ANCC PMHNP EXAM QUESTIONS AND ANSWERS WITH 392
QUESTIONS AND CORRECT ANSWERS RATED A+ [NEWEST!!!]
Which 2ND gen antipsychotic can cause hyperprolactinemia?
Risperidone
Clozapine can cause ______ and you should d/c medication with an ______ less
than ______.
agranulocytosis, ANC, 1000
Akathesis is characterized by ______ and treated with _______.
-restlessness (pacing, tapping)
-beta blocker (chill out)
Depression and anxiety NTs
low serotonin and imbalanced norepinephrine
Normal lithium levels
0.6-1.2
With suspected lithium toxicity what do you do?
d/c med!!
Bipolar depression NTs
low serotonin (depression) and high dopamine (manic & hypomanic)
lithium toxicity symptoms
tremors, nausea, confusion, coarse hand tremors
serotonin syndrome symptoms
agitation, high fever, tachy, dilated pupils, sweating, muscle rigidity
lithium is primarily excreted through ______
the kidneys
,ETOH use disorder can lead to _____ and in combo with lithium can lead to
________.
impaired renal function, increased lithium levels due to decreased renal clearance
lithium modulates _______ which can lower _______ and be good for _______.
glutamate, impulsivity, SI/SA
lithium patient with excessive thirst and urination...what do you do?
order levels
lithium patient with coarse tremors and confusion...what do you do?
d/c lithium (suspect toxicity)
Antipsychotic patient who develops metabolic syndrome...what do you do?
educate on diet and lifestyle, dietician referral.
GI side effects of lithum
nausea and diarrhea
lithium and dehydration can lead to ___________
decreased renal excretion and increased lithium levels
lithium and NSAIDS can lead to
decreased renal excretion and increased lithium levels
Hyponatremia S&S
nausea, confusion, increased thrist, lethargy, decreased urine
lithium and hyponatremia can lead to
decreased renal excretion and increased lithium levels
With lithium you need to stay _____, maintain ______ in diet and get regular
______
hydrated, sodium, blood testing
lithium blood testing should be taken at
,the same time of the day in the AM before next dose
take lithium with __________ for proper ______ and reduced ______________.
full glass of water, proper absorption, GI tract irritation
MI Principles - RULE
R. Resist the Right Reflex
U. Understand Your Client's Motivation
L. Listen to Your Client
E. Empower Your Client
mesolimbic is the ____ pathway
Reward
mesolimbic is related to ____ which is a result of ____
positive schitzo symptoms, too much dopamine
antipsychotic treatment works by treating ____ by ____
positive symptoms, lowering dopamine
mesocorticle is related to ____ which is a result of ____
negative symptoms, too little dopamine
Nigrostriatal Pathway is responsible for
coordination of movement
Nigrostriatal Pathway is related to ____ which is a result of ____
parkinsonism, tool little dopamine from tx (antipsychotics)
Signs of Parkinsonism
resting tremor
masked face
shuffling feet
cogwheel rigidity
tuberoinfundibular is related to ____ which is a result of ____
, hyper prolactin (galacteria), too little dopamine
amenorrhea in the _____ pathway is due to ____
tuberoinfundibular, decreased FSH and dopamine
1st gen antipsychotics mnemonic
The happy furry cat
-Thioridazine
-Haloperidol
-Fluphenazine
-Chlorpromazine
1st gen antipsychotics mech of action
-D2 receptor inhibition - lowers dopamine
1st gen antipsychotics side effects - "anti-HAM"
Histamine - weight gain and sedation
Alpha - orthostasis, HypoTN, and priapism
Muscarinic - dry mouth
1st gen antipsychotics have the highest instance of _____________
EPS & NMS
2ND gen antipsychotics mech of action
D2 AND Serotonin2A antagonist
What dos the antagonism of serotonin2A in 2ND gen antipsychotics do?
Less instance of EPS due to raising dopamine just enough to still correct +
symptoms but avoiding lowing dopamine to much causing EPS
2ND gen antipsychotics mnemonic
"Really Awesome Zebra Loves Quiet Cozy Oasis"
-Risperidone
-Aripiprazole
-Ziprasidone
-Lurasidone
QUESTIONS AND CORRECT ANSWERS RATED A+ [NEWEST!!!]
