PMHNP FINAL EXAM PREP QUESTIONS
AND VERIFIED ANSWERS |GRADE A+|
JUST RELEASED
1. A 45-year-old patient diagnosed with schizophrenia has been on Clozapine for 6 months.
During a routine follow-up, the Absolute Neutrophil Count (ANC) is reported as 950/mm³.
Which of the following is the most appropriate next step?
A. Continue Clozapine and repeat the test in one week.
B. Increase the Clozapine dose to achieve therapeutic levels.
C. Interrupt Clozapine treatment, notify the Clozapine REMS, and monitor ANC daily.
D. Add a prophylactic antibiotic and continue Clozapine.
Answer: C
Conceptual Explanation: For patients on Clozapine, an ANC between 500-999/mm³
(moderate neutropenia) requires interruption of treatment, notification of the REMS, and
daily monitoring until the ANC rises above 1000/mm³.
2. Which dopamine pathway is primarily associated with the negative symptoms of
schizophrenia, such as apathy and social withdrawal?
A. Mesolimbic pathway
B. Tuberoinfundibular pathway
,C. Nigrostriatal pathway
D. Mesocortical pathway
Answer: D
Conceptual Explanation: The mesocortical pathway is associated with cognitive and
negative symptoms of schizophrenia, typically resulting from a deficit in dopamine in this
region.
3. A patient is started on Lithium for Bipolar I Disorder. Which of the following lab findings
would most likely increase the risk of lithium toxicity?
A. Hypernatremia
B. Hypokalemia
C. Hyponatremia
D. Hypercalcemia
Answer: C
Conceptual Explanation: Sodium and lithium are both monovalent cations handled
similarly by the kidneys. Hyponatremia (low sodium) leads to increased renal reabsorption
of lithium, potentially causing toxicity.
4. Which of the following antidepressants is considered a potent inhibitor of the CYP2D6
enzyme?
A. Sertraline
, B. Citalopram
C. Venlafaxine
D. Fluoxetine
Answer: D
Conceptual Explanation: Fluoxetine and Paroxetine are potent inhibitors of CYP2D6,
which can lead to increased plasma levels of other drugs metabolized by this enzyme, such
as certain beta-blockers or antipsychotics.
5. A 28-year-old female patient with a history of seizures is seeking treatment for depression.
Which antidepressant is strictly contraindicated in this patient?
A. Bupropion
B. Mirtazapine
C. Escitalopram
D. Duloxetine
Answer: A
Conceptual Explanation: Bupropion is contraindicated in patients with a history of
seizure disorders or eating disorders because it lowers the seizure threshold.
6. According to Erikson’s stages of psychosocial development, which conflict is primarily faced
by individuals in the ‘Young Adulthood’ stage (ages 20-39)?
A. Generativity vs. Stagnation
AND VERIFIED ANSWERS |GRADE A+|
JUST RELEASED
1. A 45-year-old patient diagnosed with schizophrenia has been on Clozapine for 6 months.
During a routine follow-up, the Absolute Neutrophil Count (ANC) is reported as 950/mm³.
Which of the following is the most appropriate next step?
A. Continue Clozapine and repeat the test in one week.
B. Increase the Clozapine dose to achieve therapeutic levels.
C. Interrupt Clozapine treatment, notify the Clozapine REMS, and monitor ANC daily.
D. Add a prophylactic antibiotic and continue Clozapine.
Answer: C
Conceptual Explanation: For patients on Clozapine, an ANC between 500-999/mm³
(moderate neutropenia) requires interruption of treatment, notification of the REMS, and
daily monitoring until the ANC rises above 1000/mm³.
2. Which dopamine pathway is primarily associated with the negative symptoms of
schizophrenia, such as apathy and social withdrawal?
A. Mesolimbic pathway
B. Tuberoinfundibular pathway
,C. Nigrostriatal pathway
D. Mesocortical pathway
Answer: D
Conceptual Explanation: The mesocortical pathway is associated with cognitive and
negative symptoms of schizophrenia, typically resulting from a deficit in dopamine in this
region.
3. A patient is started on Lithium for Bipolar I Disorder. Which of the following lab findings
would most likely increase the risk of lithium toxicity?
A. Hypernatremia
B. Hypokalemia
C. Hyponatremia
D. Hypercalcemia
Answer: C
Conceptual Explanation: Sodium and lithium are both monovalent cations handled
similarly by the kidneys. Hyponatremia (low sodium) leads to increased renal reabsorption
of lithium, potentially causing toxicity.
4. Which of the following antidepressants is considered a potent inhibitor of the CYP2D6
enzyme?
A. Sertraline
, B. Citalopram
C. Venlafaxine
D. Fluoxetine
Answer: D
Conceptual Explanation: Fluoxetine and Paroxetine are potent inhibitors of CYP2D6,
which can lead to increased plasma levels of other drugs metabolized by this enzyme, such
as certain beta-blockers or antipsychotics.
5. A 28-year-old female patient with a history of seizures is seeking treatment for depression.
Which antidepressant is strictly contraindicated in this patient?
A. Bupropion
B. Mirtazapine
C. Escitalopram
D. Duloxetine
Answer: A
Conceptual Explanation: Bupropion is contraindicated in patients with a history of
seizure disorders or eating disorders because it lowers the seizure threshold.
6. According to Erikson’s stages of psychosocial development, which conflict is primarily faced
by individuals in the ‘Young Adulthood’ stage (ages 20-39)?
A. Generativity vs. Stagnation
