ANCC Practice Questions 2025 with
Answers
A 46 year old male with a history of bipolar disorder comes for a regular follow up
appointment with a PMHNP and presents with complaints of severe vomiting,
diarrhea, muscle weakness, blurred vision, and ataxia. The patient is currently
taking 900 mg of lithium daily. The psychiatric nurse practitioner identifies these
symptoms as signs of lithium toxicity. What is the priority action of the PMHNP?
A. Maintains medication regimen and monitors the symptoms.
B. Tells the patient to stop taking lithium in orders of serum lithium level.
C. Order an electrocardiogram.
D. Take the patient's vital signs. - ANSWER-B. Tells the patient to stop taking
lithium in orders of serum lithium level.
For 12 years, a 65 year old patient with bipolar affective disorder has been treated
with lithium 900 mg daily. When oral hydrochlorothiazide 12.5 mg daily is added
for hypertension, the patient develops nausea, vomiting, ataxia, and muscle
....COPYRIGHT © ️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 1
,weakness, and the patient's serum lithium level is 2.0 the interaction of the lithium
and thiazide diuretic has induced:
A. Hypokalemia.
B. Hyponatremia.
C. Increased Renal clearance of lithium.
D. Reduced renal clearance of lithium. - ANSWER-D. Reduced renal clearance of
lithium
Mary, a 45-year-old African-American female has been treated on isocarboxazid
(Marplan) for over six years. Mari is going in for a surgical procedure. Which
medication is strictly contraindicated with isocarboxazid?
A. Morphine.
B. NSAIDs.
C. Methylphenidate.
D. Acetaminophen. - ANSWER-C. Methylphenidate
The psychiatric mental health nurse practitioner is aware of the following signs to
watch out for in patients taking clozapine (clozaril)
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,A. Nosebleeds, bleeding gums, and skin rash
B. Mutism, muscle rigidity, and hyperthermia
C. Fever, sore throat, and chills
D. Ataxia, confusion, hypothyroidism - ANSWER-C. Fever, sore throat, and chills
A new prescription of carbamazepine is given to a patient who is baseline white
blood cell count is 5000 an absolute neutrophil count is 4000. Laboratory test
show that the patient WBC count has decreased to 2500 and ANC has decreased
to 750 after two weeks of therapy. Similar outcomes are obtained when the
laboratory studies are repeated. The patient is not present with any signs of
infection. What is the next action of the PMHNP?
A. Continues a patient on Tegretol and monitor the patient for signs of infection.
B. Tell the patient to stop taking Tegretol and recheck the ANC and WBC.
C. Continues the patient on Tegretol since the WBC is within normal limits.
D. Refer the patient to a primary care provider. - ANSWER-B. Tell the patient to
stop taking Tegretol and recheck the ANC and WBC
If given during pregnancy sodium valproate (depakote) can cause which of the
following medical problems in the baby?
....COPYRIGHT © ️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 3
, A. Steven Johnson syndrome
B. Ebstein's anomaly
C. Spina bifida
D. Cleft palate - ANSWER-C. Spina bifida
Which mood stabilizer is associated with potential life threatening rash in the Asian
population?
A. Carbamazepine (tegretol)
B. Depakote
C. Lithium
D. Lamictal - ANSWER-A. Carbamazepine (tegretol)
Which of the following physical exam finding would help the PMHNP
differentiate anorexia nervosa from bulimia nervosa?
A. Russel sign
B. Low body mass index
C. Erosion of dental enamel
....COPYRIGHT © ️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 4
Answers
A 46 year old male with a history of bipolar disorder comes for a regular follow up
appointment with a PMHNP and presents with complaints of severe vomiting,
diarrhea, muscle weakness, blurred vision, and ataxia. The patient is currently
taking 900 mg of lithium daily. The psychiatric nurse practitioner identifies these
symptoms as signs of lithium toxicity. What is the priority action of the PMHNP?
A. Maintains medication regimen and monitors the symptoms.
B. Tells the patient to stop taking lithium in orders of serum lithium level.
C. Order an electrocardiogram.
D. Take the patient's vital signs. - ANSWER-B. Tells the patient to stop taking
lithium in orders of serum lithium level.
For 12 years, a 65 year old patient with bipolar affective disorder has been treated
with lithium 900 mg daily. When oral hydrochlorothiazide 12.5 mg daily is added
for hypertension, the patient develops nausea, vomiting, ataxia, and muscle
....COPYRIGHT © ️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 1
,weakness, and the patient's serum lithium level is 2.0 the interaction of the lithium
and thiazide diuretic has induced:
A. Hypokalemia.
B. Hyponatremia.
C. Increased Renal clearance of lithium.
D. Reduced renal clearance of lithium. - ANSWER-D. Reduced renal clearance of
lithium
Mary, a 45-year-old African-American female has been treated on isocarboxazid
(Marplan) for over six years. Mari is going in for a surgical procedure. Which
medication is strictly contraindicated with isocarboxazid?
A. Morphine.
B. NSAIDs.
C. Methylphenidate.
D. Acetaminophen. - ANSWER-C. Methylphenidate
The psychiatric mental health nurse practitioner is aware of the following signs to
watch out for in patients taking clozapine (clozaril)
....COPYRIGHT © ️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 2
,A. Nosebleeds, bleeding gums, and skin rash
B. Mutism, muscle rigidity, and hyperthermia
C. Fever, sore throat, and chills
D. Ataxia, confusion, hypothyroidism - ANSWER-C. Fever, sore throat, and chills
A new prescription of carbamazepine is given to a patient who is baseline white
blood cell count is 5000 an absolute neutrophil count is 4000. Laboratory test
show that the patient WBC count has decreased to 2500 and ANC has decreased
to 750 after two weeks of therapy. Similar outcomes are obtained when the
laboratory studies are repeated. The patient is not present with any signs of
infection. What is the next action of the PMHNP?
A. Continues a patient on Tegretol and monitor the patient for signs of infection.
B. Tell the patient to stop taking Tegretol and recheck the ANC and WBC.
C. Continues the patient on Tegretol since the WBC is within normal limits.
D. Refer the patient to a primary care provider. - ANSWER-B. Tell the patient to
stop taking Tegretol and recheck the ANC and WBC
If given during pregnancy sodium valproate (depakote) can cause which of the
following medical problems in the baby?
....COPYRIGHT © ️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 3
, A. Steven Johnson syndrome
B. Ebstein's anomaly
C. Spina bifida
D. Cleft palate - ANSWER-C. Spina bifida
Which mood stabilizer is associated with potential life threatening rash in the Asian
population?
A. Carbamazepine (tegretol)
B. Depakote
C. Lithium
D. Lamictal - ANSWER-A. Carbamazepine (tegretol)
Which of the following physical exam finding would help the PMHNP
differentiate anorexia nervosa from bulimia nervosa?
A. Russel sign
B. Low body mass index
C. Erosion of dental enamel
....COPYRIGHT © ️ 2025 ALL RIGHTS RESERVED...TRUSTED & VERIFIED 4
