lOMoARcPSD|65953097
ANCC (PMHNP IQ) Exam Study
Guide – Practice Questions with
Verified Answers with
Rationales. GRADED A+. Latest
2026/2027 Update
What direct-acting dopamine receptor agonist is recommended to be used in the
treatments of neuroleptic malignant syndrome (NMS) fo help lower the dopamine
blockade?
A) benzotropine (Cogentin)
B) bromocriptine (Parlodel)C) dantrolene (Dantrium)
D) trihexyphenidyl (Artane)
A) Bromocriptine (Parlodel) is the recommended direct acting dopamine receptor
agonist to help decrease the dopamine blockade. Danrolene (Dantrium) is a
muscle relaxant. Benzotropine (Cogentin) and Trihexyphenidyl (Artane) are
anticholinergic medications used for extrapyramidal side effects (EPS).
Mr. Smith is a 56 year old white male who has been successfully treated on
Selegiline for over 4 years. Mr. Smith is going in for elective surgical procedure.
Which medication is strictly contraindicated with Selegiline?
A) Non-steroidal anti-inflammatory drugs (NSAIDS)
B) Codeine
C) Morphine
D) Meperidine
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D) Meperidine is strictly prohibited when a patient is treated on a monoamine
oxidase inhibitor (MAOI) due to the risk of hypertensive crisis and death.
A WBC of 4,000 in a patient taking Clozapine would prompt the PMHNP to take
which of the following actions?
A) Consult with hematologist to determine appropriate antibiotic regimen and
monitor closely.
B) Institute twice-weekly complete blood count with differentials and monitor
closely.
C) Discontinue clozapine, initiate alternative antipsychotic medication and monitor
closely.
D) Institute daily complete blood count with differentials and monitor closely.
B) Institute twice-weekly complete blood count with differentials and monitor
closely.
The recommended cut-points for discontinuation of clozapine are WBC of 2,000 to
3,000 or granulocytes of 1,000 to 1,500 for agranulocytosis and severely
compromised immune system. At a WBC of 4,000, the recommendation is to
closely monitor CBC with differential twice a week while patient may continue
clozapine in the absence of any other signs or symptoms.
A patient with a diagnosis of schizophrenia has a history of suicidal ideation and
suicide attempts. The PMHNP should consider which antipsychotic medication
that is the only antipsychotic to reduce the risk of suicide in schizophrenia?
A) Abilify (aripriprazole)
B) Latuda (lurasidone)
C) Invega (iloperidone)D) Clozaril (clozapine)
D) Clozaril (clozapine) is the only known antipsychotic medication that had been
shown to reduce the risk of suicide in patients diagnosed with schizophrenia.
A patient being treated for major depressive disorder and on sertraline (Zoloft),
150 mg po daily for the past 16 years, presents to the psychiatric mental health
practitioner for an outpatient follow-up visit. During the visit she states that she
has not been feeling well, reporting the flu. She also states she has not taken her
medication in the last five days. Which of the following symptoms would she be
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, lOMoARcPSD|65953097
describing if you suspect selective serotonin reputable inhibitors (SSRIs)
discontinuation syndrome?
A) Agitation, nausea, dysphoria, and diequilibrium
B) Agitation, nausea, tremor, and ataxia.
C) Restlessness, tremor, fever, and shivering.
D) Restlessness, headache, increased heart rate, and diarrhea.
A) Agitation; nausea, dysphoria, and disequilibrium
The patient has SSRI discontinuation syndrome and would be presenting with flu-
like symptoms. If the patient had serotonin syndrome, she would present with
symptoms of autonomic instability.
Which of the following statements reflect the current understanding of dopamine
(DA) pathways and clinical symptoms in schizophrenia?
A) Negative symptoms are related to DA deficit in the cerebral cortex; positive
symptoms are related to DA excess in the nucleus accumbens and mesolimbic
system.
B) Negative symptoms are related to DA excess in the cerebral cortex; positive
symptoms are related to DA deficit in the nucleus accumbens and mesolimbic
system.
