Comprehensive Mental Health and Psychiatric Nursing Flashcards
7 cards from real Psychiatric-Mental Health Nurse Practitioner Exam practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Comprehensive Mental Health and Psychiatric Nursing flashcards as text
A patient on clozapine has an ANC of 1,200 cells/mm³. What is the PMHNP's priority action?
Answer: Immediately discontinue clozapine and notify the prescriber
An ANC below 1,500 cells/mm³ (severe neutropenia threshold) requires immediate discontinuation of clozapine to prevent life-threatening agranulocytosis.
Which neurotransmitter imbalance is most associated with the positive symptoms of schizophrenia?
Answer: Dopamine excess in the mesolimbic pathway
Excess dopaminergic activity in the mesolimbic pathway is the primary mechanism underlying positive symptoms such as hallucinations and delusions in schizophrenia.
A nurse practitioner is evaluating a 16-year-old who self-harms by cutting. Which therapeutic approach has the strongest evidence base for this population?
Answer: Dialectical Behavior Therapy adapted for adolescents (DBT-A)
DBT-A is specifically designed for suicidal and self-harming adolescents and has the strongest RCT evidence for reducing non-suicidal self-injury in this age group.
A patient taking an MAOI needs analgesia for acute pain. Which agent is CONTRAINDICATED due to risk of serotonin syndrome?
Answer: Meperidine
Meperidine (pethidine) combined with MAOIs can precipitate a fatal serotonin syndrome or hypertensive crisis and is absolutely contraindicated.
When assessing a patient using the Columbia Suicide Severity Rating Scale (C-SSRS), which finding indicates the HIGHEST level of ideation?
Answer: Active ideation with a specific plan and intent to act
On the C-SSRS, active suicidal ideation with a specific plan and intent to act represents the highest ideation severity and requires immediate intervention.
A patient with bipolar I disorder is in a manic episode. Which medication is FDA-approved as monotherapy for acute mania?
Answer: Valproate
Valproate (divalproex) is FDA-approved for acute manic episodes in bipolar I disorder and can be used as monotherapy.
A PMHNP is initiating lithium therapy. Which baseline laboratory test is MOST critical before starting treatment?
Answer: Serum creatinine and thyroid-stimulating hormone (TSH)
Renal function (creatinine/GFR) and thyroid function (TSH) must be assessed before lithium initiation because lithium is renally cleared and causes hypothyroidism with long-term use.