Georgette Quiz – All Modules: Questions With Precise
Solutions
A 46-year-old male with a history of bipolar disorder comes for a regular
follow up appoint with a PMHNP and presents with complaints of severe
vomiting, diarrhea, muscle weakness, blurred vision, and ataxia. The patient is
currently taking 900mg of Lithium daily. The PMHNP identifies these
symptoms as signs of lithium toxicity. What is the priority action of the
PMHNP?
a) Maintains medication of and monitors the symptoms
b) Tells the patient to stop taking lithium an orders a serum Lithium level
c) Order an EKG
d) Take the Patients vital signs Correct Answer - b) Tells the patient to
stop taking lithium an orders a serum Lithium level
For 12 years a 65-year-old patient with bipolar affective disorder has been
treated with lithium (Eskalith) 900 mg daily. When oral HCTZ 12.5 mg daily is
added for HTN, the patient develops nausea, vomiting, ataxia, muscle
weakness ad the patient serum lithium level s 2.0 mEq/L. The interaction of
the lithium and the thiazide diuretic has induced:
a) hypokalemia
b) hyponatremia
c) increased renal clearance of Lithium
d) reduced renal clearance of lithium Correct Answer - d) reduced renal
clearance of lithium
Mary, a 45 year old AA female has been treated on isocarboxazid (Marplan)
for over 6 years. Mary is going in for a surgical procedure. Which medication I
strictly contraindicated with Isocarboxazid?
a) Morphine
b) NSAIDS
c) Methylphenidate
d) Acetaminophen Correct Answer - c) Methylphenidate
The PMHNP is aware of the following signs to watch out for in patients taking
Clozapine (Clozaril):
A. Nosebleeds, bleeding gums, and skin rash
B. mutism, muscle rigidity, and hyperthermia
,C. fever, sore throat, and chills
D. Ataxia, confusion, and hypothyroidism Correct Answer - C. fever, sore
throat, and chills
A new prescription of carbamazepine (Tegretol) is given to a patient whose
baseline white blood cell (WBC) count is 5000/uL and absolute neutrophil
count (ANC) is 4000/uL. Laboratory tests show the patients WBC count has
decreased to 2500/uL and ANC has decreased to 750/uL after 2 weeks of
therapy. Similar outcomes are obtained when the laboratory studies are
repeated. The patient does not present with any signs of infection. What is the
next action of the PMHNP?
A) Continues the patient on Tegretol and monitors the patient for sign of
infection
B) Tells the patient to stop taking Tegretol and recheck the ANC and WBC
C) Continues the patient on Tegretol since the WBC is within normal limits
D) Refer the patient to a PCP Correct Answer - B) Tells the patient to stop
taking Tegretol and recheck the ANC and WBC
If given during pregnancy Sodium Valproate (Depakote) can cause which of
the following medical problems in the baby?
A) Steven-Johnson syndrome
B) Ebstein's anomaly
C) Spina bifida
D) Cleft Palate Correct Answer - C) Spina Bifida
Which mood stabilizer is associated with potential life-threatening rash in the
Asian population?
A) Carbamazepine (Tegretol)
B) Depakote
C) Lithium
D) Lamictal Correct Answer - A) Carbamazepine (Tegretol)
Which of the following physical exam finding would help the PMHNP
differentiate anorexia nervosa from bulimia nervosa?
A) Russell sign
B) Low body mass index
C) Erosion of dental enamel
D) Hypertrophy of salivary glands Correct Answer - Low body mass index
,Which of the following medications has a unique medication that is a
norepinephrine and dopamine reuptake inhibitor?
A) Bupriopion (Wellbutrin)
B) Sertraline (Zoloft)
C) Clomipramine (Anafranil)
D) Duloxetine (Cymbalta) Correct Answer - Bupropion (Wellbutrin)
Which cytochrome (CYP) enzyme is implicated as a tobacco inducer when an
individual is treated with clozapine?
A) 2D6
B) 1A2
C) 2C19
D) 2C9 Correct Answer - 1A2
When treating older adults you should keep in mind that they are more
sensitive to issues of drug toxicity because of which of the following reasons?
