Page 1 of 176
ANCC IQ DOMAINS 1-5 Psychiatric-Mental
Health Nurse Questions & Correct Verified
Answers 100% Guaranteed Pass
||Complete A+ Guide
1. A patient with schizophrenia has refractory auditory
hallucinations. Which neurotransmitter system is the
primary target for augmentation?
• A) GABA
• B) Glutamate
• C) Serotonin (5-HT2A)
• D) Dopamine (D2)
Answer: B (Glutamate)
*Rationale: Refractory symptoms may respond to
,Page 2 of 176
glutamate modulators (e.g., glycine, sarcosine). D2
blockade is first-line but not always sufficient.*
2. A PMHNP prescribes fluoxetine. The patient reports
nausea and insomnia. This is most likely due to which
receptor effect?
• A) 5-HT2C antagonism
• B) 5-HT3 activation
• C) Histamine H1 blockade
• D) Alpha-1 antagonism
Answer: B (5-HT3 activation)
*Rationale: SSRIs increase serotonin, activating 5-HT3
receptors in the gut and brainstem → nausea, GI
distress.*
3. (Scenario) A 68-year-old with Parkinson’s disease
develops visual hallucinations of small animals. He takes
carbidopa/levodopa. What is the most likely cause?
,Page 3 of 176
• A) Dopamine deficiency in mesocortical pathway
• B) Excess dopamine in mesolimbic pathway
• C) Acetylcholine excess
• D) Serotonin toxicity
Answer: B
Rationale: Dopaminergic medications overstimulate
mesolimbic D2 receptors → psychosis.
4. Which anticonvulsant is most associated with
hyponatremia in older adults?
• A) Lamotrigine
• B) Oxcarbazepine
• C) Valproate
• D) Gabapentin
Answer: B (Oxcarbazepine)
Rationale: Carbamazepine and oxcarbazepine cause
SIADH → hyponatremia, especially in elderly.
, Page 4 of 176
5. A patient on clozapine develops fever, tachycardia, and
k k k k k k k
k rigidmuscles.Whatisthepriority action?
k k k k k k
• A) Draw CK and hold clozapine
k k k k k
• B) Give diphenhydramine
k k
• C) Increase clozapine dose
k k k
• D)Order EEG k k
Answer: A k
Rationale: Suspect neuroleptic malignant syndrome (NMS).
k k k k k
k Holdantipsychotic,monitorCK,transfertomedicalunit.
k k k k k k k
6. Which receptor blockade is most responsible for weight
k k k k k k k
gainwitholanzapine?
k k k
• A) D2 k
• B) 5-HT2A
k
• C) H1 k
• D)M1 k
Answer: C (H1) k k
ANCC IQ DOMAINS 1-5 Psychiatric-Mental
Health Nurse Questions & Correct Verified
Answers 100% Guaranteed Pass
||Complete A+ Guide
1. A patient with schizophrenia has refractory auditory
hallucinations. Which neurotransmitter system is the
primary target for augmentation?
• A) GABA
• B) Glutamate
• C) Serotonin (5-HT2A)
• D) Dopamine (D2)
Answer: B (Glutamate)
*Rationale: Refractory symptoms may respond to
,Page 2 of 176
glutamate modulators (e.g., glycine, sarcosine). D2
blockade is first-line but not always sufficient.*
2. A PMHNP prescribes fluoxetine. The patient reports
nausea and insomnia. This is most likely due to which
receptor effect?
• A) 5-HT2C antagonism
• B) 5-HT3 activation
• C) Histamine H1 blockade
• D) Alpha-1 antagonism
Answer: B (5-HT3 activation)
*Rationale: SSRIs increase serotonin, activating 5-HT3
receptors in the gut and brainstem → nausea, GI
distress.*
3. (Scenario) A 68-year-old with Parkinson’s disease
develops visual hallucinations of small animals. He takes
carbidopa/levodopa. What is the most likely cause?
,Page 3 of 176
• A) Dopamine deficiency in mesocortical pathway
• B) Excess dopamine in mesolimbic pathway
• C) Acetylcholine excess
• D) Serotonin toxicity
Answer: B
Rationale: Dopaminergic medications overstimulate
mesolimbic D2 receptors → psychosis.
4. Which anticonvulsant is most associated with
hyponatremia in older adults?
• A) Lamotrigine
• B) Oxcarbazepine
• C) Valproate
• D) Gabapentin
Answer: B (Oxcarbazepine)
Rationale: Carbamazepine and oxcarbazepine cause
SIADH → hyponatremia, especially in elderly.
, Page 4 of 176
5. A patient on clozapine develops fever, tachycardia, and
k k k k k k k
k rigidmuscles.Whatisthepriority action?
k k k k k k
• A) Draw CK and hold clozapine
k k k k k
• B) Give diphenhydramine
k k
• C) Increase clozapine dose
k k k
• D)Order EEG k k
Answer: A k
Rationale: Suspect neuroleptic malignant syndrome (NMS).
k k k k k
k Holdantipsychotic,monitorCK,transfertomedicalunit.
k k k k k k k
6. Which receptor blockade is most responsible for weight
k k k k k k k
gainwitholanzapine?
k k k
• A) D2 k
• B) 5-HT2A
k
• C) H1 k
• D)M1 k
Answer: C (H1) k k
