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NURS 660: PSYCHOPHARM EXAM STUDY GUIDE SOLUTIONS
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NURS 660: PSYCHOPHARM EXAM STUDY GUIDE SOLUTIONS Minimum ANC level to prescribe Clozapine, general population: - ANSWER-1,500 μL Severe Neutropenia - ANSWER-< 500μL Moderate Neutropenia - ANSWER-500-999μL Mild Neutropenia - ANSWER-μL BEN patients: Normal ANC range for Clozaril - ANSWE...

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  • November 19, 2024
  • 48
  • 2024/2025
  • Exam (elaborations)
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  • nurs 660 psychopharm exam study guide solutions

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NURS 660: PSYCHOPHARM EXAM
STUDY GUIDE SOLUTIONS

Minimum ANC level to prescribe Clozapine, general population: - ANSWER✔✔-1,500

μL


Severe Neutropenia - ANSWER✔✔-< 500μL


Moderate Neutropenia - ANSWER✔✔-500-999μL


Mild Neutropenia - ANSWER✔✔-1000-1499μL


BEN patients: Normal ANC range for Clozaril - ANSWER✔✔-≥1,000 μL


Clozaril BEN patient: severe neutropenia - ANSWER✔✔-<500 μL


BEN neutropenia - ANSWER✔✔-500-999 μL


Lower ANC threshold for starting clozapine: General population - ANSWER✔✔-

≥1,500/μL


Lower ANC threshold for starting clozapine: Benign ethnic neutropenia (BEN) -

ANSWER✔✔-1,000/μL


Medical emergencies when prescribing anti-psychotics - ANSWER✔✔-- NMS



Copyright ©SOPHIABENNETT 2025 ACADEMIC YEARALL RIGHTS RESERVED. Page 1/48

,- Agranulocytosis


- Serotonin Syndrome


Clinical findings in agranulocytosis - ANSWER✔✔-


Clozaril: most likely side effect if pt develops fever within 6 weeks - ANSWER✔✔-

Myocarditis


Clozaril: if pt develops fever within 6 weeks order a ______, _________ and _______. -

ANSWER✔✔-EKG, CRP, Troponin, as this is likely due to myocarditis


Common complaints in patients with neutropenia:


F,P, U, P - ANSWER✔✔-- Fever (low grade)


- painful swallowing (odynophagia)


- URI (sinusitis, otitis, cough)


- Perirectal pain/irritation


Symptoms of neuroleptic malignant syndrome (NMS): - ANSWER✔✔-- High fever


- Tachycardia/irregular pulse


- Increased respiratory rate


- Muscle Rigidity


- altered mental status



Copyright ©SOPHIABENNETT 2025 ACADEMIC YEARALL RIGHTS RESERVED. Page 2/48

,Off label TX for NMS - ANSWER✔✔-Amantadine (SYMMETREL)


Serotonin Syndrome onset: - ANSWER✔✔--24 hours of combining antidepressants


Serotonin Syndrome Cardinal features - ANSWER✔✔-- Myoclonic jerks


- Hyperreflexia


- Mental status changes


- Shivering


- Fever


- Tachycardia, HTN, hypotension (AUTONOMIC instability)


- Confused/ restless/ hyperactive/ unresponsive


Management of Serotonin syndrome - ANSWER✔✔-- Discontinue meds, stablize vitals


Potentially


helpful meds with Serotonin syndrome: - ANSWER✔✔-Benzodiazepines for agitation


Cyproheptadine (anti-serotonergic antihistamine)


Methysergide (anti-serotonergic migraine medication)


5-HT "TWITCHY FROG" Serotonin Syndrome - ANSWER✔✔--Agitated


-Sweating


-Fever

Copyright ©SOPHIABENNETT 2025 ACADEMIC YEARALL RIGHTS RESERVED. Page 3/48

, -Hyperreflexia


-Dilated pupils


Neuroleptic Malignant Syndrome - ANSWER✔✔-a potentially fatal hyperpyrexia with

temp of over 104, looks like EPS except for temp


Neuroleptic Malignant Syndrome- "can't bender(er)" - ANSWER✔✔-Life-threatening

muscle rigidity, fever, and rhabdomyolysis.


Mental status changes


Mechanism of NMS.


-What's blocked? Where (2)? - ANSWER✔✔-Dopamine blockade in the hypothalamus

(fever)


and nigrostriatal pathway (rigidity


Onset of NMS - ANSWER✔✔-30 days of starting or increasing antipsychotics or stoping

a domaminergic drug


NMS cardinal features - ANSWER✔✔-High fever 100% by definition


Rigidity 100% by definition


Mental status changes 99%


Elevated or labile BP most


NMS motor activity - ANSWER✔✔-Bradykinesia

Copyright ©SOPHIABENNETT 2025 ACADEMIC YEARALL RIGHTS RESERVED. Page 4/48

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