NSG-552: EXAM 1 [Wilkes University]

What is the primary mechanism of action by which first-generation antipsychotics (FGAs) are thought to exert their therapeutic effects?

✅ A) Antagonism of dopamine D2 receptors.

B) Partial agonism of dopamine D2 receptors.
C) Antagonism of serotonin 5-HT2A receptors.
D) Partial agonism of 5-HT1A receptors.

Which dopamine pathway is primarily associated with the positive symptoms of schizophrenia and is known for its involvement in the experience of reward and pleasure?

A) Mesocortical Pathway
B) Nigrostriatal Pathway
C) Tuberoinfundibular Pathway

✅ D) Mesolimbic Pathway

What effect does the blockade of dopamine (DA) in the Nigrostriatal Pathway produce?

✅ A) Reduced motor movements

B) Increased motor movements
C) Decreased sensory perception
D) Enhanced cognitive function

What medication is considered a first-line treatment for schizophrenia due to its efficacy for both positive and negative symptoms, along with its lower risk of neurological side effects and reduced incidence of tardive dyskinesia?

A) Fluphenazine
B) Haloperidol
C) Perphenazine

✅ D) Olanzapine

A 30-year-old male recently started on paliperidone 2 months ago presents to clinic with complaints of enlarged breasts and sexual dysfunction. Which of the following adverse drug reactions is responsible for these symptoms?

A) Weight gain

✅ B) Hyperprolactinemia

C) Agranulocytosis
D) Anticholinergic effects

FD is a 23-year-old obese male admitted to the inpatient psychiatric ward with a relapse of schizophrenia. He has trialed risperidone but it caused significant weight gain so he self discontinued the medication. All initial lab work and vitals are normal and he has no other disease states. Based off the patient information you have, which of the following would be the most appropriate antipsychotic for this patient?

A) Chlorpromazine
B) Olanzapine
C) Quetiapine

✅ D) Ziprasidone

A 25-year-old male has been brought into the ER by police. He is acutely psychotic and uncooperative, agitated, swinging at staff, and requiring restraints. Which of the following treatment options would be the most appropriate?

✅ A) Haloperidol injection

B) Aripiprazole tablet
C) Paliperidone palmitate
D) Quetiapine tablet

AD is a 36-year-old female diagnosed with schizophrenia being readmitted to your inpatient psychiatric unit. She has failed trials of olanzapine, haloperidol, and aripiprazole and she has been deemed treatment resistant. During this admission she reports worsening depressive symptoms as well and admits to suicidal ideation with a plan. Which of the following treatment options would be most appropriate for AD at this time?