ANCC Review Questions
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).
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.
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 closely. - 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 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.
, 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.
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.
Which of the following statements reflect the current understanding of dopamine (DA)
pathways and clinical symptoms in schizophrenia?
A) Negative symptoms are related to DA deficit in the cerebral cortex; positive
symptoms are related to DA excess in the nucleus accumbens and mesolimbic system.
B) Negative symptoms are related to DA excess in the cerebral cortex; positive
symptoms are related to DA deficit in the nucleus accumbens and mesolimbic system.
C) Negative symptoms are related to DA excess in the mesolimbic system; positive
symptoms are related to DA deficit in the substantia nigra and ventral tegmental area.
Negative symptoms are related to DA deficit in the mesolimbic system; positive
symptoms are related to DA excess in the substantia nigra and ventral tegmental area. -
A) Negative symptoms are related to DA deficit in the cerebral cortex; positive
symptoms are related to DA excess in the nucleus accumbens and mesolimbic system.
Negative symptoms & cognitive impairment are thought to be related to hypoactivity of
the mesocortical dopiminergic tract, which by its association with the prefrontal cortex
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).
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.
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 closely. - 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 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.
, 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.
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.
Which of the following statements reflect the current understanding of dopamine (DA)
pathways and clinical symptoms in schizophrenia?
A) Negative symptoms are related to DA deficit in the cerebral cortex; positive
symptoms are related to DA excess in the nucleus accumbens and mesolimbic system.
B) Negative symptoms are related to DA excess in the cerebral cortex; positive
symptoms are related to DA deficit in the nucleus accumbens and mesolimbic system.
C) Negative symptoms are related to DA excess in the mesolimbic system; positive
symptoms are related to DA deficit in the substantia nigra and ventral tegmental area.
Negative symptoms are related to DA deficit in the mesolimbic system; positive
symptoms are related to DA excess in the substantia nigra and ventral tegmental area. -
A) Negative symptoms are related to DA deficit in the cerebral cortex; positive
symptoms are related to DA excess in the nucleus accumbens and mesolimbic system.
Negative symptoms & cognitive impairment are thought to be related to hypoactivity of
the mesocortical dopiminergic tract, which by its association with the prefrontal cortex
