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Download Nurs6630 psychopharmacology final exam week 11with 100% verified solutions. and more Exams Nursing in PDF only on Docsity!
Nurs6630 psychopharmacology finalexam week 11with 100% verified solutions. Question 1 0 outof 1 points A patient diagnosed with obsessive compulsive disorder has been taking a high-dose SSRI and is participating in therapy twice a week. He reports an inability to carry out responsibilities due to consistent interferences of his obsessions and compulsions. The PMHNP knows that the next step would be which of the following? Selected Answer: B. Decrease his SSRI andaddan MAOL. 1 Question 2 0 out of 1 points Which statement best describes a pharmacological approach to treating patients for impulsive aggression? Selected B. Answer: Atypical antipsychotics can increase subcortical dopaminergic stimulation. 2 Question3 0 outof | points The PMHNP evaluates a patient presenting with symptoms of dementia. Before the PMHNP considers treatment options, the patient must be assessed for other possible causes of dementia. Which of the following answers addresses both possible other causes of dementia anda rational treatment option for Dementia? Selected B. [Date] | | Answer: Possible other causes: hypothyroidism, adrenal insufficiency, hyperparathyroidism Possible treatment option: donepezil 3 Question 4 1 outof 1 points An 80-year-old female patient diagnosed with Stage II Alzheimer’s has a history of irritable bowel syndrome. Which cholinergic drug may be the best choice for treatment given the patient’s gastrointestinal problems? Selected Answer: A. Donepezil (Aricept) 4 Question5 0 outof 1 points The PMHMP is teaching parents about their child’ s new prescription for Ritalin. What will the PMHNP include in the teaching? Selected Answer: D. There will be continued effects into the evening. 5 Question 6 1 outof 1 points The PMHNP prescribes gabapentin (Neurontin) fora patient’s chronic pain. How does the PMHNP anticipate the drug to work? [Date] | | “Tamunable to fall asleep at night.” 9 Question 10 1 outof 1 points a. patient recovering from shingles presents with tenderness and sensitivity to the upper back. He states itis bothersome to puta shirt on most days. This patient has end stage renal disease (ESRD) and is scheduled to have hemodialysis tomorrow but states that he does not know how he can lie ina recliner for 3 hours feeling this uncomfortable. What will be the PMHNP’s priority? Selected Answer: C. Prescribe lidocaine 5% 10 Question 11 0 outof 1 points a. 63-year-old patient presents with the following symptoms. The PMHNP determines which set of symptoms warrant prescribing a medication? Select the answer that is matched with an appropriate treatment. Selected C. Answer: Reduced ability to find the correct word is most problematic, and an appropriate treatment option would be memantine. 11 Question 12 1 out of 1 points The PMHNP is caring for a patient who openly admitted to drinking a quart of [Date] | | vodka daily. Prior to prescribing this patient disulfiram (Antabuse), it is important forthe PMHNP to: Selected A. Answer: Evaluate the patient’s willingness to abstain from alcohol 12 Question 13 0 outof 1 points a. PMHNP supervisor is discussing with a nursing student how stimulants and noradrenergic agents assist with ADHD symptoms. What is the appropriate response? Selected A. Answer: They both increase signal strength output dopamine (DA) and norepinephrine (NE). 13 Question 14 1 outof | points The PMHMP isassessing a female patient who has been taking lamotrigine (Lamictal) for migraine prophylaxis. After discovering that the patient has reached the maximum dose of this medication, the PMHNP decides to change the patient’s medication to zonisamide (Zonegran). In addition to evaluating this patient’s day-to-day activities, what should the PMHNP ensure that this patientunderstands? Selected D. Answer: This medication has unwanted side effects such as sedation, lack of coordination, and drowsiness. 