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NSG552 / NSG 552 EXAM 1 (PSYCHOPHARMACOLOGY) 2025/2026
WITH 120 VERIFIED QUESTIONS AND ANSWERS, INCLUDING
RATIONALES FOR 100% CORRECT RESPONSES
1. Which neurotransmitter is primarily responsible for the positive
symptoms of schizophrenia?
A. Serotonin
B. Dopamine
C. GABA
D. Norepinephrine
Answer: B. Dopamine
Rationale: Hyperactivity of dopamine in the mesolimbic pathway is
linked to hallucinations, delusions, and thought disorders. First-
generation antipsychotics block D₂ receptors to reduce positive
symptoms. Excessive blockade can cause extrapyramidal symptoms
(EPS), so monitoring is essential.
2. A patient on haloperidol develops tremor, rigidity, and bradykinesia.
What is the most likely diagnosis?
A. Serotonin syndrome
B. Extrapyramidal symptoms (EPS)
C. Neuroleptic malignant syndrome (NMS)
D. Akathisia
Answer: B. Extrapyramidal symptoms (EPS)
Rationale: FGAs inhibit dopamine in the nigrostriatal pathway,
causing movement disorders such as parkinsonism, dystonia, and
tremor. NMS would include fever and autonomic instability; akathisia
presents as inner restlessness, not rigidity.
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3. Which SSRI is most activating and may worsen insomnia?
A. Paroxetine
B. Sertraline
C. Fluoxetine
D. Citalopram
Answer: C. Fluoxetine
Rationale: Fluoxetine has a long half-life and stimulating effect,
which can cause insomnia and anxiety. Administering it in the
morning can reduce sleep disturbances.
4. Early lithium toxicity typically presents with:
A. Hypertension and tachycardia
B. Diarrhea, vomiting, tremors
C. Weight gain and edema
D. Sedation and hypotension
Answer: B. Diarrhea, vomiting, tremors
Rationale: Lithium has a narrow therapeutic window (0.6–1.2
mEq/L). Early toxicity symptoms include GI upset, tremor, lethargy,
and ataxia. Serum levels and renal function must be monitored.
5. Which food should a patient on MAOIs avoid to prevent hypertensive
crisis?
A. Bananas and aged cheese
B. Grapefruit juice
C. Leafy greens
D. Fish
Answer: A. Bananas and aged cheese
Rationale: MAOIs inhibit monoamine oxidase, which metabolizes
tyramine. High-tyramine foods can cause sudden hypertensive crises.
Patient education is critical.
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6. Which second-generation antipsychotic has the highest risk of
metabolic syndrome?
A. Risperidone
B. Clozapine
C. Ziprasidone
D. Aripiprazole
Answer: B. Clozapine
Rationale: Clozapine and olanzapine block histamine H1, serotonin 5-
HT2C, and muscarinic receptors, leading to weight gain,
hyperlipidemia, and hyperglycemia. Regular BMI, glucose, and lipid
monitoring is necessary.
7. Mechanism of action of benzodiazepines:
A. Dopamine receptor antagonism
B. GABA-A receptor potentiation
C. Serotonin reuptake inhibition
D. Norepinephrine blockade
Answer: B. GABA-A receptor potentiation
Rationale: Benzodiazepines bind allosterically to GABA-A receptors,
increasing chloride influx and hyperpolarizing neurons, producing
sedation, anxiolysis, and muscle relaxation. Nursing should monitor
for sedation and respiratory depression.
8. Why are TCAs dangerous in overdose?
A. Cause serotonin syndrome
B. Block sodium channels → arrhythmias
C. Cause hypotension through histamine blockade
D. Increase dopamine excessively
Answer: B. Block sodium channels → arrhythmias
Rationale: TCAs inhibit cardiac sodium channels, prolonging QRS
and PR intervals. Overdose may lead to ventricular arrhythmias and
death. Nursing: monitor ECG in overdose.
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9. Common side effects of SSRIs include:
A. Dry mouth and constipation
B. Sedation and hypotension
C. Sexual dysfunction and GI upset
D. EPS
Answer: C. Sexual dysfunction and GI upset
Rationale: SSRIs inhibit serotonin reuptake in CNS and GI tract.
Sexual dysfunction and nausea are frequent side effects;
anticholinergic effects are minimal.
10.First-line treatment for generalized anxiety disorder (GAD):
A. Benzodiazepines
B. SSRIs
C. TCAs
D. MAOIs
Answer: B. SSRIs
Rationale: SSRIs reduce anxiety through serotonin reuptake
inhibition. Benzodiazepines are second-line due to risk of dependence.
11.Which drug treats depression and aids smoking cessation?
A. Bupropion
B. Venlafaxine
C. Fluoxetine
D. Trazodone
Answer: A. Bupropion
Rationale: Blocks dopamine and norepinephrine reuptake, improves
mood, and reduces nicotine craving. Contraindicated in seizure
disorders.
