ANCC REVIEW QUESTIONS (PMHNP IQ)
Questions and Answers
1. What direct-acting dopamine receptor agonist is
recommended to be used in the treatments of neuroleptic
malignant syndrome (NMS) for help lower the dopamine
blockade?
A) benzotropine (Cogentin)
B) bromocriptine (Parlodel)
C) dantrolene (Dantrium)
D) trihexyphenidyl (Artane)
Answer A) Bromocriptine (Parlodel) is the recommended direct acting dopamine receptor
agonist to help decrease the dopamine blockade. Danrolene (Dantrium) is a muscle relaxant.
Benzotropine (Cogentin) and Trihexyphenidyl (Artane) are anticholinergic medications used for
extrapyramidal side ettects (EPS).
2. Mr. Smith is a 56 year old white male who has been
successfully treated on Selegiline for over 4 years. Mr. Smith is
going in for elective surgical procedure. Which medication is strictly
contraindicated with Selegiline?
A) Non-steroidal anti-inflammatory drugs (NSAIDS)
B) Codeine
1/
17
,C) Morphine
D) Meperidine
Answer D) Meperidine is strictly prohibited when a patient is treated on a monoamine oxidase
inhibitor (MAOI) due to the risk of hypertensive crisis and death.
3. A WBC of 4,000 in a patient taking Clozapine would prompt the
PMHNP to take which of the following actions?
A) Consult with hematologist to determine appropriate antibiotic
regimen and monitor closely.
B) Institute twice-weekly complete blood count with differentials
and monitor closely.
C) Discontinue clozapine, initiate alternative antipsychotic
medication and monitor closely.
D) Institute daily complete blood count with differentials and
monitor closely.-
Answer B) Institute twice-weekly complete blood count with ditterentials and monitor closely.
The recommended cut-points for discontinuation of clozapine are WBC of 2,000 to 3,000 or granulocytes of
1,000 to
1,500 for agranulocytosis and severely compromised immune system. At a WBC of 4,000, the
recommendation is to closely monitor CBC with ditterential twice a week while patient may continue
clozapine in the absence of any other signs or symptoms.
2/
17
, 4. A patient with a diagnosis of schizophrenia has a history of
suicidal ideation and suicide attempts. The PMHNP should consider
which antipsychotic medica-tion that is the only antipsychotic to
reduce the risk of suicide in schizophrenia?
A) Abilify (aripriprazole)
B) Latuda (lurasidone)
C) Invega (iloperidone)
D) Clozaril (clozapine)
Answer D) Clozaril (clozapine) is the only known antipsychotic medication that had been
shown to reduce the risk of suicide in patients diagnosed with schizophrenia.
5. A patient being treated for major depressive disorder and on
sertraline (Zoloft), 150 mg po daily for the past 16 years,
presents to the psychiatric mental health practitioner for an
outpatient follow-up visit. During the visit she states that she has
not been feeling well, reporting the flu. She also states she has not
taken her medication in the last five days. Which of the following
symptoms would she be describing if you suspect selective serotonin
reputable inhibitors (SSRIs) discontinuation syndrome?
A) Agitation, nausea, dysphoria, and diequilibrium
B) Agitation, nausea, tremor, and ataxia.
C) Restlessness, tremor, fever, and shivering.
D) Restlessness, headache, increased heart rate, and diarrhea.
3/
17
Questions and Answers
1. What direct-acting dopamine receptor agonist is
recommended to be used in the treatments of neuroleptic
malignant syndrome (NMS) for help lower the dopamine
blockade?
A) benzotropine (Cogentin)
B) bromocriptine (Parlodel)
C) dantrolene (Dantrium)
D) trihexyphenidyl (Artane)
Answer A) Bromocriptine (Parlodel) is the recommended direct acting dopamine receptor
agonist to help decrease the dopamine blockade. Danrolene (Dantrium) is a muscle relaxant.
Benzotropine (Cogentin) and Trihexyphenidyl (Artane) are anticholinergic medications used for
extrapyramidal side ettects (EPS).
2. Mr. Smith is a 56 year old white male who has been
successfully treated on Selegiline for over 4 years. Mr. Smith is
going in for elective surgical procedure. Which medication is strictly
contraindicated with Selegiline?
A) Non-steroidal anti-inflammatory drugs (NSAIDS)
B) Codeine
1/
17
,C) Morphine
D) Meperidine
Answer D) Meperidine is strictly prohibited when a patient is treated on a monoamine oxidase
inhibitor (MAOI) due to the risk of hypertensive crisis and death.
3. A WBC of 4,000 in a patient taking Clozapine would prompt the
PMHNP to take which of the following actions?
A) Consult with hematologist to determine appropriate antibiotic
regimen and monitor closely.
B) Institute twice-weekly complete blood count with differentials
and monitor closely.
C) Discontinue clozapine, initiate alternative antipsychotic
medication and monitor closely.
D) Institute daily complete blood count with differentials and
monitor closely.-
Answer B) Institute twice-weekly complete blood count with ditterentials and monitor closely.
The recommended cut-points for discontinuation of clozapine are WBC of 2,000 to 3,000 or granulocytes of
1,000 to
1,500 for agranulocytosis and severely compromised immune system. At a WBC of 4,000, the
recommendation is to closely monitor CBC with ditterential twice a week while patient may continue
clozapine in the absence of any other signs or symptoms.
2/
17
, 4. A patient with a diagnosis of schizophrenia has a history of
suicidal ideation and suicide attempts. The PMHNP should consider
which antipsychotic medica-tion that is the only antipsychotic to
reduce the risk of suicide in schizophrenia?
A) Abilify (aripriprazole)
B) Latuda (lurasidone)
C) Invega (iloperidone)
D) Clozaril (clozapine)
Answer D) Clozaril (clozapine) is the only known antipsychotic medication that had been
shown to reduce the risk of suicide in patients diagnosed with schizophrenia.
5. A patient being treated for major depressive disorder and on
sertraline (Zoloft), 150 mg po daily for the past 16 years,
presents to the psychiatric mental health practitioner for an
outpatient follow-up visit. During the visit she states that she has
not been feeling well, reporting the flu. She also states she has not
taken her medication in the last five days. Which of the following
symptoms would she be describing if you suspect selective serotonin
reputable inhibitors (SSRIs) discontinuation syndrome?
A) Agitation, nausea, dysphoria, and diequilibrium
B) Agitation, nausea, tremor, and ataxia.
C) Restlessness, tremor, fever, and shivering.
D) Restlessness, headache, increased heart rate, and diarrhea.
3/
17
