Domain 1 ANCC Exam
Questions with Complete
Solutions
The PMHNP is treating a 12 yr old boy for ADHD. The physical features that would cause the PMHNP to
consider genetic evaluation for fragile X syndrome are: - Correct Answers: Long head and ears, short
stature, and hyperextensible joints.
A patient with depression and insomnia is worried about sexual side effects from medications. The most
appropriate medication choice for this patient is: - Correct Answers: Mirtazapine (Remeron)
Esketamine (Spravato) is classified as a(n): - Correct Answers: N-Methyl_D-aspartete receptor (NMDA)
antagonist
Which of these medications is excreted unchanged from the body? - Correct Answers: Lithium (Eskalith)
(Lithium acts to stabilize reuptake of neurotransmitters inclusive to Norepi & dopamine)
A 32-year-old separated patient presents for an initial intake. The patient states that they recently left
an abusive relationship; are living alone; and are experiencing fear, panic, and extreme anxiety. Which
brain structure is activated in patients with severe anxiety as expressed by the patient? - Correct
Answers: Amygdala (emotion) mediates fear, anxiety, and panic.
A 62-year-old patient with bipolar 1 disorder has been stable for two years on valproate and
risperidone. They were recently diagnosed with shingles and were prescribed corticosteroids. The
psychiatric-mental health nurse practitioner is concerned that the addition of the corticosteroids may
cause: - Correct Answers: A manic episode.
Most serotonin in the brain is generated in the: - Correct Answers: Raphe nuclei.
When considering pharmacodynamics involving receptors, the PMHNP knows that an inverse agonist
produces the following effect: - Correct Answers: Causing the opposite effect of an agonist and causing
the receptor to close the ion channel.
, A client is suffering from schizophrenia and experiencing side effects. Which of the following is an
appropriate question for the PMHNP to ask when assessing side effects produced by dopamine
antagonism in the tuberoinfundibular pathway? - Correct Answers: Are you experiencing breast
discharge?
A patient is diagnosed with schizophrenia and alcohol use disorder. The effect that alcohol has on GABA
and glutamate in the ventral tegmental area of this patient is to: - Correct Answers: Increase GABA and
decrease glutamate (ETOH enhances inhibition at GABA synapses and reduces excitation at glutamate
synapse in VTA).
A week after an increase in dosage of risperidone (Risperdal), a patient treated for schizophrenia
presents to the clinic with reports of an acute change in mental status, fever, and rigidity. These
symptoms are consistent with: - Correct Answers: Neuroleptic Malignant Syndrome (NMS)
The most active ingredient in cannabis is: - Correct Answers: Delta-9- tetrahydrocannabinol (THC)
The PMHNP would expect to see which of the following during a physical exam for a patient with
bulimia nervosa? - Correct Answers: Erosion of dental enamel
Which of the following is an inhibitory neurotransmitter? - Correct Answers: GABA
Antagonism of which serotonin receptor makes an antipsychotic "atypical"? - Correct Answers: 5HT2A
A 56-year-old patient has taken Selegiline for over four years and is scheduled for elective surgery.
Which medication is contraindicated in combination with Selegiline? - Correct Answers: Meperidine
Norepinephrine is a neurotransmitter that is implicated in alertness and anxiety. What area of the brain
has a majority of norepinephrine neurons? - Correct Answers: Locus coeruleus (another area is
medullary reticular formation)
A 43-year-old male is treated for bipolar I with lithium. The hematologic change associated with lithium
is: - Correct Answers: Leukocytosis
Questions with Complete
Solutions
The PMHNP is treating a 12 yr old boy for ADHD. The physical features that would cause the PMHNP to
consider genetic evaluation for fragile X syndrome are: - Correct Answers: Long head and ears, short
stature, and hyperextensible joints.
A patient with depression and insomnia is worried about sexual side effects from medications. The most
appropriate medication choice for this patient is: - Correct Answers: Mirtazapine (Remeron)
Esketamine (Spravato) is classified as a(n): - Correct Answers: N-Methyl_D-aspartete receptor (NMDA)
antagonist
Which of these medications is excreted unchanged from the body? - Correct Answers: Lithium (Eskalith)
(Lithium acts to stabilize reuptake of neurotransmitters inclusive to Norepi & dopamine)
A 32-year-old separated patient presents for an initial intake. The patient states that they recently left
an abusive relationship; are living alone; and are experiencing fear, panic, and extreme anxiety. Which
brain structure is activated in patients with severe anxiety as expressed by the patient? - Correct
Answers: Amygdala (emotion) mediates fear, anxiety, and panic.
A 62-year-old patient with bipolar 1 disorder has been stable for two years on valproate and
risperidone. They were recently diagnosed with shingles and were prescribed corticosteroids. The
psychiatric-mental health nurse practitioner is concerned that the addition of the corticosteroids may
cause: - Correct Answers: A manic episode.
Most serotonin in the brain is generated in the: - Correct Answers: Raphe nuclei.
When considering pharmacodynamics involving receptors, the PMHNP knows that an inverse agonist
produces the following effect: - Correct Answers: Causing the opposite effect of an agonist and causing
the receptor to close the ion channel.
, A client is suffering from schizophrenia and experiencing side effects. Which of the following is an
appropriate question for the PMHNP to ask when assessing side effects produced by dopamine
antagonism in the tuberoinfundibular pathway? - Correct Answers: Are you experiencing breast
discharge?
A patient is diagnosed with schizophrenia and alcohol use disorder. The effect that alcohol has on GABA
and glutamate in the ventral tegmental area of this patient is to: - Correct Answers: Increase GABA and
decrease glutamate (ETOH enhances inhibition at GABA synapses and reduces excitation at glutamate
synapse in VTA).
A week after an increase in dosage of risperidone (Risperdal), a patient treated for schizophrenia
presents to the clinic with reports of an acute change in mental status, fever, and rigidity. These
symptoms are consistent with: - Correct Answers: Neuroleptic Malignant Syndrome (NMS)
The most active ingredient in cannabis is: - Correct Answers: Delta-9- tetrahydrocannabinol (THC)
The PMHNP would expect to see which of the following during a physical exam for a patient with
bulimia nervosa? - Correct Answers: Erosion of dental enamel
Which of the following is an inhibitory neurotransmitter? - Correct Answers: GABA
Antagonism of which serotonin receptor makes an antipsychotic "atypical"? - Correct Answers: 5HT2A
A 56-year-old patient has taken Selegiline for over four years and is scheduled for elective surgery.
Which medication is contraindicated in combination with Selegiline? - Correct Answers: Meperidine
Norepinephrine is a neurotransmitter that is implicated in alertness and anxiety. What area of the brain
has a majority of norepinephrine neurons? - Correct Answers: Locus coeruleus (another area is
medullary reticular formation)
A 43-year-old male is treated for bipolar I with lithium. The hematologic change associated with lithium
is: - Correct Answers: Leukocytosis
