PMHNP Psychopharm Exam 1 2024
The PMHNP is evaluating a 68-year-old man for symptoms of major depression. While
assessing the appearance of the patient, an obvious left-sided ptosis is noted. Which cranial
nerve is directly linked to this condition?
a. III
b. IV
c. V
d. VI - A
A 55-year-old woman has been referred for a psychiatric evaluation for a change in
personality, lack of impulse control, and increasingly reckless decision-making. Which area
of the brain would be responsible for these symptoms?
a. Parietal lobe
b. Broca's area
c. Wernicke's area
d. Frontal lobe - D
A patient was recently started on a dopamine antagonist, and complains of breast tenderness
and a milky discharge. What is the most likely explanation for these symptoms?
a. Dopamine transmission in the nigrostriatal pathway
b. Dopamine transmission in the tuberoinfundibular pathway
c. Dopamine transmission in the mesolimbic pathway
d. Dopamine increases throughout the basal ganglia - B
A patient who was recently started on haloperidol for psychosis begins to manifest hand
tremor, and a shuffling gait. What is the most likely explanation for these symptoms?
a. Dopamine transmission in the nigrostriatal pathway
b. Dopamine transmission in the tuberoinfundibular pathway
c. Dopamine transmission in the mesolimbic pathway
d. Dopamine increases throughout the basal ganglia - A
A 72-year-old man with a comorbid history of uncontrolled hypertension is referred to the
PMHNP for dementia secondary to depression. The mental status exam reveals difficulty
speaking fluently, inappropriate and confabulated responses, incongruent affect, and poor
judgment. A cerebrovascular accident in which region of the brain would better explain these
symptoms?
a. Parietal lobe
b. Wernicke's area
c. Broca's area
d. Occipital lobe - C
Which region of the brain is associated with sensory integration, spatial awareness, and
conscious awareness of the opposite side of the body?
a. Occipital lobe
b. Wernicke's area
c. Broca's area
,d. Parietal lobe - D
A patient appears internally preoccupied and responding to auditory hallucination. This
patient may have a pathology affecting which lobe of the brain?
a. Temporal lobe
b. Occipital lobe
c. Parietal lobe
d. Cerebellum - A
A patient presents with atypical symptoms of psychosis that include inconsistent auditory
hallucinations without disorganization. What is the best definition of an EEG and its utility?
a. Radiologic test utilizing magnets and radio waves to provide a detailed image of the
structures of the brain
b. Electrophysiologic test that depicts electrical activity on the surface of the brain
c. A serum test to indicate nutritional deficiencies that inhibit the formation of
neurotransmitters
d. A neuropsychological test to distinguish psychosis from a psychosomatic illness. - B
Neurons that only travel from the body to the brain are called:
a. Sensory neurons
b. Motor neurons
c. Inter neurons
d. Astrocytes - A
The part of the neuron that takes in and receives messages is called:
a. Dendrite
b. Axon
c. Synapse
d. Node of Ranvier - A
What is the fatty layer that prevents interference and increases the speed of impulse
transmission along the axon?
a. Dendrite
b. Axon
c. Synapse
d. Myelin sheath - D
Which of the following receives messages and conducts impulses to the soma?
a. Dendrite
b. Axon
c. Synapse
d. Myelin sheath - A
The junction between two neurons is known as the:
a. Dendrite
b. Node of Ranvier
c. Synapse
d. Soma - C
,When explaining the means by which neurotransmitters relate to mental illness, a patient ask,
"What is a neurotransmitter?" The best answer is:
a. A fatty layer covering the axon
b. A chemical messenger
c. A nerve cell
d. The space between nerve cells - B
A patient is diagnosed with major depressive disorder with the most prominent feature of
apathy, anhedonia, and isolation. Which neurotransmitter is associated with the symptoms?
a. Serotonin
b. Gamma-amino benzoic acid (GABA)
c. Dopamine
d. Cannabinoids - C
The PMHNP prescribes fluoxetine to treat depression. Which neurotransmitter will be made
readily available in the synapse?
a. Dopamine
b. Serotonin
c. Gamma-amino benzoic acid (GABA)
d. Acetylcholine - B
The PMHNP in the ED is evaluating a 68-year-old woman who was recently diagnosed with
mild cognitive impairment and cannot remember the name of the medication that she has
recently started 1 week ago. The patient is complaining of increased heart rate, sweating, and
muscle spasms progressively worsening for the last 3 days. Which neurotransmitter is
associated with this adverse effect?
a. Serotonin
b. Acetylcholine
c. Gamma-amino benzoic acid (GABA)
d. Dopamine - B
Which of the following neurotransmitters exert inhibition over neuronal function?
a. Acetylcholine
b. Cannabinoids
c. Gamma-amino benzoic acid (GABA)
d. Dopamine - C
A patient with alcohol use disorder is admitted for detox in anticipation of admission to an
inpatient rehabilitation facility. The patient takes metoprolol for hypertension, which he has
forgotten to take today, and his last drink was 72 hours ago. Which tool should the PMHNP
use to evaluate for symptoms of withdrawal?
