PMHNP Boards – question with answers%
Which of the following is a contraindication to benzodiazepines?
a. Acute alcohol intoxication
b. Acute narrow angle glaucoma
c. Psychosis
d. All the above - -a. Acute alcohol intoxication
-In the pharmacological treatment of psychosis, when antipsychotics are
administered, which block dopamine, a secondary effect is blocking in another tract,
which causes potential prolactin problems, such as gynecomastia in males. This tract
is the:
a. mesolimbic
b. tuberoinfundibular
c. nigrostrial dopamine tract
d. mesocortical - -b. tuberoinfundibular
-A six-year-old patient with autism spectrum disorder has not responded to six
months of psychosocial interventions and continues to demonstrate aggressive
tendencies toward a younger sibling. The psychiatric-mental health nurse practitioner
prescribes:
1. carbamazepine (Tegretol) 200 mg once a day.
2. haloperidol (Haldol) 2 mg once a day.
3. risperidone (Risperdal) 0.25 mg once a day.
4. venlafaxine ER (Effexor XR) 37.5 mg once a day. - -3. risperidone (Risperdal) 0.25
mg once a day.
-Which drug is likely to produce liver failure and hepatitis?
1. Lamotrigine
2. Gabapentin
3. Carbamazepine
4. Topiramate - -3. Carbamazepine
-EPS arises from:
a. D2 blockade in the nigrostriatial tract
b. D2 blockade in the tuberoinfundibular tract
c. D2 blockade in the alpha-1 adrenergic receptor blockade
d. D2 blockade in the HPA axis - -a. D2 blockade in the nigrostriatial tract
-Which drug carries a higher risk of metabolic effects than the other second
generation antipsychotics: weight gain, diabetes, dyslipidemia ?
a. Clozaril
b. Zyprexa
c. Risperdal
d. Geodon - -b. Zyprexa
-A patient has not had any relief of symptoms with Fluoxetine, and is going to be
started on an MAOI. How long before starting the MAOI should the Fluoxetine be
withdrawn?
,a. 2 weeks
b. 3 weeks
c. 4 weeks
d. 5 weeks - -a. 2 weeks
-Which drug can produce serious side effect of rash in some Asians, and the FDA has
mandated genetic testing before the administration of this drug?
a. Dilantin
b. Lamictal
c. Depakote
d. Tegretol - -d. Tegretol
-Which is considered the most sedating SSRI?
a. Paroxetine
b. Sertraline
c. Fluoxetine
d. Escitalopram Oxalate - -a. Paroxetine (Paxil is EVIL)
-Brain structure responsible for mediating mood, fear, emotion, and aggression; also
responsible for connecting sensory smell information with emotions - -amygdala
-Regulates memory and converts short-term memory into long-term memory - -
-Plays key roles in various regulatory functions such as appetite, sensations of
hunger and thirst, water balance, circadian rhythms, body temperature, libido, and
hormonal regulation - -
-Patient on lithium and cipro Cipro _____________ lithium level - -
-Patient on psych meds and dexamethasone will complain of what? - -
-Patient w/ schizophrenia, structural changes of the brain on CT - -
-Which lab is checked with clozaril? - -ANC
-Lobes of the Brain - Fred Tore his Pants Off - -Frontal - executive fx, logical thinking
Temporal (tempo) sound
Occipital (optic) vision
Parietal (pat) touch
-You ask a patient to clench her teeth, which cranial nerve are you testing? - -Cranial
nerve 5 - TRIGEMINAL
-What does the frontal lobe affect? (LIMP) - -Executive functions:
Language
Intelligence (cognitive functoning)
Motor Function
Personality
-What does temporal lobe affect? (LAME) - -Language
, Affective Component of speech
Memory
Emotion
-In which lobe of the brain does the limbic system reside? - -The temporal lobe
-What is Wernicke's area responsible for and where does it reside in the brain? - -
Wernicke's area is responsible for receptive speech and it resides in the temporal lobe.
-What is the first line drug for OCD? - -SSRIs
-What is the drug of choice for ADHD for 8 y.o and above? - -Stimulants (specifically
ritalin - methyphenidate)
-If child develops tics, what do you prescribe? - -Guanfacine
-What does parietal lobe affect? (VAST) - -Visual spatial processing
Association cortex
Symbolic recognition
Topographic sense
-what is sterognosis? how do you test it? - -Place objects in hand with closed eyes.
Ability to differentiate items comes from parietal lobe
-What does the occipital lobe affect? (VIP) - -Visual integration
Primary visual cortex
-Patient was prescribed paroxetine 1 month ago and had since developed ED, he is
not a candidate for Wellbutrin because of a history of seizure disorder. What can you
prescribe? - -Cialis (tadalafil) or Viagra (sildenafil) phophodiasterase inhibitors
-What is mechanism of action of phophodiasterase inhibitors? - -Rapid absorption.
They pull blood to corpus cavernosum.
