ANCC Review Questions & Answers (PMHNP IQ)

ANCC Review Questions (PMHNP IQ) 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 D) Reflection and open-ended questions. C) Techniques to increase arousal Activation is needed to allow memories stored in the amygdala to be processed. The PMHNP knows that the ego is a part of the personality and is the logical/rational mind including defense mechanisms. What might this personality part say? A) "I should" B) "I want" C) "I evaluate" D) "I ought" C) "I evaluate" The ego is the logical and rational mind. The ego monitors the is and would say "I think. I evaluate." Mr. Jones, a 78 year old patient, presents to the PMHNP for a follow-up medication appointment. Mr. Jones' depression has been successfully treated with citalopram 20 mg by mouth daily. During the visit, Mr Jones complains that in the last 2 or 3 weeks, he has had nausea, fatigue, feeling weak, with a headache and decreased appetite. Which action would be most appropriate for Mr. Jones? A) Assess for other symptoms of hyponatremia and check a serum sodium level. B) Discuss SSRI discontinuation syndrome and stress importance of medication adherence. C) Discuss rates of relapse on a SSRI and increase his medication to citalopram 40 mg by mouth daily. D) Discuss rates of relapse on a SSRI and recommend switching his medication to a different class. A) Assess for other symptoms of hyponatremia and check serum sodium level. Hyponatremia can occur on SSRIs, and is more common in elderly patients. This patient is reporting symptoms of moderate hyponatremia and needs to be assessed, and his sodium levels need to be checked. Normal sodium level: 135-145 mEq/L The PMHNP mental health nurse practitioner treating a patient for schizophrenia on ziprasidone orders an electrocardiograph. Which QTc interval result places the patient at greatest risk for torsades de pointes? A) 100-200 milliseconds B) 160-260 milliseconds C) 300-500 milliseconds D) 500-700 milliseconds D) 500-700 milliseconds A patient with a QTc interval of 500-700 milliseconds is at a higher risk of developing torsades de pointes. Which lab test should be ordered to rule out a medical cause of dementia symptoms? A) Albumin B) thiamine C) Vitamin D3 D) Vitamin B12 D) Vitamin B12 Low vitamin B12 levels have been associated with the development of dementa- like symptoms, and when dementia is a differential diagnosis, a Vitamin B12 should be checked. Which of the following lab findings would raise the greatest concern