Free PMHNP Board Practice: 10 Questions
Real board-style psychopharmacology and diagnosis questions with instant explanations, from SOAPsync PMHNP Review. Try 3 now. Create a free account to unlock all 10.
Question 1 of 10 · Clozapine Neutropenia Monitoring
A 38 year old patient with treatment resistant schizophrenia taking clozapine presents with a fever of 101.5 F and a severe sore throat. Which action is the priority?
Why: Fever and sore throat in a patient taking clozapine suggest neutropenia or agranulocytosis. The immediate priority is obtaining an absolute neutrophil count (ANC) and holding clozapine per protocol if the ANC drops below 1000/mm3.
Learning objective: Identify clozapine induced neutropenia and execute protocol guided laboratory monitoring.
Question 2 of 10 · Lithium Renal Clearance and Toxicity
A 45 year old patient taking lithium for bipolar I disorder develops gastroenteritis with severe vomiting and diarrhea. The patient presents with coarse tremors, ataxia, and confusion. Which mechanism explains this presentation?
Why: Dehydration reduces renal clearance, prompting the kidneys to reabsorb sodium and lithium, which elevates serum lithium levels into the toxic range.
Learning objective: Recognize dehydration as a primary trigger for lithium toxicity.
Question 3 of 10 · Teratogenicity of Mood Stabilizers
A 26 year old female with bipolar I disorder plans to become pregnant. Which mood stabilizer carries the highest risk for neural tube defects and cognitive impairment?
Why: Valproic acid is strongly teratogenic, carrying a significant risk of neural tube defects such as spina bifida and cognitive impairment. Lamotrigine is often favored when mood stabilization is needed during pregnancy planning.
Learning objective: Differentiate teratogenic risks among mood stabilizers in reproductive age patients.
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Educational content for exam preparation only. It is not medical advice and does not replace clinical judgment or current prescribing information.