NU664C | NU664C Family Psychiatric Mental
Health Exam 2 Version 1 | Questions with Correct
Answers and Expert Explanation for Each Question
| Regis
1. Which neurotransmitter is primarily implicated in the regulation of mood, sleep,
and appetite and is a frequent target for first-line antidepressant therapy?
A. Serotonin
B. Dopamine
C. GABA
D. Glutamate
Correct Answer: A
Expert Explanation: Serotonin (5-HT) plays a central role in modulating several
psychological and physiological processes including mood stabilization. Selective
Serotonin Reuptake Inhibitors (SSRIs) are the standard first-line treatment for
depression because they increase the availability of this neurotransmitter in the
synaptic cleft. Other neurotransmitters like Dopamine are more closely linked to
reward pathways, while GABA is the primary inhibitory neurotransmitter.
2. A patient taking Lithium for Bipolar Disorder presents with coarse tremors, ataxia,
and confusion. Which of the following should the PMHNP suspect first?
A. Hypothyroidism
,B. Serotonin syndrome
C. Neuroleptic malignant syndrome
D. Lithium toxicity
Correct Answer: D
Expert Explanation: Lithium has a narrow therapeutic index, and levels above 1.5
mEq/L can lead to toxicity symptoms such as coarse tremors and ataxia. The
presence of confusion indicates a potential medical emergency that requires
immediate serum level testing. Serotonin syndrome and NMS present with different
clinical markers such as muscle rigidity and hyperthermia.
3. In the treatment of Schizophrenia, which brain pathway is associated with the
negative symptoms of the disorder, such as apathy and social withdrawal?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Correct Answer: C
Expert Explanation: The mesocortical pathway is believed to be hypoactive in
schizophrenia, leading to negative symptoms and cognitive deficits. In contrast, the
,mesolimbic pathway is associated with positive symptoms like hallucinations due to
dopaminergic overactivity. Understanding these pathways is essential for selecting
antipsychotics that balance receptor blockade.
4. Which of the following antidepressants is contraindicated in patients with a history
of seizure disorders or eating disorders?
A. Fluoxetine
B. Sertraline
C. Venlafaxine
D. Bupropion
Correct Answer: D
Expert Explanation: Bupropion lowers the seizure threshold and is strictly
contraindicated in patients with bulimia or anorexia nervosa due to the high risk of
electrolyte imbalances leading to seizures. It is an NDRI that lacks the sexual side
effects and weight gain common in SSRIs. Clinicians must screen for seizure history
and eating habits before prescribing this medication.
5. What is the mechanism of action for second-generation (atypical) antipsychotics
that differentiates them from first-generation antipsychotics?
A. Pure D2 receptor antagonism
B. GABA receptor agonism
, C. D2 antagonism and 5-HT2A antagonism
D. Norepinephrine reuptake inhibition
Correct Answer: C
Expert Explanation: Second-generation antipsychotics (SGAs) act as both
dopamine D2 antagonists and serotonin 5-HT2A antagonists. This dual action helps
reduce extrapyramidal side effects and potentially treats negative symptoms more
effectively than first-generation agents. First-generation agents primarily focus on
D2 antagonism, which increases the risk of movement disorders.
6. A 10-year-old child presents with persistent irritability and frequent outbursts that
are out of proportion to the situation. Which diagnosis is most likely?
A. Oppositional Defiant Disorder
B. Bipolar I Disorder
C. Disruptive Mood Dysregulation Disorder
D. Conduct Disorder
Correct Answer: C
Expert Explanation: Disruptive Mood Dysregulation Disorder (DMDD) was
introduced in the DSM-5 to address chronic, severe irritability in children under 18.
It is characterized by frequent temper outbursts and a persistent angry mood
Health Exam 2 Version 1 | Questions with Correct
Answers and Expert Explanation for Each Question
| Regis
1. Which neurotransmitter is primarily implicated in the regulation of mood, sleep,
and appetite and is a frequent target for first-line antidepressant therapy?
A. Serotonin
B. Dopamine
C. GABA
D. Glutamate
Correct Answer: A
Expert Explanation: Serotonin (5-HT) plays a central role in modulating several
psychological and physiological processes including mood stabilization. Selective
Serotonin Reuptake Inhibitors (SSRIs) are the standard first-line treatment for
depression because they increase the availability of this neurotransmitter in the
synaptic cleft. Other neurotransmitters like Dopamine are more closely linked to
reward pathways, while GABA is the primary inhibitory neurotransmitter.
2. A patient taking Lithium for Bipolar Disorder presents with coarse tremors, ataxia,
and confusion. Which of the following should the PMHNP suspect first?
A. Hypothyroidism
,B. Serotonin syndrome
C. Neuroleptic malignant syndrome
D. Lithium toxicity
Correct Answer: D
Expert Explanation: Lithium has a narrow therapeutic index, and levels above 1.5
mEq/L can lead to toxicity symptoms such as coarse tremors and ataxia. The
presence of confusion indicates a potential medical emergency that requires
immediate serum level testing. Serotonin syndrome and NMS present with different
clinical markers such as muscle rigidity and hyperthermia.
3. In the treatment of Schizophrenia, which brain pathway is associated with the
negative symptoms of the disorder, such as apathy and social withdrawal?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Correct Answer: C
Expert Explanation: The mesocortical pathway is believed to be hypoactive in
schizophrenia, leading to negative symptoms and cognitive deficits. In contrast, the
,mesolimbic pathway is associated with positive symptoms like hallucinations due to
dopaminergic overactivity. Understanding these pathways is essential for selecting
antipsychotics that balance receptor blockade.
4. Which of the following antidepressants is contraindicated in patients with a history
of seizure disorders or eating disorders?
A. Fluoxetine
B. Sertraline
C. Venlafaxine
D. Bupropion
Correct Answer: D
Expert Explanation: Bupropion lowers the seizure threshold and is strictly
contraindicated in patients with bulimia or anorexia nervosa due to the high risk of
electrolyte imbalances leading to seizures. It is an NDRI that lacks the sexual side
effects and weight gain common in SSRIs. Clinicians must screen for seizure history
and eating habits before prescribing this medication.
5. What is the mechanism of action for second-generation (atypical) antipsychotics
that differentiates them from first-generation antipsychotics?
A. Pure D2 receptor antagonism
B. GABA receptor agonism
, C. D2 antagonism and 5-HT2A antagonism
D. Norepinephrine reuptake inhibition
Correct Answer: C
Expert Explanation: Second-generation antipsychotics (SGAs) act as both
dopamine D2 antagonists and serotonin 5-HT2A antagonists. This dual action helps
reduce extrapyramidal side effects and potentially treats negative symptoms more
effectively than first-generation agents. First-generation agents primarily focus on
D2 antagonism, which increases the risk of movement disorders.
6. A 10-year-old child presents with persistent irritability and frequent outbursts that
are out of proportion to the situation. Which diagnosis is most likely?
A. Oppositional Defiant Disorder
B. Bipolar I Disorder
C. Disruptive Mood Dysregulation Disorder
D. Conduct Disorder
Correct Answer: C
Expert Explanation: Disruptive Mood Dysregulation Disorder (DMDD) was
introduced in the DSM-5 to address chronic, severe irritability in children under 18.
It is characterized by frequent temper outbursts and a persistent angry mood
