ANCC REVIEW QUESTIONS (PMHNP IQ)
2026 ACTUAL EXAM TEST
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 days. Which of the following
symptoms would she be describing if you suspect selective
serotonin reputable inhibitors (SSRIs) discontinuation syndrome?
A) Agitation, nausea, dysphoria, and diequilibrium
B) Agitation, nausea, tremor, and ataxia.
C) Restlessness, tremor, fever, and shivering.
D) Restlessness, headache, increased heart rate, and diarrhea.
Correct Answer A) Agitation; nausea, dysphoria, and
disequilibrium
The patient has SSRI discontinuation syndrome and would
be presenting with flu-like symptoms. If the patient had
serotonin syndrome, she would present with symptoms of
autonomic instability.
,Which of the following statements reflect the current
understanding of dopamine (DA) pathways and clinical symptoms
in schizophrenia?
A) Negative symptoms are related to DA deficit in the cerebral
cortex; positive symptoms are related to DA excess in the nucleus
accumbens and mesolimbic system.
B) Negative symptoms are related to DA excess in the cerebral
cortex; positive symptoms are related to DA deficit in the nucleus
accumbens and mesolimbic system.
C) Negative symptoms are related to DA excess in the
mesolimbic system; positive symptoms are related to DA deficit in
the substantia nigra and ventral tegmental area.
Negative symptoms are related to DA deficit in the mesolimbic
system; positive symptoms are related to DA excess in the
substantia nigra and ventral tegmental area. Correct Answer A)
Negative symptoms are related to DA deficit in the cerebral
cortex; positive symptoms are related to DA excess in the nucleus
accumbens and mesolimbic system.
Negative symptoms & cognitive impairment are thought to be
related to hypoactivity of the mesocortical dopiminergic
tract, which by its association with the prefrontal cortex and
neocortex contributes to motivation, planning, sequencing of
behaviors in time, attention, and social behavior. Positive
, symptoms (hallucination and delusions) are thought to be
caused by dopamine hyperactivity in the mesolimbic tract,
which regulates emotion. This hyperactivity could result in
overactive modulation of nueurotransmission from the
nucleus accumbens.
Norepinephrine is a neurotransmitter that is implicated in
alertness and anxiety. What area of the brain has a large majority
of norepinephrine neurons?
A) Amygdala
B) Hippocampus
C) Locus Coeruleus
D) Nucleus Accumbens Correct Answer C) Locus coeruleus
There are two areas in the brain that produce norepinephrine
neurons, one is the locus coeruleus and the other is the
medullary reticular formation.
Which cytochrome (CYP) enzyme is implicated as a tobacco
inducer when an individual is treated on clozapine?
A) 1A2
B) 2D6
2026 ACTUAL EXAM TEST
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 days. Which of the following
symptoms would she be describing if you suspect selective
serotonin reputable inhibitors (SSRIs) discontinuation syndrome?
A) Agitation, nausea, dysphoria, and diequilibrium
B) Agitation, nausea, tremor, and ataxia.
C) Restlessness, tremor, fever, and shivering.
D) Restlessness, headache, increased heart rate, and diarrhea.
Correct Answer A) Agitation; nausea, dysphoria, and
disequilibrium
The patient has SSRI discontinuation syndrome and would
be presenting with flu-like symptoms. If the patient had
serotonin syndrome, she would present with symptoms of
autonomic instability.
,Which of the following statements reflect the current
understanding of dopamine (DA) pathways and clinical symptoms
in schizophrenia?
A) Negative symptoms are related to DA deficit in the cerebral
cortex; positive symptoms are related to DA excess in the nucleus
accumbens and mesolimbic system.
B) Negative symptoms are related to DA excess in the cerebral
cortex; positive symptoms are related to DA deficit in the nucleus
accumbens and mesolimbic system.
C) Negative symptoms are related to DA excess in the
mesolimbic system; positive symptoms are related to DA deficit in
the substantia nigra and ventral tegmental area.
Negative symptoms are related to DA deficit in the mesolimbic
system; positive symptoms are related to DA excess in the
substantia nigra and ventral tegmental area. Correct Answer A)
Negative symptoms are related to DA deficit in the cerebral
cortex; positive symptoms are related to DA excess in the nucleus
accumbens and mesolimbic system.
Negative symptoms & cognitive impairment are thought to be
related to hypoactivity of the mesocortical dopiminergic
tract, which by its association with the prefrontal cortex and
neocortex contributes to motivation, planning, sequencing of
behaviors in time, attention, and social behavior. Positive
, symptoms (hallucination and delusions) are thought to be
caused by dopamine hyperactivity in the mesolimbic tract,
which regulates emotion. This hyperactivity could result in
overactive modulation of nueurotransmission from the
nucleus accumbens.
Norepinephrine is a neurotransmitter that is implicated in
alertness and anxiety. What area of the brain has a large majority
of norepinephrine neurons?
A) Amygdala
B) Hippocampus
C) Locus Coeruleus
D) Nucleus Accumbens Correct Answer C) Locus coeruleus
There are two areas in the brain that produce norepinephrine
neurons, one is the locus coeruleus and the other is the
medullary reticular formation.
Which cytochrome (CYP) enzyme is implicated as a tobacco
inducer when an individual is treated on clozapine?
A) 1A2
B) 2D6
