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?
A) benzotropine (Cogentin)
B) bromocriptine (Parlodel)
C) dantrolene (Dantrium)
D) trihexyphenidyl (Artane) A) 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).
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?
A) Non-steroidal anti-inflammatory drugs (NSAIDS)
B) Codeine
C) Morphine
D) Meperidine D) Meperidine is strictly prohibited when a patient is
treated on a monoamine oxidase inhibitor (MAOI) due to the risk of
hypertensive crisis and death.
A WBC of 4,000 in a patient taking Clozapine would prompt the PMHNP to
take which of the following actions?
A) Consult with hematologist to determine appropriate antibiotic regimen
and monitor closely.
B) Institute twice-weekly complete blood count with differentials and
monitor closely.
C) Discontinue clozapine, initiate alternative antipsychotic medication and
monitor closely.
D) Institute daily complete blood count with differentials and monitor
closely. B) 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
while patient may continue clozapine in the absence of any other signs or
symptoms.
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 (aripriprazole)
B) Latuda (lurasidone)
C) Invega (iloperidone)
D) Clozaril (clozapine) 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 diequilibrium
B) Agitation, nausea, tremor, and ataxia.
C) Restlessness, tremor, fever, and shivering.