NURS 660: Psychopharm Exam 1 Questions With
Complete Solutions 2025
NURS 660: Psychopharm Exam 1 Questions With
Complete Solutions 2025
Minimum ANC level to prescribe Clozapine, general population:
1,500 μL
Severe Neutropenia
< 500μL
Moderate Neutropenia
500-999μL
Mild Neutropenia
1000-1499μL
BEN patients: Normal ANC range for Clozaril
≥1,000 μL
Clozaril BEN patient: severe neutropenia
<500 μL
BEN neutropenia
500-999 μL
Lower ANC threshold for starting clozapine: General population
≥1,500/μL
, NURS 660: Psychopharm Exam 1 Questions With
Complete Solutions 2025
Lower ANC threshold for starting clozapine: Benign ethnic neutropenia (BEN)
1,000/μL
Medical emergencies when prescribing anti-psychotics
- NMS
- Agranulocytosis
- Serotonin Syndrome
Clinical findings in agranulocytosis
Clozaril: most likely side effect if pt develops fever within 6 weeks
Myocarditis
Clozaril: if pt develops fever within 6 weeks order a ______, _________ and _______. EKG,
CRP, Troponin, as this is likely due to myocarditis
Common complaints in patients with neutropenia:
F,P, U, P
- Fever (low grade)
- painful swallowing (odynophagia)
- URI (sinusitis, otitis, cough)
- Perirectal pain/irritation
Symptoms of neuroleptic malignant syndrome (NMS):
- High fever
- Tachycardia/irregular pulse
- Increased respiratory rate
, NURS 660: Psychopharm Exam 1 Questions With
Complete Solutions 2025
- Muscle Rigidity
- altered mental status
Off label TX for NMS
Amantadine (SYMMETREL)
Serotonin Syndrome onset:
-24 hours of combining antidepressants
Serotonin Syndrome Cardinal features
- Myoclonic jerks
- Hyperreflexia
- Mental status changes
- Shivering
- Fever
- Tachycardia, HTN, hypotension (AUTONOMIC instability)
- Confused/ restless/ hyperactive/ unresponsive
Management of Serotonin syndrome
- Discontinue meds, stablize vitals
Potentially helpful meds with Serotonin
syndrome:
Benzodiazepines for agitation
Cyproheptadine (anti-serotonergic antihistamine)
Methysergide (anti-serotonergic migraine medication)
Complete Solutions 2025
NURS 660: Psychopharm Exam 1 Questions With
Complete Solutions 2025
Minimum ANC level to prescribe Clozapine, general population:
1,500 μL
Severe Neutropenia
< 500μL
Moderate Neutropenia
500-999μL
Mild Neutropenia
1000-1499μL
BEN patients: Normal ANC range for Clozaril
≥1,000 μL
Clozaril BEN patient: severe neutropenia
<500 μL
BEN neutropenia
500-999 μL
Lower ANC threshold for starting clozapine: General population
≥1,500/μL
, NURS 660: Psychopharm Exam 1 Questions With
Complete Solutions 2025
Lower ANC threshold for starting clozapine: Benign ethnic neutropenia (BEN)
1,000/μL
Medical emergencies when prescribing anti-psychotics
- NMS
- Agranulocytosis
- Serotonin Syndrome
Clinical findings in agranulocytosis
Clozaril: most likely side effect if pt develops fever within 6 weeks
Myocarditis
Clozaril: if pt develops fever within 6 weeks order a ______, _________ and _______. EKG,
CRP, Troponin, as this is likely due to myocarditis
Common complaints in patients with neutropenia:
F,P, U, P
- Fever (low grade)
- painful swallowing (odynophagia)
- URI (sinusitis, otitis, cough)
- Perirectal pain/irritation
Symptoms of neuroleptic malignant syndrome (NMS):
- High fever
- Tachycardia/irregular pulse
- Increased respiratory rate
, NURS 660: Psychopharm Exam 1 Questions With
Complete Solutions 2025
- Muscle Rigidity
- altered mental status
Off label TX for NMS
Amantadine (SYMMETREL)
Serotonin Syndrome onset:
-24 hours of combining antidepressants
Serotonin Syndrome Cardinal features
- Myoclonic jerks
- Hyperreflexia
- Mental status changes
- Shivering
- Fever
- Tachycardia, HTN, hypotension (AUTONOMIC instability)
- Confused/ restless/ hyperactive/ unresponsive
Management of Serotonin syndrome
- Discontinue meds, stablize vitals
Potentially helpful meds with Serotonin
syndrome:
Benzodiazepines for agitation
Cyproheptadine (anti-serotonergic antihistamine)
Methysergide (anti-serotonergic migraine medication)
