ANCC Review Questions {PMHNP}
1. What direct-acting dopamine receptor agonist is recommended to be
used in the treatments of neuroleptic malignant syndrome (NMS) fo help
lower the dopamine blockade?
A) benzotropine (Cogentin)
B) bromocriptine (Parlodel)
C) dantrolene (Dantrium)
D) trihexyphenidyl (Artane): A) Bromocriptine (Parlodel) is the
recommended direct acting dopamine receptor agonist to help
decrease the dopamine block- ade. Danrolene (Dantrium) is a muscle
relaxant. Benzotropine (Cogentin) and Trihexyphenidyl (Artane) are
anticholinergic medications used for extrapyramidal side effects
(EPS).
2. Mr. Smith is a 56 year old white male who has been successfully
treated on Selegiline for over 4 years. Mr. Smith is going in for elective
surgical procedure. Which medication is strictly contraindicated with
Selegiline?
1/9
,A) Non-steroidal anti-inflammatory drugs (NSAIDS)
B) Codeine
C) Morphine
D) Meperidine: D) Meperidine is strictly prohibited when a patient is
treated on a monoamine oxidase inhibitor (MAOI) due to the risk of
hypertensive crisis and death.
3. A WBC of 4,000 in a patient taking Clozapine would prompt the PMHNP
to take which of the following actions?
A) Consult with hematologist to determine appropriate antibiotic
regimen and monitor closely.
B) Institute twice-weekly complete blood count with differentials and
monitor closely.
C) Discontinue clozapine, initiate alternative antipsychotic medication
and monitor closely.
D) Institute daily complete blood count with differentials and monitor
close- ly.: B) Institute twice-weekly complete blood count with
differentials and monitor closely.
The recommended cut-points for discontinuation of clozapine are WBC
of 2,000 to 3,000 or granulocytes of 1,000 to 1,500 for
agranulocytosis and severely com- promised immune system. At a
WBC of 4,000, the recommendation is to closely
2/9
, monitor CBC with differential twice a week while patient may continue
clozapine in the absence of any other signs or symptoms.
4. A patient with a diagnosis of schizophrenia has a history of suicidal
ideation and suicide attempts. The PMHNP should consider which antipsy-
chotic medication that is the only antipsychotic to reduce the risk of
suicide in schizophrenia?
A) Abilify (aripriprazole)
B) Latuda (lurasidone)
C) Invega (iloperidone)
D) Clozaril (clozapine): D) Clozaril (clozapine) is the only known
antipsychotic medication that had been shown to reduce the risk of
suicide in patients diagnosed with schizophrenia.
5. A patient being treated for major depressive disorder and on
sertraline (Zoloft), 150 mg po daily for the past 16 years, presents to the
psychiatric mental health practitioner for an outpatient follow-up visit.
During the visit she states that she has not been feeling well, reporting
the flu. She also states she has not taken her medication in the last five
days. Which of
the following symptoms would she be describing if you suspect
selective serotonin reputable inhibitors (SSRIs) discontinuation
syndrome?
3/9
1. What direct-acting dopamine receptor agonist is recommended to be
used in the treatments of neuroleptic malignant syndrome (NMS) fo help
lower the dopamine blockade?
A) benzotropine (Cogentin)
B) bromocriptine (Parlodel)
C) dantrolene (Dantrium)
D) trihexyphenidyl (Artane): A) Bromocriptine (Parlodel) is the
recommended direct acting dopamine receptor agonist to help
decrease the dopamine block- ade. Danrolene (Dantrium) is a muscle
relaxant. Benzotropine (Cogentin) and Trihexyphenidyl (Artane) are
anticholinergic medications used for extrapyramidal side effects
(EPS).
2. Mr. Smith is a 56 year old white male who has been successfully
treated on Selegiline for over 4 years. Mr. Smith is going in for elective
surgical procedure. Which medication is strictly contraindicated with
Selegiline?
1/9
,A) Non-steroidal anti-inflammatory drugs (NSAIDS)
B) Codeine
C) Morphine
D) Meperidine: D) Meperidine is strictly prohibited when a patient is
treated on a monoamine oxidase inhibitor (MAOI) due to the risk of
hypertensive crisis and death.
3. A WBC of 4,000 in a patient taking Clozapine would prompt the PMHNP
to take which of the following actions?
A) Consult with hematologist to determine appropriate antibiotic
regimen and monitor closely.
B) Institute twice-weekly complete blood count with differentials and
monitor closely.
C) Discontinue clozapine, initiate alternative antipsychotic medication
and monitor closely.
D) Institute daily complete blood count with differentials and monitor
close- ly.: B) Institute twice-weekly complete blood count with
differentials and monitor closely.
The recommended cut-points for discontinuation of clozapine are WBC
of 2,000 to 3,000 or granulocytes of 1,000 to 1,500 for
agranulocytosis and severely com- promised immune system. At a
WBC of 4,000, the recommendation is to closely
2/9
, monitor CBC with differential twice a week while patient may continue
clozapine in the absence of any other signs or symptoms.
4. A patient with a diagnosis of schizophrenia has a history of suicidal
ideation and suicide attempts. The PMHNP should consider which antipsy-
chotic medication that is the only antipsychotic to reduce the risk of
suicide in schizophrenia?
A) Abilify (aripriprazole)
B) Latuda (lurasidone)
C) Invega (iloperidone)
D) Clozaril (clozapine): D) Clozaril (clozapine) is the only known
antipsychotic medication that had been shown to reduce the risk of
suicide in patients diagnosed with schizophrenia.
5. A patient being treated for major depressive disorder and on
sertraline (Zoloft), 150 mg po daily for the past 16 years, presents to the
psychiatric mental health practitioner for an outpatient follow-up visit.
During the visit she states that she has not been feeling well, reporting
the flu. She also states she has not taken her medication in the last five
days. Which of
the following symptoms would she be describing if you suspect
selective serotonin reputable inhibitors (SSRIs) discontinuation
syndrome?
3/9
