Comprehensive ANCC PMHNP Exam Review: Neuro, Pharmacology,
and Mental Health Disorders
Cranial nerve V (trigeminal) assessment - correct answer Tell patient to close eyes, take piece of
cotton or other soft item and lightly touch either one of both sides of each of the three
divisions of the trigeminal.
Cranial nerve VII (facial) assessment - correct answer Observe the patient for nystagmus or
twitching of the eye. This nerve controls facial movements and expression, check for symmetry.
Have the patient wrinkle forehead, close eyes, smile, pucker lips, show teeth, and puff out
cheeks.
Primitive reflexes - correct answer Reflexes, controlled by 'primitive' parts of the brain, that
disappear during the first year of life.
Mororeflex - correct answer Extending of limbs when they hear a loud noise (defend
themselves).
Rooting reflex - correct answer A baby's tendency, when touched on the cheek, to turn toward
the touch, open the mouth, and search for the nipple.
Palmer grasp - correct answer Grasping with the whole hand.
Scope of practice - correct answer The range of clinical procedures and activities that are
allowed by law for a profession.
Quality Improvement (QI) - correct answer An approach to the continuous study and
improvement of the processes of providing health care services to meet the needs of patients
and others and inform health care policy.
PDSA model - correct answer Plan-Do-Study-Act Model from the Institute for Healthcare
Improvement (IHI).
Trendelenburg sign - correct answer Occurs with severe subluxation of one hip. When the child
stands on the good leg, the pelvis looks level. When the child stands on the affected leg the
pelvis drops toward the good side.
CYP450 inhibitors - correct answer Fluvoxamine, Fluoxetine, Paroxetine, Duloxetine, Sertraline.
CYP450 inducers - correct answer Carbamazepine, Phenobarbital, Phenytoin, Rifampin,
Griseofulvin, St John's Wort.
Adverse effect of Depakote on the liver - correct answer Can cause liver damage, and the risk is
more likely to occur during the first 6 months of taking the medication. Signs might include
nausea or vomiting, loss of appetite, abdominal pain, dark-colored urine, facial swelling, and
yellowing of the skin or white of eyes.
, Management for patient on Depakote with +4 protein in urine - correct answer Rule out UTI, no
adjustment for medication is needed.
Effect of carbamazepine and erythromycin together - correct answer It will decrease the effect
of the antibiotic by inhibition.
Effect of zyprexa and smoking - correct answer Nicotine will increase the excretion of the drug
thereby inhibiting its effect.
ICP in Infants S/S - correct answer Bulging fontanels, high-pitch cry, irritability, restlessness.
ICP in Children signs and symptoms - correct answer Headache, Vomiting (usually projectile),
Seizures, Diplopia (Double vision), blurred vision.
Neuro cry - correct answer High-pitched and very grating on the ears due to their neurological
symptoms being overwhelmed.
Neuroleptic Malignant Syndrome (NMS) - correct answer Adverse reaction to antipsychotics
with severe 'lead pipe' rigidity, FEVER, and mental status changes.
NMS treatment - correct answer Dantrolene, D2 agonists (e.g., bromocriptine).
lead poisoning - correct answer A medical condition caused by toxic levels of the metal lead in
the blood
chelation therapy - correct answer Lead poisoning treatment
Amygdala's role in emotion - correct answer Aggression center; Role in storing implicit
emotional memories; Stimulation (+) anger/violence or fear/anxiety; Damage (-) mellow;
hyperorality; hypersexuality; dis-inhibited behavior
Amygdala role in aggression - correct answer Small volume increase aggression.
Frontal Lobe Atrophy - correct answer As neurons die in the frontal and temporal regions, these
lobes atrophy, or shrink. Gradually, this damage causes difficulties in thinking and behaviors
normally controlled by these parts of the brain.
FTLD - correct answer Frontal temporal lobe dementia, the most common cause of dementia in
people younger than age 60.
mesocortical pathway - correct answer A path through which dopaminergic projections travel
to reach the neocortex.
mesolimbic pathway - correct answer The mesolimbic pathway, sometimes referred to as the
reward pathway, is a dopaminergic pathway in the brain that connects the ventral tegmental
area in the midbrain to the ventral striatum of the basal ganglia in the forebrain.
and Mental Health Disorders
Cranial nerve V (trigeminal) assessment - correct answer Tell patient to close eyes, take piece of
cotton or other soft item and lightly touch either one of both sides of each of the three
divisions of the trigeminal.
