ANCC Review Questions and
Answers(PMHNP IQ)(Latest 2022/2023
updated questions with complete
solution)
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? - Correct Answer 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? - Correct Answer 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? - Correct Answer 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? - Correct Answer 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? - 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? - Correct Answer 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 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? - Correct Answer
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? - Correct Answer 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? - Correct Answer 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? - Correct
Answer "I evaluate"
The ego is the logical and rational mind. The ego monitors the is and would say "I think.
I evaluate."
Answers(PMHNP IQ)(Latest 2022/2023
updated questions with complete
solution)
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? - Correct Answer 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? - Correct Answer 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? - Correct Answer 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? - Correct Answer 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? - 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? - Correct Answer 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 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? - Correct Answer
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? - Correct Answer 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? - Correct Answer 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? - Correct
Answer "I evaluate"
The ego is the logical and rational mind. The ego monitors the is and would say "I think.
I evaluate."
