ANCC Review Questions (PMHNP IQ) Qbank answered
all correctly answered; latest updated summer 2022
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) Correct Answer: 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 Correct Answer: 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.
Correct Answer: 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) Correct Answer: 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
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. Correct Answer: 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?
all correctly answered; latest updated summer 2022
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) Correct Answer: 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 Correct Answer: 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.
Correct Answer: 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) Correct Answer: 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
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. Correct Answer: 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?