Cranial nerve VII (facial) assessment - correct answer Observe the patient for nystagmus or
twitching of the eye. This nerve controls facial movements and expression, check for symmetry.
Have the patient wrinkle forehead, close eyes, smile, pucker lips, show teeth, and puff out
cheeks.
Primitive reflexes - correct answer Reflexes, controlled by 'primitive' parts of the brain, that
disappear during the first year of life.
Mororeflex - correct answer Extending of limbs when they hear a loud noise (defend
themselves).
Rooting reflex - correct answer A baby's tendency, when touched on the cheek, to turn toward
the touch, open the mouth, and search for the nipple.
Palmer grasp - correct answer Grasping with the whole hand.
Scope of practice - correct answer The range of clinical procedures and activities that are
allowed by law for a profession.
Quality Improvement (QI) - correct answer An approach to the continuous study and
improvement of the processes of providing health care services to meet the needs of patients
and others and inform health care policy.
PDSA model - correct answer Plan-Do-Study-Act Model from the Institute for Healthcare
Improvement (IHI).
Trendelenburg sign - correct answer Occurs with severe subluxation of one hip. When the child
stands on the good leg, the pelvis looks level. When the child stands on the affected leg the
pelvis drops toward the good side.
CYP450 inhibitors - correct answer Fluvoxamine, Fluoxetine, Paroxetine, Duloxetine, Sertraline.
CYP450 inducers - correct answer Carbamazepine, Phenobarbital, Phenytoin, Rifampin,
Griseofulvin, St John's Wort.
Adverse effect of Depakote on the liver - correct answer Can cause liver damage, and the risk is
more likely to occur during the first 6 months of taking the medication. Signs might include
nausea or vomiting, loss of appetite, abdominal pain, dark-colored urine, facial swelling, and
yellowing of the skin or white of eyes.
, Management for patient on Depakote with +4 protein in urine - correct answer Rule out UTI, no
adjustment for medication is needed.
Effect of carbamazepine and erythromycin together - correct answer It will decrease the effect
of the antibiotic by inhibition.
Effect of zyprexa and smoking - correct answer Nicotine will increase the excretion of the drug
thereby inhibiting its effect.
ICP in Infants S/S - correct answer Bulging fontanels, high-pitch cry, irritability, restlessness.
ICP in Children signs and symptoms - correct answer Headache, Vomiting (usually projectile),
Seizures, Diplopia (Double vision), blurred vision.
Neuro cry - correct answer High-pitched and very grating on the ears due to their neurological
symptoms being overwhelmed.
Neuroleptic Malignant Syndrome (NMS) - correct answer Adverse reaction to antipsychotics
with severe 'lead pipe' rigidity, FEVER, and mental status changes.
NMS treatment - correct answer Dantrolene, D2 agonists (e.g., bromocriptine).
lead poisoning - correct answer A medical condition caused by toxic levels of the metal lead in
the blood
chelation therapy - correct answer Lead poisoning treatment
Amygdala's role in emotion - correct answer Aggression center; Role in storing implicit
emotional memories; Stimulation (+) anger/violence or fear/anxiety; Damage (-) mellow;
hyperorality; hypersexuality; dis-inhibited behavior
Amygdala role in aggression - correct answer Small volume increase aggression.
Frontal Lobe Atrophy - correct answer As neurons die in the frontal and temporal regions, these
lobes atrophy, or shrink. Gradually, this damage causes difficulties in thinking and behaviors
normally controlled by these parts of the brain.
FTLD - correct answer Frontal temporal lobe dementia, the most common cause of dementia in
people younger than age 60.
mesocortical pathway - correct answer A path through which dopaminergic projections travel
to reach the neocortex.
mesolimbic pathway - correct answer The mesolimbic pathway, sometimes referred to as the
reward pathway, is a dopaminergic pathway in the brain that connects the ventral tegmental
area in the midbrain to the ventral striatum of the basal ganglia in the forebrain.
