ANCC IQ DOMAINS 1-5 TEST BANK LATEST UPDATE
ACTUAL EXAM VERSION
A patient with depression and insomnia is worried about sexual side effects from
medications. The most appropriate medication choice for this patient is:
A. Amitryptiline (Elavil)
B. Sertraline (Zoloft)
C. Trazodone (Desyrel)
D. Mirtazapine (Remeron) - ANSWER: D. Mirtazapine (Remeron)
Mirtazapine causes sexual dysfunction infrequently
Esketamine (Spravato) is classified as a(n):
A. N-methyl-D-aspartate receptor (NMDA) antagonist
B. Dopamine serotonin receptor agonist
C. serotonin norepinephrine dopamine multimodal enzyme inhibitor
D. Dopamine and norepinephrine reuptake inhibitor and releaser. - ANSWER: A. N-
methyl-D-aspartate receptor (NMDA) antagonist
Esketamine (Spravato) is an NMDA receptor antagonist
Which of these medications is excreted unchanged from the body?
A. Olanzapine (Zyprexa)
B. Carbamazepine (Tegretol)
C. Disulfiram (Antabuse)
D. Lithium (Eskalith) - ANSWER: D. Lithium (Eskalith)
Lithium is not metabolized and is excreted unchanged in urine
A 32-year-old separated patient presents for an initial intake. The patient states that
they recently left an abusive relationship; are living alone; and are experiencing fear,
panic, and extreme anxiety. Which brain structure is activated in patients with
severe anxiety as expressed by the patient?
A. Hippocampus
B. Amygdala
C. Cingulate gyrus
D. Thalamus - ANSWER: B. Amygdala
The amygdala is important in mediation of fear, anxiety, and panic
A 62-year-old patient with bipolar 1 disorder has been stable for two years on
valproate and risperidone. The were recently diagnosed with shingles and were
,prescribed corticosteroids. The psychiatric-mental health nurse practitioner is
concerned that the addition of the corticosteroids may cause:
A. Stevens-Johnson syndrome
B. Neuroleptic Malignant syndrome
C. A manic episode
D. a hypertensive crisis - ANSWER: C. A manic episode
Corticosteroids have been known to be a pharmacologic cause of mania
Most serotonin in the brain is generated in the:
A. Nucleus accumbens
B. Raphe Nuclei
C. Presynaptic terminals
D. Hypothalamus - ANSWER: B. Raphe Nuclei
The neurons of the raphe nuclei are the principal source of serotonin release in the
brain
When considering pharmacodynamics involving receptors, the psychiatric-mental
health nurse practitioner (PMHNP) knows that an inverse agonist produces the
following effect:
A. Preventing the agonist from opening the channel and preventing a biological
response
B. Not fully activating the receptor and causing only limited actions
C. Activating a biological response and causing the receptor to open the ion channel
D. Causing the opposite effect of an agonist and causing the receptor to close the ion
channel - ANSWER: D. Causing the opposite effect of an agonist and causing the
receptor to close the ion channel
Inverse agonists do the opposite if agonists. They cause the receptor to close the ion
channel.
A client is suffering from schizophrenia and experiencing side effects. Which of the
following is an appropriate question for the psychiatric-mental health nurse
practitioner to ask when assessing side effects produced by dopamine antagonism in
the tuberoinfundibular pathway?
A. "Are you experiencing breast discharge?"
B. "Are you experiencing dizziness?"
C. "Are you experiencing drooling?"
D. "Are you experiencing tremors?" - ANSWER: A. "Are you experiencing breast
discharge?"
, Galactorrhea, or breast discharge, can result when antipsychotic drugs cause
dopamine blockade in the tuberofundibular pathway.
a patient is diagnosed with schizophrenia and alcoohol use disorder. The effect that
alcohol has on GABA and glutamate in the ventral tegmental area of this patient is
to:
A. Increase glutamate and decrease GABA
B. Increase both GABA and glutamate
C. Decrease both glutamate and GABA
D. Increase GABA and decrease glutamate - ANSWER: D. Increase GABA and
decrease glutamate. Rationale: Alcohol enhances inhibition at GABA synapses and
reduces excitation at glutamate synapses in the ventral tegmental area (VTA)
A week after an increase in dosage of risperidone (Risperdal), a patient treated for
schizophrenia presents to the clinic with reports of an acute change in mental status,
fever, and rigidity. These symptoms are consistent with:
A. Serotonin syndrome
B. Anticholinergic withdrawal syndrome
C. Extrapyramidal side effects
D. Neuroleptic Malignant Syndrome (NMS) - ANSWER: D. Neuroleptic Malignant
Syndrome (NMS)
The patient is presenting with classic symptoms of NMS: acute mental status change,
muscular rigidity, and autonomic instability.
The most active ingredient in cannabis is:
A. Delta-6 tetrahydrocannabinol (THC)
B. Cannabidiol
C. Cannabinol
D. Delta-9 tetrahydrocannabinol (THC) - ANSWER: D. Delta-9 tetrahydrocannabinol
(THC)
The most active ingredient in cannabis is delta-9 THC, which is the chemical
responsible for the psychoactive effects of cannabis.
The psychiatric-mental health nurse practitioner would expect to see which of the
following during a physical exam for a patient with bulimia nervosa?
