ANCC REVIEW QUESTIONS AND ANSWERS
(PMHNP IQ) GRADED A+ 2025/2026
.
What .direct-acting .dopamine .receptor .agonist .is .recommended .to .be .used .in .the
.treatments .of .neuroleptic .malignant .syndrome .(NMS) .fo .help .lower .the .dopamine
.blockade?
A) .benzotropine .(Cogentin)
B) .bromocriptine .(Parlodel)
C) .dantrolene .(Dantrium)
D) .trihexyphenidyl .(Artane) .- .CORRECT .ANSWER-A) .Bromocriptine .(Parlodel) .is .the
.recommended .direct .acting .dopamine .receptor .agonist .to .help .decrease .the .dopamine
.blockade. .Danrolene .(Dantrium) .is .a .muscle .relaxant. .Benzotropine .(Cogentin) .and
.Trihexyphenidyl .(Artane) .are .anticholinergic .medications .used .for .extrapyramidal .side
.effects .(EPS).
Mr. .Smith .is .a .56 .year .old .white .male .who .has .been .successfully .treated .on .Selegiline .for
.over .4 .years. .Mr. .Smith .is .going .in .for .elective .surgical .procedure. .Which .medication .is
.strictly .contraindicated .with .Selegiline?
A) .Non-steroidal .anti-inflammatory .drugs .(NSAIDS)
B) .Codeine
C) .Morphine
D) .Meperidine .- .CORRECT .ANSWER-D) .Meperidine .is .strictly .prohibited .when .a .patient .is
.treated .on .a .monoamine .oxidase .inhibitor .(MAOI) .due .to .the .risk .of .hypertensive .crisis
.and .death.
, A .WBC .of .4,000 .in .a .patient .taking .Clozapine .would .prompt .the .PMHNP .to .take .which .of
.the .following .actions?
A) .Consult .with .hematologist .to .determine .appropriate .antibiotic .regimen .and .monitor
.closely.
B) .Institute .twice-weekly .complete .blood .count .with .differentials .and .monitor .closely.
C) .Discontinue .clozapine, .initiate .alternative .antipsychotic .medication .and .monitor .closely.
D) .Institute .daily .complete .blood .count .with .differentials .and .monitor .closely. .- .CORRECT
.ANSWER-B) .Institute .twice-weekly .complete .blood .count .with .differentials .and .monitor
.closely. .
The .recommended .cut-points .for .discontinuation .of .clozapine .are .WBC .of .2,000 .to .3,000
.or .granulocytes .of .1,000 .to .1,500 .for .agranulocytosis .and .severely .compromised .immune
.system. .At .a .WBC .of .4,000, .the .recommendation .is .to .closely .monitor .CBC .with
.differential .twice .a .week .while .patient .may .continue .clozapine .in .the .absence .of .any
.other .signs .or .symptoms.
A .patient .with .a .diagnosis .of .schizophrenia .has .a .history .of .suicidal .ideation .and .suicide
.attempts. .The .PMHNP .should .consider .which .antipsychotic .medication .that .is .the .only
.antipsychotic .to .reduce .the .risk .of .suicide .in .schizophrenia?
A) .Abilify .(aripriprazole)
B) .Latuda .(lurasidone)
C) .Invega .(iloperidone)
D) .Clozaril .(clozapine) .- .CORRECT .ANSWER-D) .Clozaril .(clozapine) .is .the .only .known
.antipsychotic .medication .that .had .been .shown .to .reduce .the .risk .of .suicide .in .patients
.diagnosed .with .schizophrenia.
A .patient .being .treated .for .major .depressive .disorder .and .on .sertraline .(Zoloft), .150 .mg
.po .daily .for .the .past .16 .years, .presents .to .the .psychiatric .mental .health .practitioner .for
.an .outpatient .follow-up .visit. .During .the .visit .she .states .that .she .has .not .been .feeling
.well, .reporting .the .flu. .She .also .states .she .has .not .taken .her .medication .in .the .last .five
(PMHNP IQ) GRADED A+ 2025/2026
.
