NR547 PSYCHIATRIC-MENTAL HEALTH
NURSE PRACTITIONER
COMPREHENSIVE FINAL PREP
QUESTIONS WITH CORRECT ANSWERS
(LATEST ), (A+ GUARANTEE).
1. A 28-year-old patient with schizophrenia has been started on Clozapine after failing two
other antipsychotic trials. Which absolute neutrophil count (ANC) value requires immediate
cessation of the medication and consultation with a hematologist?
A. ANC 1,600 /mm3
B. ANC 900 /mm3
C. ANC 1,200 /mm3
D. ANC 2,100 /mm3
Answer: B
Conceptual Explanation: For the general population, Clozapine must be interrupted if the
ANC falls below 1,000 /mm3 (Severe Neutropenia). Patients with ANC between 1,000-
1,499 require increased monitoring but not necessarily immediate cessation unless
specified by clinical decline.
,2. Which neurotransmitter pathway is primarily associated with the negative symptoms of
schizophrenia, such as alogia and avolition?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: The mesocortical pathway is hypothesized to be responsible for
negative and cognitive symptoms due to a deficit of dopamine. The mesolimbic pathway is
associated with positive symptoms (hallucinations/delusions) due to dopamine excess.
3. A patient taking Lithium Carbonate for Bipolar I Disorder presents with coarse tremors,
ataxia, and confusion. The serum lithium level is 2.2 mEq/L. What is the most appropriate
next step?
A. Initiate emergency hemodialysis or gastric lavage and admit to ICU.
B. Decrease the dosage by 50%.
C. Hold the dose and encourage fluid intake.
D. Switch to Valproic Acid immediately.
Answer: A
, Conceptual Explanation: Levels above 2.0 mEq/L indicate severe toxicity. Coarse tremors
and ataxia are signs of neurotoxicity. Hemodialysis is often required for levels above 2.0-
2.5 mEq/L or if the patient is symptomatic.
4. Which antidepressant is contraindicated in a patient with a history of Bulimia Nervosa or a
seizure disorder?
A. Fluoxetine
B. Sertraline
C. Duloxetine
D. Bupropion
Answer: D
Conceptual Explanation: Bupropion is contraindicated in patients with eating disorders
(Bulimia/Anorexia) because it significantly lowers the seizure threshold in these
individuals, who may have electrolyte imbalances.
5. A PMHNP is treating a patient with PTSD who experiences frequent nightmares. Which
medication is the gold standard for reducing trauma-related nightmares?
A. Quetiapine
B. Prazosin
C. Trazodone
D. Clonazepam
NURSE PRACTITIONER
COMPREHENSIVE FINAL PREP
QUESTIONS WITH CORRECT ANSWERS
(LATEST ), (A+ GUARANTEE).
1. A 28-year-old patient with schizophrenia has been started on Clozapine after failing two
other antipsychotic trials. Which absolute neutrophil count (ANC) value requires immediate
cessation of the medication and consultation with a hematologist?
A. ANC 1,600 /mm3
B. ANC 900 /mm3
C. ANC 1,200 /mm3
D. ANC 2,100 /mm3
Answer: B
Conceptual Explanation: For the general population, Clozapine must be interrupted if the
ANC falls below 1,000 /mm3 (Severe Neutropenia). Patients with ANC between 1,000-
1,499 require increased monitoring but not necessarily immediate cessation unless
specified by clinical decline.
,2. Which neurotransmitter pathway is primarily associated with the negative symptoms of
schizophrenia, such as alogia and avolition?
A. Mesolimbic pathway
B. Nigrostriatal pathway
C. Mesocortical pathway
D. Tuberoinfundibular pathway
Answer: C
Conceptual Explanation: The mesocortical pathway is hypothesized to be responsible for
negative and cognitive symptoms due to a deficit of dopamine. The mesolimbic pathway is
associated with positive symptoms (hallucinations/delusions) due to dopamine excess.
3. A patient taking Lithium Carbonate for Bipolar I Disorder presents with coarse tremors,
ataxia, and confusion. The serum lithium level is 2.2 mEq/L. What is the most appropriate
next step?
A. Initiate emergency hemodialysis or gastric lavage and admit to ICU.
B. Decrease the dosage by 50%.
C. Hold the dose and encourage fluid intake.
D. Switch to Valproic Acid immediately.
Answer: A
, Conceptual Explanation: Levels above 2.0 mEq/L indicate severe toxicity. Coarse tremors
and ataxia are signs of neurotoxicity. Hemodialysis is often required for levels above 2.0-
2.5 mEq/L or if the patient is symptomatic.
4. Which antidepressant is contraindicated in a patient with a history of Bulimia Nervosa or a
seizure disorder?
A. Fluoxetine
B. Sertraline
C. Duloxetine
D. Bupropion
Answer: D
Conceptual Explanation: Bupropion is contraindicated in patients with eating disorders
(Bulimia/Anorexia) because it significantly lowers the seizure threshold in these
individuals, who may have electrolyte imbalances.
5. A PMHNP is treating a patient with PTSD who experiences frequent nightmares. Which
medication is the gold standard for reducing trauma-related nightmares?
A. Quetiapine
B. Prazosin
C. Trazodone
D. Clonazepam
