ANCC PSYCHIATRIC MENTAL HEALTH NURSING
EXAM 2023 REAL EXAM WITH VERIFIED
ANSWERS/A+ GRADE
What direct-acting dopamine receptor agonist is recommended
... [Show More] 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.
ANCC PSYCHIATRIC MENTAL HEALTH NURSING
EXAM 2023 REAL EXAM WITH VERIFIED
ANSWERS/A+ GRADE
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 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 flulike 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?
ANCC PSYCHIATRIC MENTAL HEALTH NURSING
EXAM 2023 REAL EXAM WITH VERIFIED
ANSWERS/A+ GRADE
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. [Show Less]