ANCC IQ domain 3
Study online at https://quizlet.com/_a1pund
1. 1. The PMHNP treating a patient for schiz- - 500-700 milliseconds
ophrenia on ziprasidone orders an electro- Rationale: A patient with a QTc interval
cardiogram. Which QTc interval result places of 500-700 milliseconds is at higher
the patient at greatest risk for torsades de risk of developing torsades de pointes.
pointes?
- 300-500 milliseconds
- 500-700 milliseconds
- 160-260 milliseconds
- 100-200 milliseconds
2. 1. A patient with a diagnosis of schizophre- - Clozaril (clozapine)
nia has a history of suicidal ideation and sui- Rationale: Clozaril (clozapine) is the
cide attempts. The PMHNP should consider only known antipsychotic medication
which antipsychotic medication that is the only that has been shown to reduce the risk
known antipsychotic to reduce the risk of sui- of suicide in patients diagnosed with
cide in schizophrenia? schizophrenia.
- Invega (iloperidone)
- Abilify (aripiprazole)
- Latuda (lurasidone)
- Clozaril (clozapine)
3. 1. A WBC of 4,000 in a patient taking clozapine - Institute twice-weekly complete blood
would prompt the PMHNP to take which of the count with differentials and monitor
following actions? closely.
- Discontinue clozapine, initiate alternative an- Rationale: The recommended
tipsychotic medication and monitor closely. cut-points for discontinuation of cloza-
- Institute daily complete blood count with dif- pine are WBC of 2,000 to 3,000 or
ferentials and monitor closely. granulocytes of 1,000 to 1,500 for
- Consult with hematologist to determine agranulocytosis and severely compro-
appropriate antibiotic regimen and monitor mised immune system. At a WBC of
closely. 4,000, the recommendation is to close-
ly monitor CBC with differential twice a
, ANCC IQ domain 3
Study online at https://quizlet.com/_a1pund
- Institute twice-weekly complete blood count week while patient may continue cloza-
with differentials and monitor closely. pine in the absence of any other signs
or symptoms.
4. 1. When evaluating a woman with major de- - Prior pregnancies
pressive disorder, which of the following would Rationale: The primary concern is to
not be a major consideration in the differential rule out bipolar disorder whenever
diagnosis? making diagnosis of major depres-
- Prior episodes of depression sive disorder. Asking about any prior
- Any episodes of hypomania episodes of mania, hypomania, and
- Any periods without sleep yet no fatigue extended periods of 2-3 days with little
- Prior pregnancies to no sleep while still not feeling fa-
tigued, or period of heightened energy
lasting several days without fatigue are
indicative of possible bipolar disorder.
Asking about prior episodes of depres-
sion, mood swings, and chronic irri-
tability is also indicated. Prior pregnan-
cies are not the relevant information
needed, but whether she experienced
any episodes of postpartum depres-
sion and the severity of any episodes.
5. 1. Electroconvulsive therapy (ECT) is a treat- - Fractures
ment of depression. What adverse effect is Rationale: Headaches, memory distur-
uncommon for a patient to experience after bance, and muscle soreness are com-
receiving ECT treatments? mon immediately after ECT treatment.
- Muscle soreness
- Headaches
- Fractures
- Memory disturbance
, ANCC IQ domain 3
Study online at https://quizlet.com/_a1pund
6. 1. An 88-year-old nursing home patient pre- - Blood chemistry, complete blood
sents to the emergency department with re- count, and urinalysis
cent mental status changes, including aggres- Rationale: A bedside MMSE can be
sion, confusion, and dizziness, over the past used to document the cognitive im-
two days. The patient scored a 20 on the pairment and to provide a baseline
MINI-Mental Status Exam (MMSE). In addition form which to measure the patient's
to the MMSE, what additional information is clinical course. The laboratory workup
needed to conduct a thorough evaluation? of a patient should include standard
- Blood chemistry, complete blood count, and tests (i.e., blood chemistries, CBC, uri-
urinalysis nalysis) and additional studies indicat-
- Patient Health Questionnaire (PHQ-9) score ed by the clinical situation.
- Hamilton Depression Scale (HAM-D) score
- Electrocardiography and pharmacogenomics
testing
7. 1. A client says that because he wished his - Schizotypal personality disorder
sister was dead, and your client's sister subse- Rationale: Schizotypal personality dis-
quently was killed in a motor vehicle accident, order is characterized by ideas of ref-
the death was caused by the client's wishes. erence and magical thinking.
The client also revealed that he can reach oth-
er's minds. This client is most likely suffering
from which personality disorder?
- Paranoid personality disorder
- Schizotypal personality disorder
- Schizoid personality disorder
- Delusional personality disorder
8. 1. In the American Journal of Psychiatry, you - Analyze the original and repeat stud-
read an article that discusses a recent study's ies for methodical rigor and verify that
evidence that the nicotine exposure in preg- there were randomized or non-ran-
nant women increases the risk for schizophre- domized clinical trials with the same
nia in offspring (i.e., 38% increased likelihood results.
