ANCC Review Questions (PMHNP IQ)
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
blockade. 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?
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.
1/9
, ANCC Review Questions (PMHNP IQ)
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.
4. 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 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?
A) Agitation, nausea, dysphoria, and diequilibrium
B) Agitation, nausea, tremor, and ataxia.
C) Restlessness, tremor, fever, and shivering.
D) Restlessness, headache, increased heart rate, and diarrhea.: A) Agitation;
nausea, dysphoria, and disequilibrium
The patient has SSRI discontinuation syndrome and would be presenting with flu-
like symptoms. If the patient had serotonin syndrome, she would present with
symptoms of autonomic instability.
6. Which of the following statements reflect the current understanding of
dopamine (DA) pathways and clinical symptoms in schizophrenia?
2/9
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
blockade. 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?
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.
1/9
, ANCC Review Questions (PMHNP IQ)
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.
4. 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 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?
A) Agitation, nausea, dysphoria, and diequilibrium
B) Agitation, nausea, tremor, and ataxia.
C) Restlessness, tremor, fever, and shivering.
D) Restlessness, headache, increased heart rate, and diarrhea.: A) Agitation;
nausea, dysphoria, and disequilibrium
The patient has SSRI discontinuation syndrome and would be presenting with flu-
like symptoms. If the patient had serotonin syndrome, she would present with
symptoms of autonomic instability.
6. Which of the following statements reflect the current understanding of
dopamine (DA) pathways and clinical symptoms in schizophrenia?
2/9