A. erosion of dental enamel
b. Alopecia areata
C. tachycardia
D. obesity - ANSWER: A. erosion of dental enamel
ACTUAL EXAM VERSION
A patient with depression and insomnia is worried about sexual side effects from
medications. The most appropriate medication choice for this patient is:
A. Amitryptiline (Elavil)
B. Sertraline (Zoloft)
C. Trazodone (Desyrel)
D. Mirtazapine (Remeron) - ANSWER: D. Mirtazapine (Remeron)
Mirtazapine causes sexual dysfunction infrequently
Esketamine (Spravato) is classified as a(n):
A. N-methyl-D-aspartate receptor (NMDA) antagonist
B. Dopamine serotonin receptor agonist
C. serotonin norepinephrine dopamine multimodal enzyme inhibitor
D. Dopamine and norepinephrine reuptake inhibitor and releaser. - ANSWER: A. N-
methyl-D-aspartate receptor (NMDA) antagonist
Esketamine (Spravato) is an NMDA receptor antagonist
Which of these medications is excreted unchanged from the body?
A. Olanzapine (Zyprexa)
B. Carbamazepine (Tegretol)
C. Disulfiram (Antabuse)
D. Lithium (Eskalith) - ANSWER: D. Lithium (Eskalith)
Lithium is not metabolized and is excreted unchanged in urine
A 32-year-old separated patient presents for an initial intake. The patient states that
they recently left an abusive relationship; are living alone; and are experiencing fear,
panic, and extreme anxiety. Which brain structure is activated in patients with
severe anxiety as expressed by the patient?
A. Hippocampus
B. Amygdala
C. Cingulate gyrus
D. Thalamus - ANSWER: B. Amygdala
The amygdala is important in mediation of fear, anxiety, and panic
A 62-year-old patient with bipolar 1 disorder has been stable for two years on
valproate and risperidone. The were recently diagnosed with shingles and were
,prescribed corticosteroids. The psychiatric-mental health nurse practitioner is
concerned that the addition of the corticosteroids may cause:
A. Stevens-Johnson syndrome
B. Neuroleptic Malignant syndrome
C. A manic episode
D. a hypertensive crisis - ANSWER: C. A manic episode
Corticosteroids have been known to be a pharmacologic cause of mania
Most serotonin in the brain is generated in the:
A. Nucleus accumbens
B. Raphe Nuclei
C. Presynaptic terminals
D. Hypothalamus - ANSWER: B. Raphe Nuclei
The neurons of the raphe nuclei are the principal source of serotonin release in the
brain
When considering pharmacodynamics involving receptors, the psychiatric-mental
health nurse practitioner (PMHNP) knows that an inverse agonist produces the
following effect:
A. Preventing the agonist from opening the channel and preventing a biological
response
B. Not fully activating the receptor and causing only limited actions
C. Activating a biological response and causing the receptor to open the ion channel
D. Causing the opposite effect of an agonist and causing the receptor to close the ion
channel - ANSWER: D. Causing the opposite effect of an agonist and causing the
receptor to close the ion channel
Inverse agonists do the opposite if agonists. They cause the receptor to close the ion
channel.
A client is suffering from schizophrenia and experiencing side effects. Which of the
following is an appropriate question for the psychiatric-mental health nurse
practitioner to ask when assessing side effects produced by dopamine antagonism in
the tuberoinfundibular pathway?
A. "Are you experiencing breast discharge?"
B. "Are you experiencing dizziness?"
C. "Are you experiencing drooling?"
D. "Are you experiencing tremors?" - ANSWER: A. "Are you experiencing breast
discharge?"
, Galactorrhea, or breast discharge, can result when antipsychotic drugs cause
dopamine blockade in the tuberofundibular pathway.
a patient is diagnosed with schizophrenia and alcoohol use disorder. The effect that
alcohol has on GABA and glutamate in the ventral tegmental area of this patient is
to:
A. Increase glutamate and decrease GABA
B. Increase both GABA and glutamate
C. Decrease both glutamate and GABA
D. Increase GABA and decrease glutamate - ANSWER: D. Increase GABA and
decrease glutamate. Rationale: Alcohol enhances inhibition at GABA synapses and
reduces excitation at glutamate synapses in the ventral tegmental area (VTA)
A week after an increase in dosage of risperidone (Risperdal), a patient treated for
schizophrenia presents to the clinic with reports of an acute change in mental status,
fever, and rigidity. These symptoms are consistent with:
A. Serotonin syndrome
B. Anticholinergic withdrawal syndrome
C. Extrapyramidal side effects
D. Neuroleptic Malignant Syndrome (NMS) - ANSWER: D. Neuroleptic Malignant
Syndrome (NMS)
The patient is presenting with classic symptoms of NMS: acute mental status change,
muscular rigidity, and autonomic instability.
The most active ingredient in cannabis is:
A. Delta-6 tetrahydrocannabinol (THC)
B. Cannabidiol
C. Cannabinol
D. Delta-9 tetrahydrocannabinol (THC) - ANSWER: D. Delta-9 tetrahydrocannabinol
(THC)
The most active ingredient in cannabis is delta-9 THC, which is the chemical
responsible for the psychoactive effects of cannabis.
The psychiatric-mental health nurse practitioner would expect to see which of the
following during a physical exam for a patient with bulimia nervosa?
A. erosion of dental enamel
b. Alopecia areata
C. tachycardia
D. obesity - ANSWER: A. erosion of dental enamel