Study online at https://quizlet.com/_a1pund
1. 1. The PMHNP treating a patient for schiz- - 500-700 milliseconds
ophrenia on ziprasidone orders an electro- Rationale: A patient with a QTc interval
cardiogram. Which QTc interval result places of 500-700 milliseconds is at higher
the patient at greatest risk for torsades de risk of developing torsades de pointes.
pointes?
- 300-500 milliseconds
- 500-700 milliseconds
- 160-260 milliseconds
- 100-200 milliseconds
2. 1. A patient with a diagnosis of schizophre- - Clozaril (clozapine)
nia has a history of suicidal ideation and sui- Rationale: Clozaril (clozapine) is the
cide attempts. The PMHNP should consider only known antipsychotic medication
which antipsychotic medication that is the only that has been shown to reduce the risk
known antipsychotic to reduce the risk of sui- of suicide in patients diagnosed with
cide in schizophrenia? schizophrenia.
- Invega (iloperidone)
- Abilify (aripiprazole)
- Latuda (lurasidone)
- Clozaril (clozapine)
3. 1. A WBC of 4,000 in a patient taking clozapine - Institute twice-weekly complete blood
would prompt the PMHNP to take which of the count with differentials and monitor
following actions? closely.
- Discontinue clozapine, initiate alternative an- Rationale: The recommended
tipsychotic medication and monitor closely. cut-points for discontinuation of cloza-
- Institute daily complete blood count with dif- pine are WBC of 2,000 to 3,000 or
ferentials and monitor closely. granulocytes of 1,000 to 1,500 for
- Consult with hematologist to determine agranulocytosis and severely compro-
appropriate antibiotic regimen and monitor mised immune system. At a WBC of
closely. 4,000, the recommendation is to close-
ly monitor CBC with differential twice a
, ANCC IQ domain 3
Study online at https://quizlet.com/_a1pund
- Institute twice-weekly complete blood count week while patient may continue cloza-
with differentials and monitor closely. pine in the absence of any other signs
or symptoms.
4. 1. When evaluating a woman with major de- - Prior pregnancies
pressive disorder, which of the following would Rationale: The primary concern is to
not be a major consideration in the differential rule out bipolar disorder whenever
diagnosis? making diagnosis of major depres-
- Prior episodes of depression sive disorder. Asking about any prior
- Any episodes of hypomania episodes of mania, hypomania, and
- Any periods without sleep yet no fatigue extended periods of 2-3 days with little
- Prior pregnancies to no sleep while still not feeling fa-
tigued, or period of heightened energy
lasting several days without fatigue are
indicative of possible bipolar disorder.
Asking about prior episodes of depres-
sion, mood swings, and chronic irri-
tability is also indicated. Prior pregnan-
cies are not the relevant information
needed, but whether she experienced
any episodes of postpartum depres-
sion and the severity of any episodes.
5. 1. Electroconvulsive therapy (ECT) is a treat- - Fractures
ment of depression. What adverse effect is Rationale: Headaches, memory distur-
uncommon for a patient to experience after bance, and muscle soreness are com-
receiving ECT treatments? mon immediately after ECT treatment.
- Muscle soreness
- Headaches
- Fractures
- Memory disturbance
, ANCC IQ domain 3
Study online at https://quizlet.com/_a1pund
6. 1. An 88-year-old nursing home patient pre- - Blood chemistry, complete blood
sents to the emergency department with re- count, and urinalysis
cent mental status changes, including aggres- Rationale: A bedside MMSE can be
sion, confusion, and dizziness, over the past used to document the cognitive im-
two days. The patient scored a 20 on the pairment and to provide a baseline
MINI-Mental Status Exam (MMSE). In addition form which to measure the patient's
to the MMSE, what additional information is clinical course. The laboratory workup
needed to conduct a thorough evaluation? of a patient should include standard
- Blood chemistry, complete blood count, and tests (i.e., blood chemistries, CBC, uri-
urinalysis nalysis) and additional studies indicat-
- Patient Health Questionnaire (PHQ-9) score ed by the clinical situation.
- Hamilton Depression Scale (HAM-D) score
- Electrocardiography and pharmacogenomics
testing
7. 1. A client says that because he wished his - Schizotypal personality disorder
sister was dead, and your client's sister subse- Rationale: Schizotypal personality dis-
quently was killed in a motor vehicle accident, order is characterized by ideas of ref-
the death was caused by the client's wishes. erence and magical thinking.
The client also revealed that he can reach oth-
er's minds. This client is most likely suffering
from which personality disorder?
- Paranoid personality disorder
- Schizotypal personality disorder
- Schizoid personality disorder
- Delusional personality disorder
8. 1. In the American Journal of Psychiatry, you - Analyze the original and repeat stud-
read an article that discusses a recent study's ies for methodical rigor and verify that
evidence that the nicotine exposure in preg- there were randomized or non-ran-
nant women increases the risk for schizophre- domized clinical trials with the same
nia in offspring (i.e., 38% increased likelihood results.
