ANCC IQ domain 3 Question bank CORRECT ANSWERS latest updated summer 2023/2024

1. The PMHNP treating a patient for schizophrenia on ziprasidone orders an electrocardiogram. Which QTc interval result places the patient at greatest risk for torsades de pointes? - 300-500 milliseconds - 500-700 milliseconds - 160-260 milliseconds - 100-200 milliseconds - 500-700 milliseconds Rationale: A patient with a QTc interval of 500-700 milliseconds is at higher risk of developing torsades de pointes. 1. A patient with a diagnosis of schizophrenia has a history of suicidal ideation and suicide attempts. The PMHNP should consider which antipsychotic medication that is the only known antipsychotic to reduce the risk of suicide in schizophrenia? - Invega (iloperidone) - Abilify (aripiprazole) - Latuda (lurasidone) - Clozaril (clozapine) - Clozaril (clozapine) Rationale: Clozaril (clozapine) is the only known antipsychotic medication that has been shown to reduce the risk of suicide in patients diagnosed with schizophrenia. 1. A WBC of 4,000 in a patient taking clozapine would prompt the PMHNP to take which of the following actions? - Discontinue clozapine, initiate alternative antipsychotic medication and monitor closely. - Institute daily complete blood count with differentials and monitor closely. - Consult with hematologist to determine appropriate antibiotic regimen and monitor closely. - Institute twice-weekly complete blood count with differentials and monitor closely. - Institute twice-weekly complete blood count with differentials and monitor closely. Rationale: 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 compromised immune system. At a WBC of 4,000, the recommendation is to closely monitor CBC with differential twice a week while patient may continue clozapine in the absence of any other signs or symptoms.