What .direct-acting .dopamine .receptor .agonist .is .recommended .to .be .used .in .the
.treatments .of .neuroleptic .malignant .syndrome .(NMS) .fo .help .lower .the .dopamine
.blockade?
A) .benzotropine .(Cogentin)
B) .bromocriptine .(Parlodel)
C) .dantrolene .(Dantrium)
D) .trihexyphenidyl .(Artane) .- .CORRECT .ANSWER-A) .Bromocriptine .(Parlodel) .is .the
.recommended .direct .acting .dopamine .receptor .agonist .to .help .decrease .the .dopamine
.blockade. .Danrolene .(Dantrium) .is .a .muscle .relaxant. .Benzotropine .(Cogentin) .and
.Trihexyphenidyl .(Artane) .are .anticholinergic .medications .used .for .extrapyramidal .side
.effects .(EPS).
Mr. .Smith .is .a .56 .year .old .white .male .who .has .been .successfully .treated .on .Selegiline .for
.over .4 .years. .Mr. .Smith .is .going .in .for .elective .surgical .procedure. .Which .medication .is
.strictly .contraindicated .with .Selegiline?
A) .Non-steroidal .anti-inflammatory .drugs .(NSAIDS)
B) .Codeine
C) .Morphine
D) .Meperidine .- .CORRECT .ANSWER-D) .Meperidine .is .strictly .prohibited .when .a .patient .is
.treated .on .a .monoamine .oxidase .inhibitor .(MAOI) .due .to .the .risk .of .hypertensive .crisis
.and .death.
, A .WBC .of .4,000 .in .a .patient .taking .Clozapine .would .prompt .the .PMHNP .to .take .which .of
.the .following .actions?
A) .Consult .with .hematologist .to .determine .appropriate .antibiotic .regimen .and .monitor
.closely.
B) .Institute .twice-weekly .complete .blood .count .with .differentials .and .monitor .closely.
C) .Discontinue .clozapine, .initiate .alternative .antipsychotic .medication .and .monitor .closely.
D) .Institute .daily .complete .blood .count .with .differentials .and .monitor .closely. .- .CORRECT
.ANSWER-B) .Institute .twice-weekly .complete .blood .count .with .differentials .and .monitor
.closely. .
The .recommended .cut-points .for .discontinuation .of .clozapine .are .WBC .of .2,000 .to .3,000
.or .granulocytes .of .1,000 .to .1,500 .for .agranulocytosis .and .severely .compromised .immune
.system. .At .a .WBC .of .4,000, .the .recommendation .is .to .closely .monitor .CBC .with
.differential .twice .a .week .while .patient .may .continue .clozapine .in .the .absence .of .any
.other .signs .or .symptoms.
A .patient .with .a .diagnosis .of .schizophrenia .has .a .history .of .suicidal .ideation .and .suicide
.attempts. .The .PMHNP .should .consider .which .antipsychotic .medication .that .is .the .only
.antipsychotic .to .reduce .the .risk .of .suicide .in .schizophrenia?
A) .Abilify .(aripriprazole)
B) .Latuda .(lurasidone)
C) .Invega .(iloperidone)
D) .Clozaril .(clozapine) .- .CORRECT .ANSWER-D) .Clozaril .(clozapine) .is .the .only .known
.antipsychotic .medication .that .had .been .shown .to .reduce .the .risk .of .suicide .in .patients
.diagnosed .with .schizophrenia.
A .patient .being .treated .for .major .depressive .disorder .and .on .sertraline .(Zoloft), .150 .mg
.po .daily .for .the .past .16 .years, .presents .to .the .psychiatric .mental .health .practitioner .for
.an .outpatient .follow-up .visit. .During .the .visit .she .states .that .she .has .not .been .feeling
.well, .reporting .the .flu. .She .also .states .she .has .not .taken .her .medication .in .the .last .five
