Medications 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 Medications flashcards as text
A patient on clozapine develops a WBC of 2,800/mm³. What is the most appropriate action?
Answer: Discontinue clozapine immediately and do not rechallenge
A WBC below 3,000/mm³ indicates agranulocytosis risk; clozapine must be stopped immediately and is permanently contraindicated for that patient.
Which antidepressant is most appropriate for a patient with major depressive disorder who also has significant insomnia but cannot tolerate anticholinergic side effects?
Answer: Mirtazapine
Mirtazapine is highly sedating via H1 antagonism and has minimal anticholinergic activity, making it suitable for patients needing sleep aid without anticholinergic burden.
A patient prescribed lithium develops nausea, vomiting, coarse tremor, and confusion. Serum lithium level is 2.1 mEq/L. What is the priority intervention?
Answer: Initiate hemodialysis
A lithium level above 2.0 mEq/L with severe neurological symptoms requires hemodialysis to rapidly remove lithium, as lithium is not bound to activated charcoal.
Which of the following is the mechanism of action of aripiprazole that differentiates it from most other second-generation antipsychotics?
Answer: D2 receptor partial agonism
Aripiprazole acts as a partial agonist at D2 and D3 receptors, stabilizing dopamine activity rather than fully blocking it, which reduces EPS risk.
A woman of childbearing potential is being started on valproate for bipolar disorder. What is the most critical counseling point?
Answer: Valproate carries a high risk of neural tube defects and requires reliable contraception
Valproate is a major teratogen associated with neural tube defects (spina bifida), cognitive impairment in offspring, and requires a REMS program with mandatory contraception.
Which medication requires monitoring of fasting glucose and HbA1c due to its high risk of causing metabolic syndrome?
Answer: Olanzapine
Olanzapine has the highest metabolic risk among antipsychotics, causing significant weight gain, hyperglycemia, and dyslipidemia requiring routine metabolic monitoring.
A patient taking phenelzine eats a meal containing aged cheese and develops a severe hypertensive crisis. What is the pharmacological explanation?
Answer: MAO inhibition prevents tyramine breakdown, causing massive norepinephrine release
MAO normally degrades tyramine in the gut and liver; when MAO is inhibited, tyramine enters circulation and triggers massive norepinephrine release causing hypertensive crisis.