ANCC IQ Domain
• Domain 1: Scientific Foundation (40 questions with rationales)
• Domain 2: Advanced Practice Skills (49 questions with rationales)
• Domain 3: Diagnosis and Treatment (52 questions with rationales)
• Domain 4: Psychotherapy and Related Theories (30 questions with ration...
ANCC Domain 1: Scientific Foundation (40 questions with rationales)
As a PMHNP, you are aware of antipsychotic medication side effects. Which of
the following side effects of antipsychotic medications has an insidious,
delayed-onset typically 1 to 2 years after initiation of the medication?
a. Dry mouth
b. Tardive dyskinesia
c. Sedation
d. Weight gain - B
In evaluating a 4-year-old, one would expect which of the following delays in
Asperger's Disorder?
a. Language development
b. Cognitive development
c. Motor skills coordination
d. Social skills development - D
Which area of the brain has been implicated to modulate pain and can help
explain how transcranial magnetic stimulation can help decrease pain?
a. Prefrontal cortex
b. Insula cortex
c. Dorsolateral prefrontal cortex
d. Anterior cingulate cortex - A
Which of the following antidepressants is associated with dose-related
cardiovascular adverse effects which require adherence to maximum
recommended dosing, unless higher doses are deemed appropriate despite
risks?
a. Citalopram (Celexa)
b. Venlafaxine (Effexor)
c. Mirtazapine (Remeron)
d. Sertraline (Zoloft) - A
Which of the following findings would raise concern in an annual sports exam
for a 15-year-old girl?
a. Scar tissue from hymenal tear at 11 o'clock (reported biking injury)
b. Blood pressure 86/56
c. Height 67 inches, weight 102 pounds
d. Pulse 60, respirations 26 - C
,A week after raising the dose of risperidone (Risperdal), a patient treated for
schizophrenia presents to the clinic with reports of an acute change in mental
status, fever, and rigidity. As the treating PMHNP, you know these symptoms
are consistent with which of the following?
a. Neuroleptic malignant syndrome (NMS)
b. Anticholinergic withdrawal syndrome
c. Extrapyramidal side effects
d. Serotonin syndrome - A
Which of the following statements regarding disulfiram (Antabuse is correct?
a. Disulfiram should not be taken for at least 6 hours after drinking alcohol.
b. Avoid anything containing alcohol (i.e., vinegar, mouthwash, aftershave,
cough medication) while using disulfiram and for 2 weeks after discontinuing.
c. A disulfiram-alcohol reaction can occur up to 1 week after discontinuing
disulfiram.
d. Disulfiram can lower liver function tests so monitoring is necessary. - B
Which mood stabilizer is most associated with a potentially life-threatening
rash?
a. Divalproex (Depakote)
b. Lamotrigine (Lamictal)
c. Lithium (Eskalith)
d. Carbamazepine (Tegretol) - B
Which of the following statements most accurately reflects the predominant
risk factors of antisocial personality disorders?
a. Gang affiliation and early substance abuse
b. Genetic predisposition of first-degree family member
c. Childhood abuse and trauma from domestic violence
d. Lower socioeconomic status from single-parent families - B
A 37-year-old patient with schizophrenia is started on a high dose of
chlorpromazine (Thorazine). The next day, he complains of lightheadedness
after standing up. Vital sign changes reflect a significant decrease in blood
pressure and an increase in heart rate. You suspect this is secondary to the
alpha 1-adrenergic blockade which is causing
a. Orthostatic hypotension
b. Dry mouth
,c. Respiratory depression
d. Decreased sweating - A
A 74-year-old female presents for an evaluation. The psychiatric nurse
practitioner has the patient complete the mini mental status examination and
clock drawing. The patient is unable to correctly draw the face of the clock.
Which area of the brain is likely to have a compromised functioning?
a. Wernicke's Area
b. Corpus Callosum
c. Left Hemisphere
d. Right hemisphere - D
Your patient comes into the office for her middle of the year appointment. She
is diagnosed with Bipolar I disorder. She has been maintained well for the past
3 years on Oxcarbazepine (Trileptal) 900 mg po QHS. Her labs are normal
except for a blood sugar of 114 and her hemoglobin A1C is 5.6. She has a
normal energy level and states that her mood is stable but complains of
excessive urination and thirst. You suspect:
a. Possible Diabetes 2
b. Possible hyponatremia
c. Possible polydipsia
d. Side effects of oxcarbazepine - D
What is a rare but serious side effect of trazodone (Desyrel)?
a. Confusion
b. Priapism
c. Rash
d. Tremor - B
When studying pharmacodynamics involving receptors, you know that an
inverse agonist produces the following effect:
a. Does not fully activate the receptor and causes only limited actions
b. Causes the opposite effect of agonist, and causes the receptor to close the
ion channel
c. Blocks the agonist from opening the channel, and does not activate a
biological response
d. Activates a biological response, and opens the ion channel. - B
, 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 an elective surgical
procedure. Which medication is strictly contraindicated with Selegiline?
a. Non-steroidal anti-inflammatory drugs (NSAIDs)
b. Meperidine
c. Codeine
d. Morphine - B
Patty is a 62-year-old white female with Bipolar I Disorder and has been
stable for 2 years on valproate and risperidone. She was recently diagnosed
with shingles, and her primary care nurse practitioner started her on
corticosteroids. As the PMHNP treating Patty, you are concerned that the
addition of the corticosteroids may cause
a. Neuroleptic Malignant Syndrome
b. A hypertensive crisis
c. A manic episode
d. Stevens-Johnson syndrome - C
Which serotonin receptor antagonism makes an antipsychotic "atypical"?
a. 5HT4A
b. 5HT1A
c. 5HT3A
d. 5HT2A - D
What direct-acting dopamine receptor agonist is recommended to be used in
the treatment of neuroleptic malignant syndrome (NMS) to help lower the
dopamine receptor blockade?
a. Benztropine (Cogentin)
b. Bromocriptine (Parlodel)
c. Trihexyphenidyl (Artane)
d. Dantrolene (Dantrium) - B
A 17-year-old female presents to your clinic reporting anhedonia, decreased
energy, and hopelessness for the past two years. She denies drinking alcohol,
smoking, or using illegal substances. Her physical examination results are
within normal limits and she denies suicidal ideations. As the treating
psychiatric mental health nurse practitioner, you decide to prescribe her
bupropion (Wellbutrin). Of the following, which is contraindication for the use
of bupropion?
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