NR547 ADVANCED PSYCHIATRIC
MENTAL HEALTH NURSING PRACTICE
QUESTIONS AND ANSWERS
1. A patient taking Clozapine for treatment-resistant schizophrenia must have regular blood
monitoring. Which laboratory parameter is most critical to monitor for the risk of
agranulocytosis?
A. Platelet count
B. Liver function tests
C. Serum Creatinine
D. Absolute Neutrophil Count (ANC)
Answer: D
Conceptual Explanation: Clozapine is associated with a risk of life-threatening
agranulocytosis. The Absolute Neutrophil Count (ANC) must be monitored weekly for the
first 6 months to ensure safety.
,2. Which neurotransmitter is primarily implicated in the reward system of the brain and is a
major target in substance use disorder research?
A. Serotonin
B. GABA
C. Acetylcholine
D. Dopamine
Answer: D
Conceptual Explanation: Dopamine, particularly in the mesolimbic pathway (nucleus
accumbens), is the primary neurotransmitter associated with reward, reinforcement, and
addiction.
3. In the treatment of Bipolar I Disorder, what is the therapeutic serum level range for
Lithium during the maintenance phase?
A. 0.2 - 0.5 mEq/L
B. 1.5 - 2.0 mEq/L
C. 0.6 - 1.2 mEq/L
D. 2.5 - 3.0 mEq/L
Answer: C
Conceptual Explanation: The standard therapeutic range for Lithium maintenance is 0.6
to 1.2 mEq/L. Levels above 1.5 mEq/L are typically considered toxic.
, 4. Which of the following antidepressants is contraindicated in patients with a history of
seizure disorders or eating disorders?
A. Sertraline
B. Fluoxetine
C. Bupropion
D. Duloxetine
Answer: C
Conceptual Explanation: Bupropion lowers the seizure threshold, especially in patients
with bulimia or anorexia nervosa due to potential electrolyte imbalances.
5. A 24-year-old male presents with muscle rigidity, high fever, autonomic instability, and
altered mental status after starting Haloperidol. What is the most likely diagnosis?
A. Neuroleptic Malignant Syndrome (NMS)
B. Serotonin Syndrome
C. Akathisia
D. Anticholinergic Toxicity
Answer: A
Conceptual Explanation: NMS is a life-threatening reaction to antipsychotics
characterized by ‘lead-pipe’ rigidity, hyperpyrexia, and autonomic instability.
MENTAL HEALTH NURSING PRACTICE
QUESTIONS AND ANSWERS
1. A patient taking Clozapine for treatment-resistant schizophrenia must have regular blood
monitoring. Which laboratory parameter is most critical to monitor for the risk of
agranulocytosis?
A. Platelet count
B. Liver function tests
C. Serum Creatinine
D. Absolute Neutrophil Count (ANC)
Answer: D
Conceptual Explanation: Clozapine is associated with a risk of life-threatening
agranulocytosis. The Absolute Neutrophil Count (ANC) must be monitored weekly for the
first 6 months to ensure safety.
,2. Which neurotransmitter is primarily implicated in the reward system of the brain and is a
major target in substance use disorder research?
A. Serotonin
B. GABA
C. Acetylcholine
D. Dopamine
Answer: D
Conceptual Explanation: Dopamine, particularly in the mesolimbic pathway (nucleus
accumbens), is the primary neurotransmitter associated with reward, reinforcement, and
addiction.
3. In the treatment of Bipolar I Disorder, what is the therapeutic serum level range for
Lithium during the maintenance phase?
A. 0.2 - 0.5 mEq/L
B. 1.5 - 2.0 mEq/L
C. 0.6 - 1.2 mEq/L
D. 2.5 - 3.0 mEq/L
Answer: C
Conceptual Explanation: The standard therapeutic range for Lithium maintenance is 0.6
to 1.2 mEq/L. Levels above 1.5 mEq/L are typically considered toxic.
, 4. Which of the following antidepressants is contraindicated in patients with a history of
seizure disorders or eating disorders?
A. Sertraline
B. Fluoxetine
C. Bupropion
D. Duloxetine
Answer: C
Conceptual Explanation: Bupropion lowers the seizure threshold, especially in patients
with bulimia or anorexia nervosa due to potential electrolyte imbalances.
5. A 24-year-old male presents with muscle rigidity, high fever, autonomic instability, and
altered mental status after starting Haloperidol. What is the most likely diagnosis?
A. Neuroleptic Malignant Syndrome (NMS)
B. Serotonin Syndrome
C. Akathisia
D. Anticholinergic Toxicity
Answer: A
Conceptual Explanation: NMS is a life-threatening reaction to antipsychotics
characterized by ‘lead-pipe’ rigidity, hyperpyrexia, and autonomic instability.
