ANCC Domain 3 Questions Answers

ANCC Domain 3 Questions & Answers

A patient presents for a clinic appointment and tells the psychiatric mental health nurse practitioner (PMHNP), "My depression is a little better, but I read about acupuncture, and I want to add this to my treatment." What is the PMHNPs best response to this patient?

• Integrative therapies have no effectiveness in improving depressive

symptoms and if your depression has not improved and you have not achieved remission of your symptoms, I recommend that we increase your antidepressant

• Integrative therapies such as acupuncture are not well studied, and I

cannot recommend that you add this to your current treatment

• Acupuncture is one of many integrative therapies, but it has the least

effectiveness in improving depression

• Acupuncture has been found to help some individuals with depression.

While the data is limited, if this is something you would like to consider, let's talk about where you might find a reputable practitioner for acupuncture treatments.(Ans - d. Acupuncture has been found to help some individuals with depression. While the data is limited, if this is something you would like to consider, let's talk about where you might find a reputable practitioner for acupuncture treatments.

You are seeing a female patient who is morbidly obese. She also suffers from major depression, anxiety, and antidepressant-induced decreased libido. She has been stabilized on Desvenlafaxine (Pristiq) 50 mg 1 PO 1 / 3

QAM and Bupropion (Wellbutrin) 50 mg. She also take Mononessa (Ortho- Cyclen) 1 PO QAM and Vitamin D 1000 IU PO QAM. She has had trouble maintaining weight loss on diet support programs, diet medications, and self-directed food reduction plans. She asks you about using Phentermine

to help her lose weight. You discuss options with her and decide to:

• Prescribe a one month course of Phentermine and Topiramate (Qsymia)

7.5/46 for 30 days. Have her return to the clinic in 1 month for a checkup.

• Prescribe a one month course of Phentermine (Adipex-P) 37.5 mg PO

QAM. Have her come back in one month for a check-up

• Prescribe a 1 month course of Topiramate (Topamax) 50 mg 1 PO QHS.

Have the patient come back in 1 month for a checkup. Let the patient know that you may have to increase the dosage at one-month intervals.

• Discontinue her current Bupropion. Prescribe Bupropion and Naloxone

(Contrave) 90mg/8mg for one week. Have her come back in one week for a check-up. You may have to increase the dosage at one-week intervals.(Ans - D. Discontinue her current Bupropion. Prescribe Bupropion and Naloxone (Contrave) 90mg/8mg for one week. Have her come back in one week for a check-up. You may have to increase the dosage at one-week intervals.

Which is the only medication that is approved by the U.S. Food and Drug Administration (FDA) to treat depression in children?

• Fluoxetine (Prozac)
• Citalopram (Celexa)
• Paroxetine (Paxil)
• Sertraline (Zoloft)

(Ans - A. Fluoxetine (Prozac) 2 / 3

Mr. Ready is a 58 y/o new patient at a community mental health center.He's seen by the psychiatric mental health nurse practitioner for depression, anxiety, and co-morbid substance use disorder, which the patient describes as effective in treatment of his symptoms. He does not have a primary care provider and does not know when he last had laboratory values drawn. Ready takes Tylenol PRN for his knee pain, Prilosec OTC 20 mg BID and has been on his current psychotropic

medications for over 2 years: Buspirone 20 mg BID, Sertraline 200 mg PO

daily, and Aripiprazole 2 mg daily. What screening labs are appropriate for this patient?

• CBC, CMP, Lipid Profile, and Vitamin B12
• BMP, LFT, and Vitamin D
• Lipid Profile, CMP, CBC, Thyroid Profile, and Vitamins B12 and D
• CBC and CMP

(Ans - C. Lipid Profile, CMP, CBC, Thyroid Profile, and Vitamins B12 and D

Which laboratory test should be ordered to rule out a medical cause of dementia symptoms?

• Vitamin B12
• Thiamine
• Vitamin D3
• Albumin

(Ans - A. Vitamin B12

Lorazepam is the preferred benzodiazepine when managing alcohol withdrawal symptoms in a patient with co-morbid:

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