A) decrease body fat
B) Increased liver capacity
C) Decreased protein binding
D) Increased muscle concentration Correct Answer - Decreased protein
binding
Serotonin is a neurotransmitter that is implicated in sleep and mood. What
area of the brain has a large majority of serotonin neurons?
A) Raphe nuclei
B) Nucleus Accumbens
C) Locus Coeruleus
D) Amygdala Correct Answer - Raphe Nuclei
A client who is experiencing difficulties with working memory, planning, and
prioritizing, insight into his problems, and impulse control presents for
assessment. In planning his care, the PMHNP should apply his or her
knowledge that these symptoms represent problems with the:
A) Frontal lobe
B) Temporal Lobe
C) Parietal lobe
, D) Occipital lobe Correct Answer - Frontal Lobe
Which of these brain structures puts emotional meaning on a stimulus, forms
emotional memories, and is involved with rage and fear?
A) Hippocampus
B) Temporal Lobe
C) Amygdala
D) Occipital Lobe Correct Answer - Amygdala
A client presents with complaints of changes in circadian rhythms, appetite,
feeling fatigued, problems with sleep-rest cycle and changes in libido. What is
the neuroanatomic area of the brain that is responsible for the normal
regulation of these functions?
A) Thalamus
B) Hypothalamus
C) Temporal lobe
D) Hippocampus Correct Answer - Hypothalamus
The anatomical structure of the limbic system that is associated with a
reaction to stress is the:
A) Cerebellum
B) Hippocampus
C) Thalamus
D) Hypothalamus Correct Answer - Hippocampus
A 45 year old AA male diagnosed with schizophrenia arrives at your clinic for
a regular medication appointment. He is currently stabilized on
chlorpromazine. You notice his face appears mask-like and he walked with a
shuffling gait. Based on this information, what eps side effect would you
suspect?
A) Akathisia
B) Akinesia
C) Dystonia
D) Pseudo-Parkinson's Correct Answer - pseudo-parkinsons
A patient has been treated for the past several years with fluphenazine
(Prolixin). You notice that he is drooling and he has tremor and slight pill
rolling movement of the fingers. These are the ESP symptoms known as:A)
Anticholinergic effect
Solutions
A 46-year-old male with a history of bipolar disorder comes for a regular
follow up appoint with a PMHNP and presents with complaints of severe
vomiting, diarrhea, muscle weakness, blurred vision, and ataxia. The patient is
currently taking 900mg of Lithium daily. The PMHNP identifies these
symptoms as signs of lithium toxicity. What is the priority action of the
PMHNP?
a) Maintains medication of and monitors the symptoms
b) Tells the patient to stop taking lithium an orders a serum Lithium level
c) Order an EKG
d) Take the Patients vital signs Correct Answer - b) Tells the patient to
stop taking lithium an orders a serum Lithium level
For 12 years a 65-year-old patient with bipolar affective disorder has been
treated with lithium (Eskalith) 900 mg daily. When oral HCTZ 12.5 mg daily is
added for HTN, the patient develops nausea, vomiting, ataxia, muscle
weakness ad the patient serum lithium level s 2.0 mEq/L. The interaction of
the lithium and the thiazide diuretic has induced:
a) hypokalemia
b) hyponatremia
c) increased renal clearance of Lithium
d) reduced renal clearance of lithium Correct Answer - d) reduced renal
clearance of lithium
Mary, a 45 year old AA female has been treated on isocarboxazid (Marplan)
for over 6 years. Mary is going in for a surgical procedure. Which medication I
strictly contraindicated with Isocarboxazid?
a) Morphine
b) NSAIDS
c) Methylphenidate
d) Acetaminophen Correct Answer - c) Methylphenidate
The PMHNP is aware of the following signs to watch out for in patients taking
Clozapine (Clozaril):
A. Nosebleeds, bleeding gums, and skin rash
B. mutism, muscle rigidity, and hyperthermia
,C. fever, sore throat, and chills
D. Ataxia, confusion, and hypothyroidism Correct Answer - C. fever, sore
throat, and chills
A new prescription of carbamazepine (Tegretol) is given to a patient whose
baseline white blood cell (WBC) count is 5000/uL and absolute neutrophil
count (ANC) is 4000/uL. Laboratory tests show the patients WBC count has
decreased to 2500/uL and ANC has decreased to 750/uL after 2 weeks of
therapy. Similar outcomes are obtained when the laboratory studies are
repeated. The patient does not present with any signs of infection. What is the
next action of the PMHNP?
