Psychiatric-Mental Health Nurse Practitioner (Across the Lifespan) Certification Free Sample Questions

A 38-year-old male with schizophrenia treated with intramuscular haloperidol decanoate is brought to the emergency department with severe diaphoresis, autonomic instability (blood pressure 178/104 mmHg, heart rate 124 bpm), a temperature of 103.8°F (39.9°C), generalized "lead-pipe" rigidity, and a serum creatine kinase level of 24,000 U/L. Antipsychotic therapy is stopped immediately. Which medication is most appropriate to administer specifically to relieve peripheral skeletal muscle rigidity and reduce hyperthermia?

A 21-year-old male receives his first dose of intramuscular haloperidol for acute agitation. Two hours later, he experiences acute involuntary muscular contraction of the neck, as illustrated with muscle X in the figure. Which intervention is the most appropriate first-line treatment for this condition?

Five days after starting aripiprazole 15 mg daily for bipolar depression, a 29-year-old female reports intense subjective motor restlessness, an irresistible urge to keep moving her legs, and inability to sit still during her session. Physical examination reveals repetitive pacing and shifting weight while standing, without muscular rigidity or fever. Which medication is considered first-line pharmacotherapy for this condition?

A 44-year-old female with recurrent major depressive disorder undergoes pharmacogenomic testing, which reveals that she is a CYP2D6 poor metabolizer (*4/*4 genotype). The psychiatric-mental health nurse practitioner is evaluating pharmacotherapy options. If this patient is prescribed standard therapeutic doses of nortriptyline, which clinical and pharmacokinetic outcome is most expected?

A psychiatric-mental health nurse practitioner evaluates a 32-year-old male of Han Chinese ancestry presenting with acute bipolar mania. Prior to initiating carbamazepine therapy, which pharmacogenetic screening test is mandated by FDA boxed warning labeling to prevent life-threatening cutaneous adverse reactions?

In clinical psychopharmacogenomics, when a patient whose genotype predicts normal (extensive) enzymatic metabolism at CYP2D6 exhibits the drug clearance and toxicity profile of a poor metabolizer due to co-prescription of a potent CYP2D6 inhibitor like fluoxetine or paroxetine, this clinical phenomenon is defined as _____