PSYCHIATRIC ASSESSMENT FOR PMHNP
EXAM 2026 COMPREHENSIVE STUDY
GUIDE WITH VERIFIED SOLUTIONS
◉Explain the clinical significance of the Sequenced Treatment
Alternative to Relieve Depression STAR D. Answer: Strong behavioral
therapy combined with medications lead to 30% better outcomes as
compared to monotherapy or medication or therapy alone.
◉Describe the mechanism of action of Typical Antipsychotics.
Answer: Blocking D2 receptors in the mesolimbic and mesocortical
◉The Blocking D2 receptors in the mesolimbic and mesocortical
tract. Answer: tract reducing positive symptoms of psychosis, does
effect the negative symptoms of the disorder, can create EPS
symptoms in the nigro-striatal tract,
◉Nigrostriatal. Answer: involved with muscular movement
◉Mesolimbic. Answer: source of visual hallucinations and auditory
hallucinations,
,◉Mesocortical. Answer: mesocortical area holds affective
symptoms,
◉Second generation antipsychotics are pharmacology directed to.
Answer: blocking both D2 and 5HT receptors in the brain and also
relieve the negative symptoms of psychosi
◉down regulation blocking Alpha ! receptors. Answer: Orthostatic
hypotension and dizziness which comes
◉down regulation of blocking Muscarinic and Histamine receptors.
Answer: Weight gain, dizziness
◉serontin down regulation in the gut. Answer: constipation
◉Neuroleptic malignant syndrome. Answer: cause by increased
medication changes or treatment naive patients
◉What are notable side effects of Clozapine. Answer: Induced by
cigarette smoking which is through the 1A2 pathway
◉Recommended dosing schedule for clozapine. Answer: Start at
12.5 first day,
then in divide doses of 25-50 mg/day up to 300-400 mg per day.
,◉Clozapine maxes. Answer: Maximum dose is 900 mg per day.
No single dose should exceed 450 mg
◉Clozapine monitoring. Answer: Need to register at the clozapine
website as a provider
Normal levels of WBCs > 3500
Normal levels of ANC > 2000
◉wbc. Answer: WBC with differentials, Absolute Neutrophil Count
Blood draws are done weekly for the first 6 months, then every
other week for 6 months, then monthly
◉Notable side effects of Risperidone. Answer: Increase risk of
seizure
Contraindicated for pregnancy
Increased prolactin
◉Metabolic syndrome diagnostic criteria. Answer: Combination of
any three of the following
Abdominal circumference > 37 in males > 31.5 in femaies
Plus any two of the following:
Elevated Triglycerides > 150 mg/dl
, HDL less than 40 mg/dl in men, 50 mg/dl in women
Blood pressure >130/85, or receiving treatment for hypertension
Fasting blood sugar >110 mg/dl or prior type of DM diagnosis
◉A weight increase of 7% should prompt the provider. Answer: to
consider a different medication.
◉Neuroleptic Malignant Syndrome criteria. Answer: Within 2 weeks
of beginning the medication or a significant medication increase / or
present with abrupt withdrawal of levodopa or exposure to a
dopamine agonist
◉Classic triad:. Answer: Hot, Stiff, and Out of it: includes extreme
mental status change/confusion, extreme muscle rigidity, and
extremem autonomic instability/hyperthermia:
◉What is the appropriate treatment for Neuroleptic Malignant
Syndrome. Answer: Dantrolene bromocriptine to relieve rigidity
◉How are TCA metabolized. Answer: the 2D6 pathway
◉The importance of TCA to be aware of:. Answer: Toxicity causes
heart block, torsade de pointes arrythmia or sudden death
EXAM 2026 COMPREHENSIVE STUDY
GUIDE WITH VERIFIED SOLUTIONS
◉Explain the clinical significance of the Sequenced Treatment
Alternative to Relieve Depression STAR D. Answer: Strong behavioral
therapy combined with medications lead to 30% better outcomes as
compared to monotherapy or medication or therapy alone.
◉Describe the mechanism of action of Typical Antipsychotics.
Answer: Blocking D2 receptors in the mesolimbic and mesocortical
◉The Blocking D2 receptors in the mesolimbic and mesocortical
tract. Answer: tract reducing positive symptoms of psychosis, does
effect the negative symptoms of the disorder, can create EPS
symptoms in the nigro-striatal tract,
◉Nigrostriatal. Answer: involved with muscular movement
◉Mesolimbic. Answer: source of visual hallucinations and auditory
hallucinations,
,◉Mesocortical. Answer: mesocortical area holds affective
symptoms,
◉Second generation antipsychotics are pharmacology directed to.
Answer: blocking both D2 and 5HT receptors in the brain and also
relieve the negative symptoms of psychosi
◉down regulation blocking Alpha ! receptors. Answer: Orthostatic
hypotension and dizziness which comes
◉down regulation of blocking Muscarinic and Histamine receptors.
Answer: Weight gain, dizziness
◉serontin down regulation in the gut. Answer: constipation
◉Neuroleptic malignant syndrome. Answer: cause by increased
medication changes or treatment naive patients
◉What are notable side effects of Clozapine. Answer: Induced by
cigarette smoking which is through the 1A2 pathway
◉Recommended dosing schedule for clozapine. Answer: Start at
12.5 first day,
then in divide doses of 25-50 mg/day up to 300-400 mg per day.
,◉Clozapine maxes. Answer: Maximum dose is 900 mg per day.
No single dose should exceed 450 mg
◉Clozapine monitoring. Answer: Need to register at the clozapine
website as a provider
Normal levels of WBCs > 3500
Normal levels of ANC > 2000
◉wbc. Answer: WBC with differentials, Absolute Neutrophil Count
Blood draws are done weekly for the first 6 months, then every
other week for 6 months, then monthly
◉Notable side effects of Risperidone. Answer: Increase risk of
seizure
Contraindicated for pregnancy
Increased prolactin
◉Metabolic syndrome diagnostic criteria. Answer: Combination of
any three of the following
Abdominal circumference > 37 in males > 31.5 in femaies
Plus any two of the following:
Elevated Triglycerides > 150 mg/dl
, HDL less than 40 mg/dl in men, 50 mg/dl in women
Blood pressure >130/85, or receiving treatment for hypertension
Fasting blood sugar >110 mg/dl or prior type of DM diagnosis
◉A weight increase of 7% should prompt the provider. Answer: to
consider a different medication.
◉Neuroleptic Malignant Syndrome criteria. Answer: Within 2 weeks
of beginning the medication or a significant medication increase / or
present with abrupt withdrawal of levodopa or exposure to a
dopamine agonist
◉Classic triad:. Answer: Hot, Stiff, and Out of it: includes extreme
mental status change/confusion, extreme muscle rigidity, and
extremem autonomic instability/hyperthermia:
◉What is the appropriate treatment for Neuroleptic Malignant
Syndrome. Answer: Dantrolene bromocriptine to relieve rigidity
◉How are TCA metabolized. Answer: the 2D6 pathway
◉The importance of TCA to be aware of:. Answer: Toxicity causes
heart block, torsade de pointes arrythmia or sudden death
