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

NURS 660 PSYCHOPHARM EXAM 2 MARYVILLE UNIVERSITY 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


Clinical findings in agranulocytosis(ANSWER)

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

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




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)


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


Serotonin Syndrome Cardinal features(ANSWER)- Myoclonic jerks
- Hyperreflexia

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

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



- 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


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.

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

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



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


Brain regions affected by schizophrenia (aggression and impulse control)
(2)(ANSWER)Orbitofrontal cortex and amygdala


Pathways affected by schizophrenia (4):
MMTN(ANSWER)-Mesolimbic
- Mesocortical
-Tuberoinfundibular
-Nigrostriatal