ANCC Review Questions (PMHNP IQ)
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 - ✔✔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 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.
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 - ✔✔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 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.
