A 46-year-old male with a history of bipolar disorder comes for a regular follow-up appointment with a PMHNP and presents with complaints of severe vomiting, diarrhea, muscle weakness, blurred vision, and ataxia. The patient is currently taking 900mg of lithium daily. The PMHNP identifies these sym...
Practice Questions ANCC PMHNP with
100% correct answers
A 46-year-old male with a history of bipolar disorder comes for a regular follow-up appointment
with a PMHNP and presents with complaints of severe vomiting, diarrhea, muscle weakness,
blurred vision, and ataxia. The patient is currently taking 900mg of lithium daily. The PMHNP
identifies these symptoms as signs of lithium toxicity. What is the priority action of the PMHNP?
- answer Tells the patient to stop taking lithium and orders a serum lithium level
Mary a 45-year-old African American female who has been treated on isocarboxazid (Marplan)
for over 6 years. Mary is going in for a surgical procedure. Which medication is strictly
contraindicated with isocarboxazid? - answer Methylphenidate
The PMHNP is aware of the following signs to watch out for in patients taking clozapine
(Clozaril): - answer Fever, sore throat, and chills
A new prescription of carbamazepine (Tegretol) is given to a patient whose baseline WBC count
is 5,000/uL and ANC is 4,000/uL. Laboratory tests show that the patient's WBC count has
decreased to 2,500/uL and ANC has decreased to 750/uL after two weeks of therapy. Similar
outcomes are obtained when the lab studies are repeated. The patient does not present with
any signs of infection. What is the next action of the PMHNP? - answer Tells the patient to stop
taking Tegretol and recheck the ANC and WBC
If given during pregnancy sodium valproate (Depakote) can cause which of the following
medical problems in the baby? - answer Spina bifida
Which mood stabilizer is associated with potential life-threatening rash in the Asian population?
- answer Carbamazepine (Tegretol)
Which of the following physical exam findings would help the PMHNP differentiate anorexia
nervosa from bulimia nervosa? - answer Low body mass index
,Which of the following medication has a unique mechanism that is both a norepinephrine and
dopamine reuptake inhibitor? - answer Bupropion (Wellbutrin)
Which cytochrome (CYP) enzyme is implicated as a tobacco inducer when an individual is
treated with clozapine? - answer 1A2
When treating older adults, you should keep in mind that they are more sensitive to issues of
drug toxicity because of which of the following reasons? - answer Decreased protein binding
For 12 years, a 65-year-old patient with bipolar disorder has been treated with lithium (Eskalith)
900mg daily. When oral HCTZ 12.5mg daily is added for hypertension, the patient develops
nausea, vomiting, ataxia, and muscle weakness and the patient's serum lithium level is 2.0
mEq/L. The interaction of the lithium and the thiazide diuretic has induced: - answer Reduced
renal clearance of lithium
Serotonin is a neurotransmitter that is implicated in sleep and mood. What area of the brain has
a large majority of serotonin neurons? - answer Raphe nuclei
A client who is experiencing difficulties with working memory, planning, and prioritizing, insight
into his problems, and impulse control presents for assessment. In planning his care, the
PMHNP should apply his or her knowledge that these symptoms represent problems with the: -
answer Frontal lobe
Which of these brain structures puts emotional meaning on a stimulus, forms emotional
memories, and is involved with rage and fear? - answer Amygdala
The anatomical structure of the limbic system that is associated with a reaction to stress is the: -
answer Hippocampus
A 45-year-old African American male diagnosed with schizophrenia. Arrives at your clinic for a
regular medication appointment. He is currently stabilized on chlorpromazine. You notice his
, face appears mask-like, and he walks with a shuffling gait. Based on this information, what
extrapyramidal symptoms side effect would you suspect? - answer Pseudo-Parkinsonism
A patient has been treated for the past several years with fluphenazine (Prolixin). You notice
that he is drooling and has a tremor and slight piull-rolling movement of the fingers. These are
the extrapyramidal symptoms known as: - answer Pseudo-Parkinsonism
A patient is diagnosed with schizophrenia. Which of the following would be the appropriate
question for the PMHNP to ask when assessing side effects produced by dopamine antagonism
in the nigrostriatal pathway? - answer Are you experiencing pill rolling tremors, shuffling gait,
and masklike facial expression?
The study of what a drug does to the body is called: - answer Pharmacodynamics
When studying pharmacodynamics involving receptors, you know that an agonist produces the
following effect: - answer Activates a biological response and opens the ion channel
Sarah presents for her initial intake appointment with complaints of depression. She is being
treated for hypertension and asthma by her primary care provider. Knowing that certain
medications can cause or exacerbate depression; you obtain a complete medication history.
Which of the following medications is known to exacerbate or cause depression? - answer
Propranolol
A patient with a known diagnosis of bipolar I disorder presents to your clinic complaining of
manic symptoms and insomnia. Your patient has been stable on lithium for the past six months.
To determine if a medication change or increase is warranted, it is important to gather more
information. You suspect a possible medication-induced manic episode when the patient
endorses what? - answer She recently had an acute flare-up of her rheumatoid arthritis and
received treatment for one week of stabilization of symptoms.
John is a 58-year-old male patient with bipolar I disorder has been stable for 5 years on
valproate and Seroquel. He was recently started on Fluticasone (Flonase) by his PCP. As the
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