a. Hamilton Rating Scale for Depression
b. Clinical Institute Withdrawal Assessment
c. Vital signs
d. Quick Inventory of Depressive Symptomatology - B
A 45-year-old man presents for a follow-up visit after starting on an SSRI 2 weeks ago for
major depressive disorder. Which assessment tool would be the best indicator of progress?
a. Geriatric Depression Scale
b. The Young Mania Rating Scale
, c. Yale-Brown Obsessive Compulsive Scale
d. Quick Inventory of Depressive Symptomatology - D
The PMHNP knows that the study of how the body absorbs, distributes, metabolizes, and
excretes a medication is known as:
a. Breakdown
b. Pharmacokinetics
c. Pharmacodynamics
d. First-pass effect - B
After a drug is absorbed the substrate binds to protein for transport. Which portion of the
drug is available for therapeutic effects?
a. Bound
b. Unbound
c. Metabolized
d. Excreted - B
A 19-year-old male is referred to the PMHNP by the student health office for alcohol use
disorder. The patient states that on one occasion he passed out much sooner than he usually
would with far less than he would usually drink. Upon further interview, the patient reveals
the time he passed out was during a fraternity hazing in which he was butt- chugging
(receiving a beer and vodka enema). What pharmacokinetic process was bypassed by this
rectal administration route?
a. Excretion
b. Absorption
c. Distribution
d. First-pass effect - D
The PMHNP is monitoring a serum drug level for a medication with a 24-hour half-life. How
many hours will it take to reach steady state?
a. 48hours
b. 72hours
c. 96hours
d. 120hours - D
A patient with schizophrenia was discharged from the hospital on olanzapine 5 mg twice a
day. He immediately resumed smoking cigarettes and escalated to one pack per day. Upon
presenting for his 1- week follow-up appointment, the patient reports he is having trouble
sleeping and the voices have started to return. Which of the following actions should the
PMHNP take?
a. Send the patient to the ED for stabilization
b. Change to another antipsychotic medication, and refer to a psychiatrist
c. Increase his olanzapine, and schedule a follow-up visit in 2 days
Tell him to stop smoking and give him a nicotine patch - C
A patient who has been stable on quetiapine (Seroquel XR) for 3 months has decided to start
to drink grapefruit juice twice daily because she has heard it helps with weight loss. She calls
to report that since her new diet she has been feeling fatigue and difficulty waking up in the
morning. What is the best response by the PMHNP?
a. "I will put in a new prescription for a lower dose of your medication."
The PMHNP is evaluating a 68-year-old man for symptoms of major depression. While
assessing the appearance of the patient, an obvious left-sided ptosis is noted. Which cranial
nerve is directly linked to this condition?
a. III
b. IV
c. V
d. VI - A
A 55-year-old woman has been referred for a psychiatric evaluation for a change in
personality, lack of impulse control, and increasingly reckless decision-making. Which area
of the brain would be responsible for these symptoms?
a. Parietal lobe
b. Broca's area
c. Wernicke's area
d. Frontal lobe - D
A patient was recently started on a dopamine antagonist, and complains of breast tenderness
and a milky discharge. What is the most likely explanation for these symptoms?
a. Dopamine transmission in the nigrostriatal pathway
b. Dopamine transmission in the tuberoinfundibular pathway
c. Dopamine transmission in the mesolimbic pathway
d. Dopamine increases throughout the basal ganglia - B
A patient who was recently started on haloperidol for psychosis begins to manifest hand
tremor, and a shuffling gait. What is the most likely explanation for these symptoms?
a. Dopamine transmission in the nigrostriatal pathway
b. Dopamine transmission in the tuberoinfundibular pathway
c. Dopamine transmission in the mesolimbic pathway
d. Dopamine increases throughout the basal ganglia - A
A 72-year-old man with a comorbid history of uncontrolled hypertension is referred to the
PMHNP for dementia secondary to depression. The mental status exam reveals difficulty
speaking fluently, inappropriate and confabulated responses, incongruent affect, and poor
judgment. A cerebrovascular accident in which region of the brain would better explain these
symptoms?
a. Parietal lobe
b. Wernicke's area
c. Broca's area
d. Occipital lobe - C
Which region of the brain is associated with sensory integration, spatial awareness, and
conscious awareness of the opposite side of the body?
a. Occipital lobe
b. Wernicke's area
c. Broca's area
,d. Parietal lobe - D
A patient appears internally preoccupied and responding to auditory hallucination. This
patient may have a pathology affecting which lobe of the brain?
a. Temporal lobe
b. Occipital lobe
c. Parietal lobe
d. Cerebellum - A
A patient presents with atypical symptoms of psychosis that include inconsistent auditory
hallucinations without disorganization. What is the best definition of an EEG and its utility?
