QUESTION 1 Richard is a 54-year-old male who suffers from schizophrenia. After exhausting various medication options, you have decided to start him on Clozapine. Which of the statements below is true regarding Clozapine?a.Regular blood monitoring must be performed to monitor for neutropenia.b.Clozapine can only be filled by a pharmacy that participates in the REMS program.c.Bradycardia is a common side effect of Clozapine.d.A & Be.All of the above 3.75 points
QUESTION 2 Which of the following statements are true?a.First-generation (typical) antipsychotics are associated with a higher incidence of EPS.b.Second-generation (atypical) antipsychotics are associated with a higher risk of metabolic side effects.c.There is evidence that atypical antipsychotics are significantly more effective than typical antipsychotics in the treatment of cognitive symptoms associated with schizophrenia.d.A & Be.A, B, and C 3.75 points
QUESTION 3 Cindy is a 55-year-old patient who presents with symptoms consistent with Generalized anxiety disorder. The patient has an unremarkable social history other than she consumes two or three glasses of wine per night. Which of the following would be an appropriate therapy to start this patient on?a.Xanax 0.25mg BID PRN Anxietyb.Escitalopram 10mg dailyc.Buspirone 10mg BIDd.Aripiprazole 10mg daily 3.75 points
QUESTION 4 Mirza is a 75-year-old patient with a long history of schizophrenia. During the past 5 years, she has shown significant cognitive decline consistent with dementia. The patient has been well controlled on a regimen of risperidone 1mg BID. As the PMHNP, the most appropriate course of action for this patient is:a.Increase the risperidone to 1mg QAM, 2mg QPMb.Discontinue risperidone and prescribe a long-acting injectable such as Invega Sustenna.c.Discontinue risperidone and initiate therapy with clozapine.d.Augment the patient’s risperidone with brexpiprazole. 3.75 points
QUESTION 5 The patient in the previous question states, “I can’t even last 1 more day without feeling like my insides are going to explode with anxiety.” The most appropriate course of action would be:a.Inform the patient to try yoga or other natural remedies until the vortioxetine takes effect.b.Prescribe a short-term course of low dose benzodiazepine, such as alprazolam.c.Prescribe an SNRI, such as venlafaxine, in addition to the vortioxetine.d.Recommend in-patient mental health for the foreseeable future. 3.75 points
QUESTION 6 Thomas is a 28-year-old male who presents to the clinic with signs and symptoms consistent with MDD. He is concerned about starting antidepressant therapy, however, because one of his friends recently experienced erectile dysfunction when he was put on an antidepressant. Which of the following would be the most appropriate antidepressant to start Thomas on?a.Vilazodoneb.Sertralinec.Paroxetined.Citalopram 3.75 points
QUESTION 7 Stephanie is a 36-year-old female who presents to the clinic with a history of anxiety. Social history is unremarkable. For the last 4 years, she has been well controlled on paroxetine, however she feels “it just doesn’t work anymore.” You have decided to change her medication regimen to vortioxetine 5mg, titrating up to a max dose of 20mg per day based on tolerability. The patient asks, “When can I expect this to start kicking in?” The best response is:a.3 or 4 daysb.1 or 2 weeksc.3 or 4 weeksd.10 weeks 3.75 points
QUESTION 8 Jane is a 17-year-old patient who presents to the office with signs consistent with schizophrenia. She states multiple times that she is concerned about gaining weight, as she has the perfect prom dress picked out and she finally got a date. Which of the following is the least appropriate choice to prescribe Jane?a.Aripiprazoleb.Olanzapinec.Haloperidold.Brexpiprazole 3.75 points
QUESTION 9 John is a 41-year old-patient who presents to the clinic with diarrhea, fatigue, and recently has been having tremors. He was diagnosed 19 years ago with bipolar …
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