NRNP 6675 PMHNP PRACTICE AND
MANAGEMENT QUESTIONS WITH
VERIFIED ANSWERS.
1. A 24-year-old male is starting Clozapine for treatment-resistant schizophrenia. Which
laboratory parameter must be monitored via the Risk Evaluation and Mitigation Strategy
(REMS) program?
A. Liver function tests (LFTs)
B. Serum creatinine and BUN
C. Absolute Neutrophil Count (ANC)
D. Glycated hemoglobin (HbA1c)
Answer: C
Conceptual Explanation: Due to the risk of severe agranulocytosis, Clozapine requires
strict monitoring of the Absolute Neutrophil Count (ANC). REMS regulations mandate
specific ANC thresholds to continue treatment.
2. A patient taking Phenelzine (an MAOI) is admitted with a hypertensive crisis after
consuming aged cheese. What is the mechanism behind this interaction?
A. Direct stimulation of the H1 histamine receptor
,B. Upregulation of beta-adrenergic receptors
C. Depletion of synaptic dopamine
D. Inhibition of Tyramine breakdown
Answer: D
Conceptual Explanation: MAOIs inhibit the breakdown of tyramine in the gut. When high-
tyramine foods like aged cheese are consumed, tyramine levels rise, causing a massive
release of norepinephrine, leading to hypertensive crisis.
3. In the treatment of Bipolar I disorder, which medication is most associated with a risk of
Stevens-Johnson Syndrome (SJS), particularly if titrated too quickly?
A. Lithium
B. Lamotrigine
C. Valproic Acid
D. Quetiapine
Answer: B
Conceptual Explanation: Lamotrigine has a black-box warning for Stevens-Johnson
Syndrome. To mitigate this risk, a slow upward titration is required, usually over several
weeks.
, 4. According to the DSM-5-TR, what is the minimum duration of symptoms required to
diagnose Generalised Anxiety Disorder (GAD)?
A. 2 weeks
B. 1 month
C. 6 months
D. 3 months
Answer: C
Conceptual Explanation: GAD requires excessive anxiety and worry occurring more days
than not for at least 6 months, about a number of events or activities.
5. Which neurobiological pathway is primarily associated with the ‘positive symptoms’ of
schizophrenia, such as hallucinations and delusions?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: Overactivity or hyperdopaminergic function in the mesolimbic
pathway is theorized to cause the positive symptoms of schizophrenia.
MANAGEMENT QUESTIONS WITH
VERIFIED ANSWERS.
1. A 24-year-old male is starting Clozapine for treatment-resistant schizophrenia. Which
laboratory parameter must be monitored via the Risk Evaluation and Mitigation Strategy
(REMS) program?
A. Liver function tests (LFTs)
B. Serum creatinine and BUN
C. Absolute Neutrophil Count (ANC)
D. Glycated hemoglobin (HbA1c)
Answer: C
Conceptual Explanation: Due to the risk of severe agranulocytosis, Clozapine requires
strict monitoring of the Absolute Neutrophil Count (ANC). REMS regulations mandate
specific ANC thresholds to continue treatment.
2. A patient taking Phenelzine (an MAOI) is admitted with a hypertensive crisis after
consuming aged cheese. What is the mechanism behind this interaction?
A. Direct stimulation of the H1 histamine receptor
,B. Upregulation of beta-adrenergic receptors
C. Depletion of synaptic dopamine
D. Inhibition of Tyramine breakdown
Answer: D
Conceptual Explanation: MAOIs inhibit the breakdown of tyramine in the gut. When high-
tyramine foods like aged cheese are consumed, tyramine levels rise, causing a massive
release of norepinephrine, leading to hypertensive crisis.
3. In the treatment of Bipolar I disorder, which medication is most associated with a risk of
Stevens-Johnson Syndrome (SJS), particularly if titrated too quickly?
A. Lithium
B. Lamotrigine
C. Valproic Acid
D. Quetiapine
Answer: B
Conceptual Explanation: Lamotrigine has a black-box warning for Stevens-Johnson
Syndrome. To mitigate this risk, a slow upward titration is required, usually over several
weeks.
, 4. According to the DSM-5-TR, what is the minimum duration of symptoms required to
diagnose Generalised Anxiety Disorder (GAD)?
A. 2 weeks
B. 1 month
C. 6 months
D. 3 months
Answer: C
Conceptual Explanation: GAD requires excessive anxiety and worry occurring more days
than not for at least 6 months, about a number of events or activities.
5. Which neurobiological pathway is primarily associated with the ‘positive symptoms’ of
schizophrenia, such as hallucinations and delusions?
A. Mesolimbic pathway
B. Mesocortical pathway
C. Nigrostriatal pathway
D. Tuberoinfundibular pathway
Answer: A
Conceptual Explanation: Overactivity or hyperdopaminergic function in the mesolimbic
pathway is theorized to cause the positive symptoms of schizophrenia.
