ANCC Domain 1- Scientific Foundation

Mr. Smith is going in for an elective surgical procedure. He is currently taking Selegiline. Which medication is he not able to take? -Morphine -Codeine -NSAIDs -Meperidine - Answer- - Meperidine is prohibited when a patient is taking an MAOI (Selegiline) due to risk of HTN crisis and death. Rationale: Meperidine is strictly prohibited when a patient is treated on a monoamine oxidase inhibitor (MAOI), due to the risk of hypertensive crisis and death. Hypertensive crisis and death can also occur when MAOIs are taken in conjunction with certain medications: meperidine (demerol), decongestants, TCAs, atypical antipsychotics, st johns wort, l-tryptophan, stimulants (and other sympathomimetics), asthma medications 17-year-old female presents to your clinic reporting anhedonia, decreased energy, and hopelessness for the past 2 years. She denies drinking alcohol, smoking, or using illegal substances. Her physical examination results are within normal limits and she denies suicidal ideations. As the treating psychiatric mental health nurse practitioner, you decide to prescribe her bupropion (Wellbutrin). Of the following, which is a contraindication for bupropion? - Dysthymia - Fatigue - Smoking - Bulimia - Answer- - Bulimia Rationale: Do not use bupropion if patient is bulimic, either currently or in the past. Prohibition for use in eating disorders due to increased risk of seizures. While treating a 12-year-old boy for ADHD, the PMHNP observes which of the following physical features that raise concerns for genetic evaluation for Fragile X Syndrome? -obesity, small stature, small hands and feet, hypotonia -café au lait spots on face and arms, neurofibromas -long head and ears, short stature, hyperextensible joints -small stature, short palpebral fissure, inner epicanthal folds - Answer- -long head and ears, short stature, hyperextensible joints -Most features are large: a broad forehead, elongated face, large ears, enlarged testicles (macroorchidism) -Short stature -hyperextensible joints, low muscle tones, soft fleshy tones Rationale: Etiological factors in mental retardation can be primarily genetic, developmental, acquired, or in combination. Genetic causes included chromosomal and inherited conditions. Many of these genetic disorders have characteristic physical features that warrant genetic testing for confirmatory diagnosis. Fragile X Syndrome occurs in abo