Which 2ND gen antipsychotic can cause hyperprolactinemia?
Risperidone
Clozapine can cause ______ and you should d/c medication with an ______ less
than ______.
agranulocytosis, ANC, 1000
Akathesis is characterized by ______ and treated with _______.
-restlessness (pacing, tapping)
-beta blocker (chill out)
Depression and anxiety NTs
low serotonin and imbalanced norepinephrine
Normal lithium levels
0.6-1.2
With suspected lithium toxicity what do you do?
d/c med!!
Bipolar depression NTs
low serotonin (depression) and high dopamine (manic & hypomanic)
lithium toxicity symptoms
tremors, nausea, confusion, coarse hand tremors
serotonin syndrome symptoms
agitation, high fever, tachy, dilated pupils, sweating, muscle rigidity
lithium is primarily excreted through ______
the kidneys
,ETOH use disorder can lead to _____ and in combo with lithium can lead to
________.
impaired renal function, increased lithium levels due to decreased renal clearance
lithium modulates _______ which can lower _______ and be good for _______.
glutamate, impulsivity, SI/SA
lithium patient with excessive thirst and urination...what do you do?
order levels
lithium patient with coarse tremors and confusion...what do you do?
d/c lithium (suspect toxicity)
Antipsychotic patient who develops metabolic syndrome...what do you do?
educate on diet and lifestyle, dietician referral.
GI side effects of lithum
nausea and diarrhea
lithium and dehydration can lead to ___________
decreased renal excretion and increased lithium levels
lithium and NSAIDS can lead to
decreased renal excretion and increased lithium levels
Hyponatremia S&S
nausea, confusion, increased thrist, lethargy, decreased urine
lithium and hyponatremia can lead to
decreased renal excretion and increased lithium levels
With lithium you need to stay _____, maintain ______ in diet and get regular
______
hydrated, sodium, blood testing
lithium blood testing should be taken at
,the same time of the day in the AM before next dose
take lithium with __________ for proper ______ and reduced ______________.
full glass of water, proper absorption, GI tract irritation
MI Principles - RULE
R. Resist the Right Reflex
U. Understand Your Client's Motivation
L. Listen to Your Client
E. Empower Your Client
mesolimbic is the ____ pathway
Reward
mesolimbic is related to ____ which is a result of ____
positive schitzo symptoms, too much dopamine
antipsychotic treatment works by treating ____ by ____
positive symptoms, lowering dopamine
mesocorticle is related to ____ which is a result of ____
negative symptoms, too little dopamine
Nigrostriatal Pathway is responsible for
coordination of movement
Nigrostriatal Pathway is related to ____ which is a result of ____
parkinsonism, tool little dopamine from tx (antipsychotics)
Signs of Parkinsonism
resting tremor
masked face
shuffling feet
cogwheel rigidity
tuberoinfundibular is related to ____ which is a result of ____
, hyper prolactin (galacteria), too little dopamine
amenorrhea in the _____ pathway is due to ____
tuberoinfundibular, decreased FSH and dopamine
1st gen antipsychotics mnemonic
The happy furry cat
-Thioridazine
-Haloperidol
-Fluphenazine
-Chlorpromazine
1st gen antipsychotics mech of action
-D2 receptor inhibition - lowers dopamine
1st gen antipsychotics side effects - "anti-HAM"
Histamine - weight gain and sedation
Alpha - orthostasis, HypoTN, and priapism
Muscarinic - dry mouth
1st gen antipsychotics have the highest instance of _____________
EPS & NMS
2ND gen antipsychotics mech of action
D2 AND Serotonin2A antagonist
What dos the antagonism of serotonin2A in 2ND gen antipsychotics do?
Less instance of EPS due to raising dopamine just enough to still correct +
symptoms but avoiding lowing dopamine to much causing EPS
2ND gen antipsychotics mnemonic
"Really Awesome Zebra Loves Quiet Cozy Oasis"
-Risperidone
-Aripiprazole
-Ziprasidone
-Lurasidone