a. Radiologic test utilizing magnets and radio waves to provide a detailed image of the
structures of the brain
b. Electrophysiologic test that depicts electrical activity on the surface of the brain
c. A serum test to indicate nutritional deficiencies that inhibit the formation of
neurotransmitters
d. A neuropsychological test to distinguish psychosis from a psychosomatic illness. - B
Neurons that only travel from the body to the brain are called:
a. Sensory neurons
b. Motor neurons
c. Inter neurons
d. Astrocytes - A
The part of the neuron that takes in and receives messages is called:
a. Dendrite
b. Axon
c. Synapse
d. Node of Ranvier - A
What is the fatty layer that prevents interference and increases the speed of impulse
transmission along the axon?
a. Dendrite
b. Axon
c. Synapse
d. Myelin sheath - D
Which of the following receives messages and conducts impulses to the soma?
a. Dendrite
b. Axon
c. Synapse
d. Myelin sheath - A
The junction between two neurons is known as the:
a. Dendrite
b. Node of Ranvier
c. Synapse
d. Soma - C
,When explaining the means by which neurotransmitters relate to mental illness, a patient ask,
"What is a neurotransmitter?" The best answer is:
a. A fatty layer covering the axon
b. A chemical messenger
c. A nerve cell
d. The space between nerve cells - B
A patient is diagnosed with major depressive disorder with the most prominent feature of
apathy, anhedonia, and isolation. Which neurotransmitter is associated with the symptoms?
a. Serotonin
b. Gamma-amino benzoic acid (GABA)
c. Dopamine
d. Cannabinoids - C
The PMHNP prescribes fluoxetine to treat depression. Which neurotransmitter will be made
readily available in the synapse?
a. Dopamine
b. Serotonin
c. Gamma-amino benzoic acid (GABA)
d. Acetylcholine - B
The PMHNP in the ED is evaluating a 68-year-old woman who was recently diagnosed with
mild cognitive impairment and cannot remember the name of the medication that she has
recently started 1 week ago. The patient is complaining of increased heart rate, sweating, and
muscle spasms progressively worsening for the last 3 days. Which neurotransmitter is
associated with this adverse effect?
a. Serotonin
b. Acetylcholine
c. Gamma-amino benzoic acid (GABA)
d. Dopamine - B
Which of the following neurotransmitters exert inhibition over neuronal function?
a. Acetylcholine
b. Cannabinoids
c. Gamma-amino benzoic acid (GABA)
d. Dopamine - C
A patient with alcohol use disorder is admitted for detox in anticipation of admission to an
inpatient rehabilitation facility. The patient takes metoprolol for hypertension, which he has
forgotten to take today, and his last drink was 72 hours ago. Which tool should the PMHNP
use to evaluate for symptoms of withdrawal?
a. Hamilton Rating Scale for Depression
b. Clinical Institute Withdrawal Assessment
c. Vital signs
d. Quick Inventory of Depressive Symptomatology - B
A 45-year-old man presents for a follow-up visit after starting on an SSRI 2 weeks ago for
major depressive disorder. Which assessment tool would be the best indicator of progress?
a. Geriatric Depression Scale
b. The Young Mania Rating Scale
, c. Yale-Brown Obsessive Compulsive Scale
d. Quick Inventory of Depressive Symptomatology - D
The PMHNP knows that the study of how the body absorbs, distributes, metabolizes, and
excretes a medication is known as:
a. Breakdown
b. Pharmacokinetics
c. Pharmacodynamics
d. First-pass effect - B
After a drug is absorbed the substrate binds to protein for transport. Which portion of the
drug is available for therapeutic effects?
a. Bound
b. Unbound
c. Metabolized
d. Excreted - B
A 19-year-old male is referred to the PMHNP by the student health office for alcohol use
disorder. The patient states that on one occasion he passed out much sooner than he usually
would with far less than he would usually drink. Upon further interview, the patient reveals
the time he passed out was during a fraternity hazing in which he was butt- chugging
(receiving a beer and vodka enema). What pharmacokinetic process was bypassed by this
rectal administration route?
a. Excretion
b. Absorption
c. Distribution
d. First-pass effect - D
The PMHNP is monitoring a serum drug level for a medication with a 24-hour half-life. How
many hours will it take to reach steady state?
a. 48hours
b. 72hours
c. 96hours
d. 120hours - D
A patient with schizophrenia was discharged from the hospital on olanzapine 5 mg twice a
day. He immediately resumed smoking cigarettes and escalated to one pack per day. Upon
presenting for his 1- week follow-up appointment, the patient reports he is having trouble
sleeping and the voices have started to return. Which of the following actions should the
PMHNP take?
a. Send the patient to the ED for stabilization
b. Change to another antipsychotic medication, and refer to a psychiatrist
c. Increase his olanzapine, and schedule a follow-up visit in 2 days
Tell him to stop smoking and give him a nicotine patch - C
A patient who has been stable on quetiapine (Seroquel XR) for 3 months has decided to start
to drink grapefruit juice twice daily because she has heard it helps with weight loss. She calls
to report that since her new diet she has been feeling fatigue and difficulty waking up in the
morning. What is the best response by the PMHNP?
a. "I will put in a new prescription for a lower dose of your medication."
