NURS 660 PSYCHOPHARM FINAL EXAM MARYVILLE UNIVERSITY 2 VERSIONS (VERSION A AND B) CURRENTLY TESTING COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS (100% CORRECT ANSWERS) |ALREADY GRADED A+

NURS 660 PSYCHOPHARM FINAL EXAM MARYVILLE UNIVERSITY 2 VERSIONS (VERSION A
AND B) CURRENTLY TESTING COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS
(100% CORRECT ANSWERS) |ALREADY GRADED A+

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Minimum ANC level to prescribe Clozapine, general population: -(ANSWER)1,500 μL


Severe Neutropenia -(ANSWER)< 500μL


Moderate Neutropenia -(ANSWER)500-999μL


Mild Neutropenia -(ANSWER)1000-1499μL


BEN patients: Normal ANC range for Clozaril -(ANSWER)≥1,000 μL


Clozaril BEN patient: severe neutropenia -(ANSWER)<500 μL


BEN neutropenia -(ANSWER)500-999 μL


Lower ANC threshold for starting clozapine: General population -(ANSWER)≥1,500/μL


Lower ANC threshold for starting clozapine: Benign ethnic neutropenia (BEN) -
(ANSWER)1,000/μL


Medical emergencies when prescribing anti-psychotics -(ANSWER)- NMS
- Agranulocytosis
- Serotonin Syndrome

,NURS 660 PSYCHOPHARM FINAL EXAM MARYVILLE UNIVERSITY 2 VERSIONS (VERSION A
AND B) CURRENTLY TESTING COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS
(100% CORRECT ANSWERS) |ALREADY GRADED A+

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Clinical findings in agranulocytosis -(ANSWER)


Clozaril: most likely side effect if pt develops fever within 6 weeks -(ANSWER)Myocarditis


Clozaril: if pt develops fever within 6 weeks order a ______, _________ and _______. -
(ANSWER)EKG, CRP, Troponin, as this is likely due to myocarditis


Common complaints in patients with neutropenia:
F,P, U, P -(ANSWER)- Fever (low grade)
- painful swallowing (odynophagia)
- URI (sinusitis, otitis, cough)
- Perirectal pain/irritation


Symptoms of neuroleptic malignant syndrome (NMS): -(ANSWER)- High fever
- Tachycardia/irregular pulse
- Increased respiratory rate
- Muscle Rigidity
- altered mental status


Off label TX for NMS -(ANSWER)Amantadine (SYMMETREL)

,NURS 660 PSYCHOPHARM FINAL EXAM MARYVILLE UNIVERSITY 2 VERSIONS (VERSION A
AND B) CURRENTLY TESTING COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS
(100% CORRECT ANSWERS) |ALREADY GRADED A+

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



Serotonin Syndrome onset: -(ANSWER)-24 hours of combining antidepressants


Serotonin Syndrome Cardinal features -(ANSWER)- Myoclonic jerks
- Hyperreflexia
- Mental status changes
- Shivering
- Fever
- Tachycardia, HTN, hypotension (AUTONOMIC instability)
- Confused/ restless/ hyperactive/ unresponsive


Management of Serotonin syndrome -(ANSWER)- Discontinue meds, stablize vitals


Potentially
helpful meds with Serotonin syndrome: -(ANSWER)Benzodiazepines for agitation
Cyproheptadine (anti-serotonergic antihistamine)
Methysergide (anti-serotonergic migraine medication)


5-HT "TWITCHY FROG" Serotonin Syndrome -(ANSWER)-Agitated
-Sweating
-Fever
-Hyperreflexia
-Dilated pupils

, NURS 660 PSYCHOPHARM FINAL EXAM MARYVILLE UNIVERSITY 2 VERSIONS (VERSION A
AND B) CURRENTLY TESTING COMPLETE QUESTIONS AND CORRECT DETAILED ANSWERS
(100% CORRECT ANSWERS) |ALREADY GRADED A+

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








Neuroleptic Malignant Syndrome -(ANSWER)a potentially fatal hyperpyrexia with temp of over
104, looks like EPS except for temp


Neuroleptic Malignant Syndrome- "can't bender(er)" -(ANSWER)Life-threatening muscle
rigidity, fever, and rhabdomyolysis.
Mental status changes


Mechanism of NMS.
-What's blocked? Where (2)? -(ANSWER)Dopamine blockade in the hypothalamus (fever)
and nigrostriatal pathway (rigidity


Onset of NMS -(ANSWER)30 days of starting or increasing antipsychotics or stoping a
domaminergic drug


NMS cardinal features -(ANSWER)High fever 100% by definition
Rigidity 100% by definition
Mental status changes 99%
Elevated or labile BP most


NMS motor activity -(ANSWER)Bradykinesia