-What are the main functions of the limbic system? - -Regulation of emotion and
memory
Olfactory sense is combined with memories
Hippocampus is located here - memory
-Where are affective domains (emotions, feelings) originating in the brain? - -Anterior
cingulate gyrus (LIMBIC SYSTEM)
-If a patient with OCD has failed on SSRIs, what should you switch to? - -TCA -
anafranil
-Mood disorder is most associated with which neurotransmitters? - -serotonin and
norepinephrine
-Serotonin DOMAINS - -Depression
Obsessions
Which of the following is a contraindication to benzodiazepines?
a. Acute alcohol intoxication
b. Acute narrow angle glaucoma
c. Psychosis
d. All the above - -a. Acute alcohol intoxication
-In the pharmacological treatment of psychosis, when antipsychotics are
administered, which block dopamine, a secondary effect is blocking in another tract,
which causes potential prolactin problems, such as gynecomastia in males. This tract
is the:
a. mesolimbic
b. tuberoinfundibular
c. nigrostrial dopamine tract
d. mesocortical - -b. tuberoinfundibular
-A six-year-old patient with autism spectrum disorder has not responded to six
months of psychosocial interventions and continues to demonstrate aggressive
tendencies toward a younger sibling. The psychiatric-mental health nurse practitioner
prescribes:
1. carbamazepine (Tegretol) 200 mg once a day.
2. haloperidol (Haldol) 2 mg once a day.
3. risperidone (Risperdal) 0.25 mg once a day.
4. venlafaxine ER (Effexor XR) 37.5 mg once a day. - -3. risperidone (Risperdal) 0.25
mg once a day.
-Which drug is likely to produce liver failure and hepatitis?
1. Lamotrigine
2. Gabapentin
3. Carbamazepine
4. Topiramate - -3. Carbamazepine
-EPS arises from:
a. D2 blockade in the nigrostriatial tract
b. D2 blockade in the tuberoinfundibular tract
c. D2 blockade in the alpha-1 adrenergic receptor blockade
d. D2 blockade in the HPA axis - -a. D2 blockade in the nigrostriatial tract
-Which drug carries a higher risk of metabolic effects than the other second
generation antipsychotics: weight gain, diabetes, dyslipidemia ?
a. Clozaril
b. Zyprexa
c. Risperdal
d. Geodon - -b. Zyprexa
-A patient has not had any relief of symptoms with Fluoxetine, and is going to be
started on an MAOI. How long before starting the MAOI should the Fluoxetine be
withdrawn?
,a. 2 weeks
b. 3 weeks
c. 4 weeks
d. 5 weeks - -a. 2 weeks
-Which drug can produce serious side effect of rash in some Asians, and the FDA has
mandated genetic testing before the administration of this drug?
a. Dilantin
b. Lamictal
c. Depakote
d. Tegretol - -d. Tegretol
-Which is considered the most sedating SSRI?
a. Paroxetine
b. Sertraline
c. Fluoxetine
d. Escitalopram Oxalate - -a. Paroxetine (Paxil is EVIL)
-Brain structure responsible for mediating mood, fear, emotion, and aggression; also
responsible for connecting sensory smell information with emotions - -amygdala
-Regulates memory and converts short-term memory into long-term memory - -
-Plays key roles in various regulatory functions such as appetite, sensations of
hunger and thirst, water balance, circadian rhythms, body temperature, libido, and
hormonal regulation - -
-Patient on lithium and cipro Cipro _____________ lithium level - -
-Patient on psych meds and dexamethasone will complain of what? - -
-Patient w/ schizophrenia, structural changes of the brain on CT - -
-Which lab is checked with clozaril? - -ANC
-Lobes of the Brain - Fred Tore his Pants Off - -Frontal - executive fx, logical thinking
Temporal (tempo) sound
Occipital (optic) vision
Parietal (pat) touch
-You ask a patient to clench her teeth, which cranial nerve are you testing? - -Cranial
nerve 5 - TRIGEMINAL
-What does the frontal lobe affect? (LIMP) - -Executive functions:
Language
Intelligence (cognitive functoning)
Motor Function
Personality
-What does temporal lobe affect? (LAME) - -Language
, Affective Component of speech
Memory
Emotion
-In which lobe of the brain does the limbic system reside? - -The temporal lobe
-What is Wernicke's area responsible for and where does it reside in the brain? - -
Wernicke's area is responsible for receptive speech and it resides in the temporal lobe.
-What is the first line drug for OCD? - -SSRIs
-What is the drug of choice for ADHD for 8 y.o and above? - -Stimulants (specifically
ritalin - methyphenidate)
-If child develops tics, what do you prescribe? - -Guanfacine
-What does parietal lobe affect? (VAST) - -Visual spatial processing
Association cortex
Symbolic recognition
Topographic sense
-what is sterognosis? how do you test it? - -Place objects in hand with closed eyes.
Ability to differentiate items comes from parietal lobe
-What does the occipital lobe affect? (VIP) - -Visual integration
Primary visual cortex
-Patient was prescribed paroxetine 1 month ago and had since developed ED, he is
not a candidate for Wellbutrin because of a history of seizure disorder. What can you
prescribe? - -Cialis (tadalafil) or Viagra (sildenafil) phophodiasterase inhibitors
-What is mechanism of action of phophodiasterase inhibitors? - -Rapid absorption.
They pull blood to corpus cavernosum.
-What are the main functions of the limbic system? - -Regulation of emotion and
memory
Olfactory sense is combined with memories
Hippocampus is located here - memory
-Where are affective domains (emotions, feelings) originating in the brain? - -Anterior
cingulate gyrus (LIMBIC SYSTEM)
-If a patient with OCD has failed on SSRIs, what should you switch to? - -TCA -
anafranil
-Mood disorder is most associated with which neurotransmitters? - -serotonin and
norepinephrine
-Serotonin DOMAINS - -Depression
Obsessions
