Download NURS 660 Exam 3 Questions and Answers: Neurotransmitters, Sleep Disorders, and Anxiety and more Exams Nursing in PDF only on Docsity!
NURS 660 EXAM 3 QUESTIONS WITH CORRECT
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Which neurotransmitter is affected by light and activity? - ANS ✓Melatonin What condition does this describe a. worry, anxiety, arousal, fatigue, sleeplessness, muscle tension? - ANS ✓GAD What condition does this describe anticipatory anxiety, worry about panic, unexpected panic attacks, trying to avoid future attacks? - ANS ✓Panic disorder What condition does this describe anxiety/fear over social performance? - ANS ✓social anxiety disorder What condition does this describe anxiety while re-experiencing, increased arousal and startle responses, nightmares? - ANS ✓PTSD What part of the body produces a substance that helps promote jet lag? - ANS ✓pineal glad The patient has been recently dx with hypothalamus tumor experiencing trouble sleeping and staying awake. What neurotransmitters are being affected in the hypothalamus. What is more activating and what is more sedating. - ANS ✓GABA vs HISTAMINE
What meds are used to treat narcolepsy? - ANS ✓Methylphenidate Pemoline Modafinil What would be the two things you suggest who needs something to help them relax to fall asleep and what would promote waking up in the morning? - ANS ✓evening melatonin, morning sunlight There is a woman who has terrible anxiety who has had for a long time. She has fears her children will be harmed when they are not with her. What circuitry in the brain is in charge of this type of thinking scenario? - ANS ✓cortico thalmic striatal circuits What is a potential therapeutic mechanism to promote wakefulness - ANS ✓enhance tonic dopamine firing What pain is so debilitating that even if you have mild pressure such as a toddler's hug, the pain is unbearable? - ANS ✓allodynia What causes diabetic peripheral neuropathy? How is that pain processed in the body? - ANS ✓inflammation in the periphery. Disrupted central processing What are the withdrawal symptoms of Paxil? - ANS ✓muscle aches, nausea, insomnia, anxiety, dizziness During an initial eval with someone with panic disorder and you start them on an SSRI. Which med is FDA approved until the SSRI effects are shown? - ANS ✓Benzodiazepines Which medications are short acting benzodiazepines? - ANS ✓alprazolam, triazolam, oxazepam, midazolam
What is the medication that is the antidote for alprazolam? - ANS ✓flumazenil What is the MOA of pregabalin that makes it alleviate pain for people with fibromyalgia or chronic fatigue? - ANS ✓binds to the alpha 2 delta sub-units of voltage sensitive calcium channels What is an antagonist of caffeine - ANS ✓adenosine Diagnose this pt: Patient comes in with a CC of anxiety. She has been excessively worrying, increased arousal, increased tiredness and irritability. What is the primary and least likely diagnosis? - ANS ✓GAD; Panic Disorder Somebody w/ anxiety worries about having a panic attack, in addition has mood changes to avoid things in order to not have a panic attack. - ANS ✓Panic disorder A woman was raped, and continues to have fear of opposite sex on her way to parking garage. Which two areas of the brain are involved? - ANS ✓amygdala and hippocampus MOA of modafinil (Provigil). How does it promote normal wakefulness - ANS ✓histamine, NE at alpha adrenergic receptor sites, dopamine at D receptors What is the MOA of eszopiclone? What receptors does it act on? - ANS ✓Binds to GABA receptors to increase GABA to increase sleepiness Which would be the first line appropriate pharmacological agent for PTSD?
What mediation is used to alleviate to help cognitive pain and physical symptoms in fibromyalgia? - ANS ✓Milnacipran (Savella) With the difficulty breathing is related hypothetically to the activation of what area of the brain? - ANS ✓parabrachial nucleous What medications are good for falling asleep "sleep induction" and are not addictive? - ANS ✓Suvorexant (Belsmora) Know the MOA of buspirone. Which receptor does it primarily act upon? - ANS ✓serotonin 1a 5HT1A partial agonist How does melatonin improve sleep? What receptors does it act on? Agonist or antatonist? - ANS ✓Secreted by the pineal glad to attach to receptors in the suprachiasmic nucleus to regulate the circadian rhythm; agonist Current dx of generalized anxiety disorder (GAD), difficulty concentrating as well as problems falling asleep. She gets very angry over basic things and is very moody in general, excessive stressful reactions, concentrate, irritability. What is going on in her brain? - ANS ✓a. Dysfunction of amygdale and CTSC (serotonin/nor-einephrine) Pt is coming in for detox with a long hx of alcohol abuse, HTN, and cirrhosis. He reports 12 beers daily for weeks. Has w/d seizures when he tries to stop drinking on his own. So he has elevated AST, LFT....what agent would you choose to detox him? - ANS ✓lorazepam Someone comes in with chronic hepatitis, also has chronic neuropathic pain. What medication would you AVOID prescribing to this patient and why? - ANS ✓Cymbalta; elevates LFTs Benzodiazepine patient education - ANS ✓Avoid ETOH may cause dizziness, may slow heart rate, avoid sedating antihistamines
