PMHNP Certification Latest 2024 Complete Exam/
150 Actual Questions with Correct Detailed Answers
(Verified Answers) Graded A+
The PMHNP mental health nurse practitioner treating a patient for schizophrenia
on ziprasidone orders an electrocardiograph. Which QTc interval result places the
patient at greatest risk for torsade’s de pointes?
A) 100-200 milliseconds
B) 160-260 milliseconds
C) 300-500 milliseconds
D) 500-700 milliseconds - Correct Answer - D) 500-700 milliseconds
A patient with a QTc interval of 500-700 milliseconds is at a higher risk of developing
torsade’s de pointes.
Which lab test should be ordered to rule out a medical cause of dementia
symptoms?
A) Albumin
B) thiamine
C) Vitamin D3
D) Vitamin B12 - Correct Answer - D) Vitamin B12
Low vitamin B12 levels have been associated with the development of dementia- like
symptoms, and when dementia is a differential diagnosis, a Vitamin B12 should be
checked.
Which of the following lab findings would raise the greatest concern when
prescribing Lithium?
A) BUN 20 mg/dL
B) GFR 115 mL
C) Serum Creatinine 3.0 mg/DL
pg. 1
,D) Serum Na+ 120 mEq/L - Correct Answer - C) Serum creatinine 3.0 mg/dL
Normal serum creatinine is < 1.5 mg/dL. Elevated creatinine indicates decreased renal
function. Lithium is excreted through the kidneys and decreased renal function can
result in lithium toxicity.
A 43-year-old male is treated for Bipolar 1 on lithium. Which of the following
hematologic changes is associated with lithium?
A) Agranulocytosis
B) Anemia
C) Leukocytosis
D) Leukopenia - Correct Answer - C) Leukocytosis
While the mechanism of action is not clear, the use of lithium can raise white blood cell
counts and therefore, CBC should be monitored in patients treated on lithium.
Which serotonin receptor antagonism makes an antipsychotic "atypical"
A) 5HT2A
B) 5HT1A
C) 5HT3A
D) 5HT4A - Correct Answer - A) 5HT2A
The mechanism of action that makes an antipsychotic medication "atypical" is related to
the 5HT2A receptor antagonism and D2 receptor antagonism.
Sally is a 27-year-old attorney who recently moved to your area. Sally presents
with social anxiety disorder, specifically symptoms of performance anxiety.
Sally's only other medical condition is exercising induced asthma, and she is
treated on Albuterol. Sally states she was in CBT without relief and would like to
try a medication. Which is the most suitable initial treatment for Sally?
A) clonazepam (Kolodin)
B) sertraline (Zoloft)
C) Inderal (Propranolol)
pg. 2
,D) risperidone (Risperdal) - Correct Answer - B) sertraline (Zoloft) is used to treat social
anxiety disorder and the patient is on albuterol; therefore, the betablocker Inderal is
contraindicated with albuterol due to the risk of increased CNS stimulation.
When suspecting a patient with neuroleptic malignant syndrome (NMS), which lab
values would help confirm diagnosis?
A) Leukocytosis and elevated creatinine phosphokinase.
B) Leukocytosis and thrombocytosis
C) Leukopenia and decreased creatinine phosphokinase
D) Leukocytosis and thrombocytopenia - Correct Answer - A) Leukocytosis and elevated
creatinine phosphokinase.
With NMS, a patient has an elevated creatinine phosphokinase (CPK) due to skeletal
muscle breakdown and an elevated white blood cell count (WBC).
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 (aripiprazole)
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 disequilibrium
B) Agitation, nausea, tremor, and ataxia.
pg. 3
, 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 flu-like
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?
A) Negative symptoms are related to DA deficit in the cerebral cortex; positive
symptoms are related to DA excess in the nucleus accumbent 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 accumbent 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 accumbent and mesolimbic
system.
Negative symptoms & cognitive impairment are thought to be related to hypoactivity of
the neocortical dopaminergic 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 neurotransmission
from the nucleus accumbent.
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
pg. 4
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