C) Negative symptoms are related to DA excess in the mesolimbic system;
positive symptoms are related to DA deficit in the substantia nigra and ventral
tegmental area.
Negative symptoms are related to DA deficit in the mesolimbic system; positive
symptoms are related to DA excess in the substantia nigra and ventral tegmental
area.
A) Negative symptoms are related to DA deficit in the cerebral cortex; positive
symptoms are related to DA excess in the nucleus accumbens and mesolimbic
system.
Negative symptoms & cognitive impairment are thought to be related to
hypoactivity of the mesocortical dopiminergic tract, which by its association with
Downloaded by Samuel Samie ()
, lOMoARcPSD|65953097
the prefrontal cortex and neocortex contributes to motivation, planning,
sequencing of behaviors in time, attention, and social behavior. Positive symptoms
(hallucination and delusions) are thought to be caused by dopamine hyperactivity
in the mesolimbic tract, which regulates emotion. This hyperactivity could result
in overactive modulation of nueurotransmission from the nucleus accumbens.
Norepinephrine is a neurotransmitter that is implicated in alertness and anxiety.
What area of the brain has a large majority of norepinephrine neurons?
A) Amygdala
B) Hippocampus
C) Locus Coeruleus
D) Nucleus Accumbens
C) Locus coeruleus
There are two areas in the brain that produce norepinephrine neurons, one is the
locus coeruleus and the other is the medullary reticular formation.
Which cytochrome (CYP) enzyme is implicated as a tobacco inducer when an
individual is treated on clozapine?
A) 1A2
B) 2D6
C) 2C9
D) 2C19
A) 1A2
When an individual is treated on clozapine and decreases tobacco use, the
clozapine level with increase, as tobacco is an inducer to the clozapine, and the
patient no longer needs the higher dose of clozapine.
When working with an avoidant patient with a history of trauma, what type of
communication techniques are helpful?
A) Techniques to decrease arousal
B) Clarification and close-ended questions
C) Techniques to increase arousal
Downloaded by Samuel Samie
ANCC (PMHNP IQ) Exam Study
Guide – Practice Questions with
Verified Answers with
Rationales. GRADED A+. Latest
2026/2027 Update
What direct-acting dopamine receptor agonist is recommended to be used in the
treatments of neuroleptic malignant syndrome (NMS) fo help lower the dopamine
blockade?
A) benzotropine (Cogentin)
B) bromocriptine (Parlodel)C) dantrolene (Dantrium)
D) trihexyphenidyl (Artane)
A) Bromocriptine (Parlodel) is the recommended direct acting dopamine receptor
agonist to help decrease the dopamine blockade. Danrolene (Dantrium) is a
muscle relaxant. Benzotropine (Cogentin) and Trihexyphenidyl (Artane) are
anticholinergic medications used for extrapyramidal side effects (EPS).
Mr. Smith is a 56 year old white male who has been successfully treated on
Selegiline for over 4 years. Mr. Smith is going in for elective surgical procedure.
Which medication is strictly contraindicated with Selegiline?
A) Non-steroidal anti-inflammatory drugs (NSAIDS)
B) Codeine
C) Morphine
D) Meperidine
Downloaded by Samuel Samie ()
, lOMoARcPSD|65953097
D) Meperidine is strictly prohibited when a patient is treated on a monoamine
oxidase inhibitor (MAOI) due to the risk of hypertensive crisis and death.
A WBC of 4,000 in a patient taking Clozapine would prompt the PMHNP to take
which of the following actions?
A) Consult with hematologist to determine appropriate antibiotic regimen and
monitor closely.
B) Institute twice-weekly complete blood count with differentials and monitor
closely.
C) Discontinue clozapine, initiate alternative antipsychotic medication and monitor
closely.
D) Institute daily complete blood count with differentials and monitor closely.
B) Institute twice-weekly complete blood count with differentials and monitor
closely.
The recommended cut-points for discontinuation of clozapine are WBC of 2,000 to
3,000 or granulocytes of 1,000 to 1,500 for agranulocytosis and severely
compromised immune system. At a WBC of 4,000, the recommendation is to
closely monitor CBC with differential twice a week while patient may continue
clozapine in the absence of any other signs or symptoms.
