Module 1 Sample Questions

1. A patient was treated for psychosis two weeks ago He presents today with hyperthermia, muscle rigidity, mutism, leukocytosis and myoglobinuria. These symptoms are identified by the PMHNP and most likely represent which condition.

A) Neuroleptic malignant syndrome and considerate administer cyproheptadine

B) Neuroleptic malignant syndrome and administer dantrolene

C) Serotonin syndrome and administer cypenamine

D) Serotonin syndrome and administer bromocriptine

2. A 24-year-old female attempts suicide by overdosing with a monoamine oxidase inhibitor, phenelzine and being admitted to the hospital for stabilization. Ten days later, she was started on venlafaxine and symptoms of tachycardia and diaphoretic and myoclonic jerks appeared. Which of the following conditions would you be most concerned with?

A) Neuroleptic malignant syndrome

B) Acute dystonia

C) Akathisia

D) Serotonin syndrome

3. A week after raising the dose of Clomipramine, a patient treated for depression presents to the clinic with reports of acute change in mental status, fever and hyperreflexia. Which of the following conditions would you be most concerned with?

A) Extra Pyramidal Side Effect (EPS)

B) Neuroleptic Malignant Syndrome

C) Serotonin Syndrome

d) Hypertensive crisis

4. Josh is a 40 years old patient African American currently taking Isocarboxazid ( Marplan) for the last six years. She is scheduled for upcoming surgical procedures. Which medication is contraindicated with Isocarboxazid?

A) Morphine

B) NSAIDs

C) Methylphenidate

d) Acetaminophen

5. Which of the following medications is both a norepinephrine and dopamine reuptake inhibitor?

A) Bupropion

b) Sertraline (SSRI)

C) Clomipramine (TCA)

D) Duloxetine (SNRI chronic neuropathic pain)

6. Serotonin is a neurotransmitter that is involved with sleep and mood. Which part of the brain is the majority of serotonin produced?

A) Raphael nuclei

B) Nucleus accumbent (Dopamine)

C) Locus Coeruleus (Norepinephrine)

D) Amygdala

7. A 46-year-old patient with a history of bipolar comes to a regular follow-up appointment with concerns about severe vomiting, diarrhea, muscle weakness, blurred vision, and ataxia; he currently takes 1000mg of lithium daily. What is the priority action for the nurse practitioner?

A) Since the patient is stabilized, maintain the patient on the current regime and monitor the patient.

B) Order an electrocardiogram

c) Tell the patient to stop lithium and order lithium levels

D) Take the patient vital signs

8. During pregnancy, a patient takes Valproate (Depakote); which of the following conditions would you be concerned about regarding the baby?

A) Steven-Johnson syndrome

B) Epstein anomaly

C) Spina bifida

D) Cleft Palate

9. A patient is taking Carbamazepine (Tegretol), and his white blood count is (WBC) 5000/UL, ANC 4000/u L. Subsequently, his WCB decreased to 2500/UL and ANC to 750/UL after three weeks of therapy and no signs of infection are present. Labs were repeated, and the results were confirmed. What would be your next action?

A) Continue the treatment and monitor for signs of infection

B) Stop Tegretol and recheck ANC and WBC

C) Since WBC is normal, continue Tegretol

D) Referrer the patient to a primary care provider for a second evaluation

10. Which cytochrome (CYP) enzyme is a tobacco inducer when an individual is treated with clozapine?

A) 2D6

B) 1A2

c) 2C19

D) 2C9

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