A) Continues the patient on Tegretol and monitors the patient for sign of
infection
B) Tells the patient to stop taking Tegretol and recheck the ANC and WBC
C) Continues the patient on Tegretol since the WBC is within normal limits
D) Refer the patient to a PCP Correct Answer - B) Tells the patient to stop
taking Tegretol and recheck the ANC and WBC
If given during pregnancy Sodium Valproate (Depakote) can cause which of
the following medical problems in the baby?
A) Steven-Johnson syndrome
B) Ebstein's anomaly
C) Spina bifida
D) Cleft Palate Correct Answer - C) Spina Bifida
Which mood stabilizer is associated with potential life-threatening rash in the
Asian population?
A) Carbamazepine (Tegretol)
B) Depakote
C) Lithium
D) Lamictal Correct Answer - A) Carbamazepine (Tegretol)
Which of the following physical exam finding would help the PMHNP
differentiate anorexia nervosa from bulimia nervosa?
A) Russell sign
B) Low body mass index
C) Erosion of dental enamel
D) Hypertrophy of salivary glands Correct Answer - Low body mass index
,Which of the following medications has a unique medication that is a
norepinephrine and dopamine reuptake inhibitor?
A) Bupriopion (Wellbutrin)
B) Sertraline (Zoloft)
C) Clomipramine (Anafranil)
D) Duloxetine (Cymbalta) Correct Answer - Bupropion (Wellbutrin)
Which cytochrome (CYP) enzyme is implicated as a tobacco inducer when an
individual is treated with clozapine?
A) 2D6
B) 1A2
C) 2C19
D) 2C9 Correct Answer - 1A2
When treating older adults you should keep in mind that they are more
sensitive to issues of drug toxicity because of which of the following reasons?
A) decrease body fat
B) Increased liver capacity
C) Decreased protein binding
D) Increased muscle concentration Correct Answer - Decreased protein
binding
Serotonin is a neurotransmitter that is implicated in sleep and mood. What
area of the brain has a large majority of serotonin neurons?
A) Raphe nuclei
B) Nucleus Accumbens
C) Locus Coeruleus
D) Amygdala Correct Answer - Raphe Nuclei
A client who is experiencing difficulties with working memory, planning, and
prioritizing, insight into his problems, and impulse control presents for
assessment. In planning his care, the PMHNP should apply his or her
knowledge that these symptoms represent problems with the:
A) Frontal lobe
B) Temporal Lobe
C) Parietal lobe
, D) Occipital lobe Correct Answer - Frontal Lobe
Which of these brain structures puts emotional meaning on a stimulus, forms
emotional memories, and is involved with rage and fear?
A) Hippocampus
B) Temporal Lobe
C) Amygdala
D) Occipital Lobe Correct Answer - Amygdala
A client presents with complaints of changes in circadian rhythms, appetite,
feeling fatigued, problems with sleep-rest cycle and changes in libido. What is
the neuroanatomic area of the brain that is responsible for the normal
regulation of these functions?
A) Thalamus
B) Hypothalamus
C) Temporal lobe
D) Hippocampus Correct Answer - Hypothalamus
The anatomical structure of the limbic system that is associated with a
reaction to stress is the:
A) Cerebellum
B) Hippocampus
C) Thalamus
D) Hypothalamus Correct Answer - Hippocampus
A 45 year old AA male diagnosed with schizophrenia arrives at your clinic for
a regular medication appointment. He is currently stabilized on
chlorpromazine. You notice his face appears mask-like and he walked with a
shuffling gait. Based on this information, what eps side effect would you
suspect?
A) Akathisia
B) Akinesia
C) Dystonia
D) Pseudo-Parkinson's Correct Answer - pseudo-parkinsons
A patient has been treated for the past several years with fluphenazine
(Prolixin). You notice that he is drooling and he has tremor and slight pill
rolling movement of the fingers. These are the ESP symptoms known as:A)
Anticholinergic effect
