NURS 660 EXAM 1 2026 TEST PAPER
QUESTIONS AND SOLUTIONS EXAMPREP
⩥ Severe Neutropenia. Answer: < 500μL
⩥ Moderate Neutropenia. Answer: 500-999μL
⩥ Mild Neutropenia. Answer: 1000-1499μL
⩥ BEN patients: Normal ANC range for Clozaril. Answer: ≥1,000 μL
⩥ Clozaril BEN patient: severe neutropenia. Answer: <500 μL
⩥ BEN neutropenia. Answer: 500-999 μL
⩥ Lower ANC threshold for starting clozapine: General population.
Answer: ≥1,500/μL
⩥ Lower ANC threshold for starting clozapine: Benign ethnic
neutropenia (BEN). Answer: 1,000/μL
,⩥ Medical emergencies when prescribing anti-psychotics. Answer: -
NMS
- Agranulocytosis
- Serotonin Syndrome
⩥ Clinical findings in agranulocytosis. Answer:
⩥ Clozaril: most likely side effect if pt develops fever within 6 weeks.
Answer: Myocarditis
⩥ Clozaril: if pt develops fever within 6 weeks order a ______,
_________ and _______.. Answer: EKG, CRP, Troponin, as this is
likely due to myocarditis
⩥ Common complaints in patients with neutropenia:
F,P, U, P. Answer: - Fever (low grade)
- painful swallowing (odynophagia)
- URI (sinusitis, otitis, cough)
- Perirectal pain/irritation
⩥ Symptoms of neuroleptic malignant syndrome (NMS):. Answer: -
High fever
- Tachycardia/irregular pulse
,- Increased respiratory rate
- Muscle Rigidity
- altered mental status
⩥ Off label TX for NMS. Answer: Amantadine (SYMMETREL)
⩥ Serotonin Syndrome onset:. Answer: -24 hours of combining
antidepressants
⩥ Serotonin Syndrome Cardinal features. Answer: - Myoclonic jerks
- Hyperreflexia
- Mental status changes
- Shivering
- Fever
- Tachycardia, HTN, hypotension (AUTONOMIC instability)
- Confused/ restless/ hyperactive/ unresponsive
⩥ Management of Serotonin syndrome. Answer: - Discontinue meds,
stablize vitals
⩥ Potentially
helpful meds with Serotonin syndrome:. Answer: Benzodiazepines for
agitation
, Cyproheptadine (anti-serotonergic antihistamine)
Methysergide (anti-serotonergic migraine medication)
⩥ 5-HT "TWITCHY FROG" Serotonin Syndrome. Answer: -Agitated
-Sweating
-Fever
-Hyperreflexia
-Dilated pupils
⩥ Neuroleptic Malignant Syndrome. Answer: a potentially fatal
hyperpyrexia with temp of over 104, looks like EPS except for temp
⩥ Neuroleptic Malignant Syndrome- "can't bender(er)". Answer: Life-
threatening muscle rigidity, fever, and rhabdomyolysis.
Mental status changes
⩥ Mechanism of NMS.
-What's blocked? Where (2)?. Answer: Dopamine blockade in the
hypothalamus (fever)
and nigrostriatal pathway (rigidity
⩥ Onset of NMS. Answer: 30 days of starting or increasing
antipsychotics or stoping a domaminergic drug
QUESTIONS AND SOLUTIONS EXAMPREP
⩥ Severe Neutropenia. Answer: < 500μL
⩥ Moderate Neutropenia. Answer: 500-999μL
⩥ Mild Neutropenia. Answer: 1000-1499μL
⩥ BEN patients: Normal ANC range for Clozaril. Answer: ≥1,000 μL
⩥ Clozaril BEN patient: severe neutropenia. Answer: <500 μL
⩥ BEN neutropenia. Answer: 500-999 μL
⩥ Lower ANC threshold for starting clozapine: General population.
Answer: ≥1,500/μL
⩥ Lower ANC threshold for starting clozapine: Benign ethnic
neutropenia (BEN). Answer: 1,000/μL
,⩥ Medical emergencies when prescribing anti-psychotics. Answer: -
NMS
- Agranulocytosis
- Serotonin Syndrome
⩥ Clinical findings in agranulocytosis. Answer:
⩥ Clozaril: most likely side effect if pt develops fever within 6 weeks.
Answer: Myocarditis
⩥ Clozaril: if pt develops fever within 6 weeks order a ______,
_________ and _______.. Answer: EKG, CRP, Troponin, as this is
likely due to myocarditis
⩥ Common complaints in patients with neutropenia:
F,P, U, P. Answer: - Fever (low grade)
- painful swallowing (odynophagia)
- URI (sinusitis, otitis, cough)
- Perirectal pain/irritation
⩥ Symptoms of neuroleptic malignant syndrome (NMS):. Answer: -
High fever
- Tachycardia/irregular pulse
,- Increased respiratory rate
- Muscle Rigidity
- altered mental status
⩥ Off label TX for NMS. Answer: Amantadine (SYMMETREL)
⩥ Serotonin Syndrome onset:. Answer: -24 hours of combining
antidepressants
⩥ Serotonin Syndrome Cardinal features. Answer: - Myoclonic jerks
- Hyperreflexia
- Mental status changes
- Shivering
- Fever
- Tachycardia, HTN, hypotension (AUTONOMIC instability)
- Confused/ restless/ hyperactive/ unresponsive
⩥ Management of Serotonin syndrome. Answer: - Discontinue meds,
stablize vitals
⩥ Potentially
helpful meds with Serotonin syndrome:. Answer: Benzodiazepines for
agitation
, Cyproheptadine (anti-serotonergic antihistamine)
Methysergide (anti-serotonergic migraine medication)
⩥ 5-HT "TWITCHY FROG" Serotonin Syndrome. Answer: -Agitated
-Sweating
-Fever
-Hyperreflexia
-Dilated pupils
⩥ Neuroleptic Malignant Syndrome. Answer: a potentially fatal
hyperpyrexia with temp of over 104, looks like EPS except for temp
⩥ Neuroleptic Malignant Syndrome- "can't bender(er)". Answer: Life-
threatening muscle rigidity, fever, and rhabdomyolysis.
Mental status changes
⩥ Mechanism of NMS.
-What's blocked? Where (2)?. Answer: Dopamine blockade in the
hypothalamus (fever)
and nigrostriatal pathway (rigidity
⩥ Onset of NMS. Answer: 30 days of starting or increasing
antipsychotics or stoping a domaminergic drug