A patient with a diagnosis of schizophrenia has a history of suicidal ideation and
suicide attempts. The PMHNP should consider which antipsychotic medication
that is the only antipsychotic to reduce the risk of suicide in schizophrenia?
A) Abilify (aripriprazole)
B) Latuda (lurasidone)
C) Invega (iloperidone)D) Clozaril (clozapine)
D) Clozaril (clozapine) is the only known antipsychotic medication that had been
shown to reduce the risk of suicide in patients diagnosed with schizophrenia.
A patient being treated for major depressive disorder and on sertraline (Zoloft),
150 mg po daily for the past 16 years, presents to the psychiatric mental health
practitioner for an outpatient follow-up visit. During the visit she states that she
has not been feeling well, reporting the flu. She also states she has not taken her
medication in the last five days. Which of the following symptoms would she be
Downloaded by Samuel Samie
, lOMoARcPSD|65953097
describing if you suspect selective serotonin reputable inhibitors (SSRIs)
discontinuation syndrome?
A) Agitation, nausea, dysphoria, and diequilibrium
B) Agitation, nausea, tremor, and ataxia.
C) Restlessness, tremor, fever, and shivering.
D) Restlessness, headache, increased heart rate, and diarrhea.
A) Agitation; nausea, dysphoria, and disequilibrium
The patient has SSRI discontinuation syndrome and would be presenting with flu-
like symptoms. If the patient had serotonin syndrome, she would present with
symptoms of autonomic instability.
Which of the following statements reflect the current understanding of dopamine
(DA) pathways and clinical symptoms in schizophrenia?
A) Negative symptoms are related to DA deficit in the cerebral cortex; positive
symptoms are related to DA excess in the nucleus accumbens and mesolimbic
system.
B) Negative symptoms are related to DA excess in the cerebral cortex; positive
symptoms are related to DA deficit in the nucleus accumbens and mesolimbic
system.
C) Negative symptoms are related to DA excess in the mesolimbic system;
positive symptoms are related to DA deficit in the substantia nigra and ventral
tegmental area.
Negative symptoms are related to DA deficit in the mesolimbic system; positive
symptoms are related to DA excess in the substantia nigra and ventral tegmental
area.
A) Negative symptoms are related to DA deficit in the cerebral cortex; positive
symptoms are related to DA excess in the nucleus accumbens and mesolimbic
system.
Negative symptoms & cognitive impairment are thought to be related to
hypoactivity of the mesocortical dopiminergic tract, which by its association with
Downloaded by Samuel Samie ()
, lOMoARcPSD|65953097
the prefrontal cortex and neocortex contributes to motivation, planning,
sequencing of behaviors in time, attention, and social behavior. Positive symptoms
(hallucination and delusions) are thought to be caused by dopamine hyperactivity
in the mesolimbic tract, which regulates emotion. This hyperactivity could result
in overactive modulation of nueurotransmission from the nucleus accumbens.
Norepinephrine is a neurotransmitter that is implicated in alertness and anxiety.
What area of the brain has a large majority of norepinephrine neurons?
A) Amygdala
B) Hippocampus
C) Locus Coeruleus
D) Nucleus Accumbens
C) Locus coeruleus
There are two areas in the brain that produce norepinephrine neurons, one is the
locus coeruleus and the other is the medullary reticular formation.
Which cytochrome (CYP) enzyme is implicated as a tobacco inducer when an
individual is treated on clozapine?
A) 1A2
B) 2D6
C) 2C9
D) 2C19
A) 1A2
When an individual is treated on clozapine and decreases tobacco use, the
clozapine level with increase, as tobacco is an inducer to the clozapine, and the
patient no longer needs the higher dose of clozapine.
When working with an avoidant patient with a history of trauma, what type of
communication techniques are helpful?
A) Techniques to decrease arousal
B) Clarification and close-ended questions
C) Techniques to increase arousal
Downloaded by Samuel Samie
