways
Mesolimbic => pathway projections from VTA to the NA (nucleus accumbens in the limbic system;
Increased dopamine in the Mesolimbic pathway mediates (+) symptoms.
VTA => Mesocortical; Decreased DA in Mesocortical => (-)negative symptoms
Which of the following statements does not reflect current understanding of neurotransmitter
pathways implicated in anxiery disorders?
A. Increase levels of CRF in amygdala, hippocampus and LC increase symptoms of anxiety.
B. Decreaseing GABA in the Mesolimbic cortex diminishes symptoms of anxiery.
C. Increasing serotoneric activity in the amygdala diminishes symptoms of anxiety.
D. Decreasing NE in the LC diminishes symptoms of anxiety. - ✔✔A, C & D are all correct so the
answer is B
As a PMHNP, you know anti-psychotic meds have side effects. Which side effects of antipsychotic
meds has an insidious delayed-onself of 1-2 after starting the medication? - ✔✔A. Dry Mouth
B. Tardive Dyskinesia
C. Wt gain
D. Sedation
We know that Dry mouth, drowsiness, dizziness, restlessness, wt gain, constipation & N/V are all SE
but, Tardive Dyskinesia does not start for 1-2 years.
My answer - B. *Tardive Dyskinesia (TD*)
** long standing blockage of DA2 in nigrostriatal pathway leads to TD
Which Serotonin receptor antagonism makes an antipsychotic "atypical"?
A. 5HT1A
B. 5HT3A
C. 5HT4A
D. 5HT2A - ✔✔Atypical antipsychotic drugs such as clozapine, olanzapine, quetiapine, risperidone,
sertindole, and ziprasidone are potent 5-HT2a receptor antagonists and relatively weaker dopamine
D2 antagonists.
Commonly Prescribed Typical and Atypical Antipsychotic Medications
Typical antipsychotics include:
Haldol (haloperidol); Loxitane (loxapine);
Mellaril (thioridazine); Geodon (ziprasidone)
Moban (molindone); Seroquel (quetiapine)
, Navane (thiothixene); Zyprexa (olanzapine)
Prolixin (fluphenazine); Serentil (mesoridazine)
Stelazine (trifluoperazine); Trilafon (perphenazine)
Thorazine (chlorpromazine)
Atypical antipsychotics include:
Abilify (aripiprazole); Clozaril (clozapine)
Geodon (ziprasidone); Seroquel (quetiapine)
Zyprexa (olanzapine)
Which medication inhibits both dopamine and norepinephrine?
A. Venlafaxine (effexor)
B. Duloxetine (Cymbalta)
C. Buproprion (Wellbutrin)
D. Imipramine (Tofranil) - ✔✔C. Buproprion (Wellbutrin)
Bupropion inhibits the presynaptic reuptake of both dopamine (DA) and noradrenaline (NA), leading
to increased levels of both of these neurotransmitters in the synaptic cleft
Current understanding of Dopamine (DA) pathways & clinical symptoms in schizophrenia is reflected
in which statement?
A. Neg symptoms are related to DA deficit in meslimbic system and pos (+) symptoms are related to
DA excess in the (SN) substanita nigra & (VTA) ventral tegmental area.
B. (-) symptoms are related to DA excess in the CC cerebral cortex; + symptoms are related to DA in
the (NA) nucleus accumbens and mesolimbic system
C. (-) related to DA in (MS) mesolimbic system; + are related to DA deficit in the SN and VTA
D. (-) related to DA deficit in the CC; (+) related to DA excess in the NA & MS - ✔✔ANS. D?
In the case of schizophrenia and other psychological disorders, a positive symptom is one that adds a
behavior, thought or feeling, whereas a negative symptom takes away a behavior, thought or feeling.
Dopamine pathways
Mesolimbic => pathway projections from VTA to the NA (nucleus accumbens in the limbic system;
Increased dopamine in the Mesolimbic pathway mediates (+) symptoms.
VTA => Mesocortical; Decreased DA in Mesocortical => (-)negative symptoms
