ANCC Review Questions PMHNP IQ

ANCC Review Questions (PMHNP IQ) Answered Updated 2024 / 2025

1. Question:

What direct-acting dopamine receptor agonist is recommended to be used in the treatments of neuroleptic malignant syndrome (NMS) fo help lower the dopamine blockade?

• benztropine (Cogentin)
• bromocriptine (Parlodel)
• dantrolene (Dantrium)
• trihexyphenidyl (Artane)

Answer:

• 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).

2. Question:

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?

• Non-steroidal anti-inflammatory drugs (NSAIDS)
• Codeine 1 / 2

• Morphine
• Meperidine

Answer:

• Meperidine is strictly prohibited when a patient is treated on a

monoamine oxidase inhibitor (MAOI) due to the risk of hypertensive crisis and death.

3. Question:

A WBC of 4,000 in a patient taking Clozapine would prompt the PMHNP to take which of the following actions?

• Consult with hematologist to determine appropriate antibiotic regimen

and monitor closely.

• Institute twice-weekly complete blood count with differentials and

monitor closely.

• Discontinue clozapine, initiate alternative antipsychotic medication and

monitor closely.

• Institute daily complete blood count with differentials and monitor

closely.

Answer:

• Institute twice-weekly complete blood count with differentials and

monitor closely.

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

• / 2