Page 1 of 176
ANCC IQ DOMAINS 1-5 Psychiatric-Mental
Health Nurse Questions & Correct Verified
Answers 100% Guaranteed Pass
||Complete A+ Guide
1. A patient with schizophrenia has refractory auditory
hallucinations. Which neurotransmitter system is the
primary target for augmentation?
• A) GABA
• B) Glutamate
• C) Serotonin (5-HT2A)
• D) Dopamine (D2)
Answer: B (Glutamate)
*Rationale: Refractory symptoms may respond to
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glutamate modulators (e.g., glycine, sarcosine). D2
blockade is first-line but not always sufficient.*
2. A PMHNP prescribes fluoxetine. The patient reports
nausea and insomnia. This is most likely due to which
receptor effect?
• A) 5-HT2C antagonism
• B) 5-HT3 activation
• C) Histamine H1 blockade
• D) Alpha-1 antagonism
Answer: B (5-HT3 activation)
*Rationale: SSRIs increase serotonin, activating 5-HT3
receptors in the gut and brainstem → nausea, GI
distress.*
3. (Scenario) A 68-year-old with Parkinson’s disease
develops visual hallucinations of small animals. He takes
carbidopa/levodopa. What is the most likely cause?
,Page 3 of 176
• A) Dopamine deficiency in mesocortical pathway
• B) Excess dopamine in mesolimbic pathway
• C) Acetylcholine excess
• D) Serotonin toxicity
Answer: B
Rationale: Dopaminergic medications overstimulate
mesolimbic D2 receptors → psychosis.
4. Which anticonvulsant is most associated with
hyponatremia in older adults?
• A) Lamotrigine
• B) Oxcarbazepine
• C) Valproate
• D) Gabapentin
Answer: B (Oxcarbazepine)
Rationale: Carbamazepine and oxcarbazepine cause
SIADH → hyponatremia, especially in elderly.
, Page 4 of 176
5. A patient on clozapine develops fever, tachycardia, and
M. M. M. M. M. M. M.
M . rigid muscles. What is the priority action?
M. M. M. M. M. M.
• A) Draw CK and hold clozapine
M. M. M. M. M.
• B) Give diphenhydramine
M. M.
• C) Increase clozapine dose
M. M. M.
• D) Order EEGM. M.
Answer: A M .
Rationale: Suspect neuroleptic malignant syndrome (NMS).
M. M. M. M. M.
M. Hold antipsychotic, monitor CK, transfer to medical unit.
M. M. M. M. M. M. M.
6. Which receptor blockade is most responsible for weight
M. M. M. M. M. M. M.
M. gain with olanzapine?
M. M.
• A) D2 M.
• B) 5-HT2A M.
• C) H1 M.
• D) M1 M.
Answer: C (H1) M. M.
ANCC IQ DOMAINS 1-5 Psychiatric-Mental
Health Nurse Questions & Correct Verified
Answers 100% Guaranteed Pass
||Complete A+ Guide
1. A patient with schizophrenia has refractory auditory
hallucinations. Which neurotransmitter system is the
primary target for augmentation?
• A) GABA
• B) Glutamate
• C) Serotonin (5-HT2A)
• D) Dopamine (D2)
Answer: B (Glutamate)
*Rationale: Refractory symptoms may respond to
,Page 2 of 176
glutamate modulators (e.g., glycine, sarcosine). D2
blockade is first-line but not always sufficient.*
2. A PMHNP prescribes fluoxetine. The patient reports
nausea and insomnia. This is most likely due to which
receptor effect?
• A) 5-HT2C antagonism
• B) 5-HT3 activation
• C) Histamine H1 blockade
• D) Alpha-1 antagonism
Answer: B (5-HT3 activation)
*Rationale: SSRIs increase serotonin, activating 5-HT3
receptors in the gut and brainstem → nausea, GI
distress.*
3. (Scenario) A 68-year-old with Parkinson’s disease
develops visual hallucinations of small animals. He takes
carbidopa/levodopa. What is the most likely cause?
,Page 3 of 176
• A) Dopamine deficiency in mesocortical pathway
• B) Excess dopamine in mesolimbic pathway
• C) Acetylcholine excess
• D) Serotonin toxicity
Answer: B
Rationale: Dopaminergic medications overstimulate
mesolimbic D2 receptors → psychosis.
4. Which anticonvulsant is most associated with
hyponatremia in older adults?
• A) Lamotrigine
• B) Oxcarbazepine
• C) Valproate
• D) Gabapentin
Answer: B (Oxcarbazepine)
Rationale: Carbamazepine and oxcarbazepine cause
SIADH → hyponatremia, especially in elderly.
, Page 4 of 176
5. A patient on clozapine develops fever, tachycardia, and
M. M. M. M. M. M. M.
M . rigid muscles. What is the priority action?
M. M. M. M. M. M.
• A) Draw CK and hold clozapine
M. M. M. M. M.
• B) Give diphenhydramine
M. M.
• C) Increase clozapine dose
M. M. M.
• D) Order EEGM. M.
Answer: A M .
Rationale: Suspect neuroleptic malignant syndrome (NMS).
M. M. M. M. M.
M. Hold antipsychotic, monitor CK, transfer to medical unit.
M. M. M. M. M. M. M.
6. Which receptor blockade is most responsible for weight
M. M. M. M. M. M. M.
M. gain with olanzapine?
M. M.
• A) D2 M.
• B) 5-HT2A M.
• C) H1 M.
• D) M1 M.
Answer: C (H1) M. M.
