ANCC2 CERTIFICATION EVALUATION QUESTIONS AND ANSWERS
◍ List the Tricyclic Antidepressants (9). Answer: Pamelor
(nortriptyline), Elavil (amitriptyline), amoxapine (no branded),
Anafranil (clomipramine), Norpramin (desipramine), Tofranil
(imipramine), Vivactil (protriptyline), Sinequan/Silenor (doxepin),
Surmontil (trimipramine)
◍ FINISH acronym for SSRI withdrawal. Answer: Flu-like symptoms
Irritability
Nausea
Imbalance/instability/incoordination/dizzy (motor)
Sensory disturbances
Headache, hyperarousal (anxiety/agitation)
◍ Signs of NMS (Neuroleptic Malignant Syndrome). Answer: Initial
Symptoms: altered sensorium, hyperreflexia, fever
Then signs of autonomic instability: extreme muscle rigidity,
hypotension, tachycardia, diaphoresis, tachypnea, hyperthermia,
coma, death.
Check for increased WBCs (leukocytosis)/LFTs/CPK
,◍ Signs of Lithium toxicity. Answer: Confusion, diplopia,
nausea/diarrhea, ataxia, lethargy, fatigue, clumsiness, weakness,
muscle cramping, severe tremor, blurred vision, nystagmus, increased
DTRs, altered mental status, cardiac dysrhythmias
◍ Signs of Serotonin Snydrome. Answer: agitation, restlessness, rapid
heart rate, blood pressure elevation, headache, sweating, shivering,
goose bumps, myoclonic jerking and loss of coordination, confusion,
fevers, unconsciousness, seizures
◍ Medications that can increase lithium level. Answer: NSAIDs,
ACE Inhibitors (-prils), ARBs (-sartans), tetracyclines, metronidazole
◍ Medications that can decrease lithium level. Answer: potassium-
sparing diuretics, thiazide diuretics, theophylline
◍ Clozaril - monitoring considerations. Answer: Monitor ANC
(absolute neutrophil count); pt needs an ANC of at least 1500 to start
clozaril therapy; watch for Benign Ethnic Neutropenia (BED);
Monitor ANC weekly x6 months, every 2 weeks x6 months, then
monthly if ANC is at least 1500.
◍ Substances that can cause a false + drug test for PCP & methadone.
Answer: Niquil, OTC cough meds
◍ Substances that can cause a false + drug test for heroin &
morphine. Answer: rifampin, fluoroquniolones
, ◍ Substances that can cause a false + drug test for cocaine. Answer:
NSAIDs, amoxicillin, most antibiotics
◍ Substances that can cause a false + drug test for amphetamines.
Answer: Prozac, Wellbutrin, Trazodone, Nefazodone, Sudafed, OTC
decongestants.
◍ Schizophrenia Prevalence:
Non-twin siblings of a schizophrenic parent
Dizygotic twins of a schizophrenic parent
Monozygotic twins of a schizophrenic parent. Answer: 8%
12%
47%
◍ Birth defects caused by benzodiazepines. Answer: Cleft palate,
floppy baby syndrome
◍ Birth defects caused by carbamazepine. Answer: Neural tube
defects
◍ Birth defects caused by depakote. Answer: Neural tube defects
(spina bifida), cleft palate, atrial-septal defects, long-term
developmental deficits
◍ List the Tricyclic Antidepressants (9). Answer: Pamelor
(nortriptyline), Elavil (amitriptyline), amoxapine (no branded),
Anafranil (clomipramine), Norpramin (desipramine), Tofranil
(imipramine), Vivactil (protriptyline), Sinequan/Silenor (doxepin),
Surmontil (trimipramine)
◍ FINISH acronym for SSRI withdrawal. Answer: Flu-like symptoms
Irritability
Nausea
Imbalance/instability/incoordination/dizzy (motor)
Sensory disturbances
Headache, hyperarousal (anxiety/agitation)
◍ Signs of NMS (Neuroleptic Malignant Syndrome). Answer: Initial
Symptoms: altered sensorium, hyperreflexia, fever
Then signs of autonomic instability: extreme muscle rigidity,
hypotension, tachycardia, diaphoresis, tachypnea, hyperthermia,
coma, death.
Check for increased WBCs (leukocytosis)/LFTs/CPK
,◍ Signs of Lithium toxicity. Answer: Confusion, diplopia,
nausea/diarrhea, ataxia, lethargy, fatigue, clumsiness, weakness,
muscle cramping, severe tremor, blurred vision, nystagmus, increased
DTRs, altered mental status, cardiac dysrhythmias
◍ Signs of Serotonin Snydrome. Answer: agitation, restlessness, rapid
heart rate, blood pressure elevation, headache, sweating, shivering,
goose bumps, myoclonic jerking and loss of coordination, confusion,
fevers, unconsciousness, seizures
◍ Medications that can increase lithium level. Answer: NSAIDs,
ACE Inhibitors (-prils), ARBs (-sartans), tetracyclines, metronidazole
◍ Medications that can decrease lithium level. Answer: potassium-
sparing diuretics, thiazide diuretics, theophylline
◍ Clozaril - monitoring considerations. Answer: Monitor ANC
(absolute neutrophil count); pt needs an ANC of at least 1500 to start
clozaril therapy; watch for Benign Ethnic Neutropenia (BED);
Monitor ANC weekly x6 months, every 2 weeks x6 months, then
monthly if ANC is at least 1500.
◍ Substances that can cause a false + drug test for PCP & methadone.
Answer: Niquil, OTC cough meds
◍ Substances that can cause a false + drug test for heroin &
morphine. Answer: rifampin, fluoroquniolones
, ◍ Substances that can cause a false + drug test for cocaine. Answer:
NSAIDs, amoxicillin, most antibiotics
◍ Substances that can cause a false + drug test for amphetamines.
Answer: Prozac, Wellbutrin, Trazodone, Nefazodone, Sudafed, OTC
decongestants.
◍ Schizophrenia Prevalence:
Non-twin siblings of a schizophrenic parent
Dizygotic twins of a schizophrenic parent
Monozygotic twins of a schizophrenic parent. Answer: 8%
12%
47%
◍ Birth defects caused by benzodiazepines. Answer: Cleft palate,
floppy baby syndrome
◍ Birth defects caused by carbamazepine. Answer: Neural tube
defects
◍ Birth defects caused by depakote. Answer: Neural tube defects
(spina bifida), cleft palate, atrial-septal defects, long-term
developmental deficits