NSG552 / NSG 552 EXAM 1 (PSYCHOPHARMACOLOGY) 2025/2026
WITH 120 VERIFIED QUESTIONS AND ANSWERS, INCLUDING
RATIONALES FOR 100% CORRECT RESPONSES
1. Which neurotransmitter is primarily responsible for the positive
symptoms of schizophrenia?
A. Serotonin
B. Dopamine
C. GABA
D. Norepinephrine
Answer: B. Dopamine
Rationale: Hyperactivity of dopamine in the mesolimbic pathway is
linked to hallucinations, delusions, and thought disorders. First-
generation antipsychotics block D₂ receptors to reduce positive
symptoms. Excessive blockade can cause extrapyramidal symptoms
(EPS), so monitoring is essential.
2. A patient on haloperidol develops tremor, rigidity, and bradykinesia.
What is the most likely diagnosis?
A. Serotonin syndrome
B. Extrapyramidal symptoms (EPS)
C. Neuroleptic malignant syndrome (NMS)
D. Akathisia
Answer: B. Extrapyramidal symptoms (EPS)
Rationale: FGAs inhibit dopamine in the nigrostriatal pathway,
causing movement disorders such as parkinsonism, dystonia, and
tremor. NMS would include fever and autonomic instability; akathisia
presents as inner restlessness, not rigidity.
,2|Page
3. Which SSRI is most activating and may worsen insomnia?
A. Paroxetine
B. Sertraline
C. Fluoxetine
D. Citalopram
Answer: C. Fluoxetine
Rationale: Fluoxetine has a long half-life and stimulating effect,
which can cause insomnia and anxiety. Administering it in the
morning can reduce sleep disturbances.
4. Early lithium toxicity typically presents with:
A. Hypertension and tachycardia
B. Diarrhea, vomiting, tremors
C. Weight gain and edema
D. Sedation and hypotension
Answer: B. Diarrhea, vomiting, tremors
Rationale: Lithium has a narrow therapeutic window (0.6–1.2
mEq/L). Early toxicity symptoms include GI upset, tremor, lethargy,
and ataxia. Serum levels and renal function must be monitored.
5. Which food should a patient on MAOIs avoid to prevent hypertensive
crisis?
A. Bananas and aged cheese
B. Grapefruit juice
C. Leafy greens
D. Fish
Answer: A. Bananas and aged cheese
Rationale: MAOIs inhibit monoamine oxidase, which metabolizes
tyramine. High-tyramine foods can cause sudden hypertensive crises.
Patient education is critical.
,3|Page
6. Which second-generation antipsychotic has the highest risk of
metabolic syndrome?
A. Risperidone
B. Clozapine
C. Ziprasidone
D. Aripiprazole
Answer: B. Clozapine
Rationale: Clozapine and olanzapine block histamine H1, serotonin 5-
HT2C, and muscarinic receptors, leading to weight gain,
hyperlipidemia, and hyperglycemia. Regular BMI, glucose, and lipid
monitoring is necessary.
7. Mechanism of action of benzodiazepines:
A. Dopamine receptor antagonism
B. GABA-A receptor potentiation
C. Serotonin reuptake inhibition
D. Norepinephrine blockade
Answer: B. GABA-A receptor potentiation
Rationale: Benzodiazepines bind allosterically to GABA-A receptors,
increasing chloride influx and hyperpolarizing neurons, producing
sedation, anxiolysis, and muscle relaxation. Nursing should monitor
for sedation and respiratory depression.
8. Why are TCAs dangerous in overdose?
A. Cause serotonin syndrome
B. Block sodium channels → arrhythmias
C. Cause hypotension through histamine blockade
D. Increase dopamine excessively
Answer: B. Block sodium channels → arrhythmias
Rationale: TCAs inhibit cardiac sodium channels, prolonging QRS
and PR intervals. Overdose may lead to ventricular arrhythmias and
death. Nursing: monitor ECG in overdose.
, 4|Page
9. Common side effects of SSRIs include:
A. Dry mouth and constipation
B. Sedation and hypotension
C. Sexual dysfunction and GI upset
D. EPS
Answer: C. Sexual dysfunction and GI upset
Rationale: SSRIs inhibit serotonin reuptake in CNS and GI tract.
Sexual dysfunction and nausea are frequent side effects;
anticholinergic effects are minimal.
10.First-line treatment for generalized anxiety disorder (GAD):
A. Benzodiazepines
B. SSRIs
C. TCAs
D. MAOIs
Answer: B. SSRIs
Rationale: SSRIs reduce anxiety through serotonin reuptake
inhibition. Benzodiazepines are second-line due to risk of dependence.
11.Which drug treats depression and aids smoking cessation?
A. Bupropion
B. Venlafaxine
C. Fluoxetine
D. Trazodone
Answer: A. Bupropion
Rationale: Blocks dopamine and norepinephrine reuptake, improves
mood, and reduces nicotine craving. Contraindicated in seizure
disorders.