14 Question 15 [Date] | | a. 14-year-old patientis prescribed Strattera and asks when the medicine should be taken. What does the PMHNP understand regarding the drug’s dosing profile? Selected Answer: B. The patient will have one or two dosesa day. 18 Question 19 1 out of 1 points The PMHMNP is assessing a patient who presents with elevated levels of brain amyloid as noted by positron emission tomography (PET). What other factors will the PMHNP consider before prescribing medication for this patient, and what medication would the PMHNP wantto avoid given these other factors? Selected Answer: D. Both“A” &“B” 19 Question 20 1 out of 1 points The PMHNP is meeting with the parents of an 8-year-old patient who is receiving an initial prescription for D-amphetamine. The PMHNP demonstrates appropriate prescribing practices when she prescribes the following dose: Selected Answer: A. The child will be prescribed 2.5 mg. 20 Question 21 1 out of 1 points A 9-year-old female patient presents with symptoms of both attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder. In evaluating her symptoms, the PMHNP determines that which of the following medications may be beneficial in augmenting stimulant medication? [Date] | | Selected Answer: C. Guanfacine ER (Intuniv) 21 Question 22 0 outof | points The PMHMPisattempting to treat a patient’s chronic insomnia and wishes to start with an initial prescription that has a half-life ofapproximately 1—2 hours. What is the most appropriate prescription forthe PMHNP to make? Selected Answer: C. Temazepam (Restoril) 22 Question 23 1 outof 1 points A7\-year-old male patient comes to an appointment with his 65-year- old wife. They are both having concerns related to her memory and ability to recognize faces. The PMNHP is considering prescribing memantine (Namenda) based on the following symptoms: Selected Answer: C. Amnesia, apraxia, agnosia 23 Question 24 1 out of 1 points The PMHNP isassessing a patient who has expressed suicidal intent and is now stating that he is hearing voices and sees people chasing him. The PMHNP identifies these symptoms to be associated with which of the following? Selected Answer: C. [Date] | | 1 out of 1 points A patient with chronic back pain has been prescribed a serotonin- norepinephrine reuptake inhibitor (SNRI). How does the PMHNP describe the action of SNRIs on the inhibition of pain to the patient? Selected A. Answer: “The SNRI can increase noradrenergic neurotransmission in the descending spinal pathway to the dorsal horn.” 28 Question 29 1 outof 1 points An 18-year-old female with a history of frequent headaches anda mood disorder is prescribed topiramate (Topamax), 25 mg by mouth daily. The PMHNP understands that this medication is effective in treating which condition(s) inthis patient? Selected Answer: A. Migraines 29 Question 30 1 out of | points Naltrexone (Revia), an opioid antagonist, is a medication that is used for which of the following conditions? Selected Answer: A. Alcoholism [Date] | | 30 Question 31 1 out of 1 points The PMHNP understands that slow-dose extended release stimulants are most appropriate for which patient with ADHD? Selected Answer: A. 8-year-old patient 31 Question 32 1 out of 1 points A 26-year-old female patient with nicotine dependence anda history ofanxicty presents with symptoms of attention deficit hyperactivity disorder (ADHD). Based on the assessment, what does the PMHNP consider? Selected A. Answer: ADHD is often not the focus of treatment in adults with comorbid conditions. 32 Question 33 1 outof | points Which of the following isa true statement regarding the use of stimulants to treat attention deficit hyperactivity disorder (ADHD)? Selected B. Answer: Signal strength output is increased by dialing up the release of dopamine (DA) and norepinephrine (NE). [Date] | | Selected A. Answer: Increase the dose of lamotrigine (Lamictal) to 25 mg twice daily. 36 Question 37 1 outof 1 points The PMHNP wants to use asymptom-based approach to treating a patient with fibromyalgia. How does the PMHNP go about treating this patient? Selected C. Answer: Matching the patient’s symptoms with the malfunctioning brain circuits and neurotransmitters that might mediate those symptoms 37 Question 38 1 outof 1 points The PMHNP has been asked to provide an in-service training to include attention to the use of antipsychotics to treat Alzheimer’s. What does the PMHNP convey to staff? Selected Answer: D. Both “A” &“C.” 38 Question 39 0 out of 1 points The PMHNP is caring for a patient with chronic insomnia who would benefit from taking hypnotics. The PMHNP wants to prescribe the patient a drug with an ultra-short half-life (1-3 hours). Which drug will the PMHNP prescribe? Selected Answer: B. Estazolam (ProSom) [Date] | | 39 Question 40 1 out of | points Why does the PMHNP avoid prescribing clozapine (Clozaril) as a first- line treatment to the patient with psychosis and aggression? Selected A. Answer: There is too high arisk of serious adverse side effects. 40 Question 41 1 outof | points The PMHNPis attempting to treat a patient’s chronic pain by having the agent bind the open channel conformation of VSCCs to block those channels with a “use-dependent” form of inhibition. Which agent will the PMHNP most likely select? Selected Answer: A. Pregabalin (Lyrica) 41 Question 42 1 outof 1 points The PMHNP scaring fora patient with chronic insomnia who is worried about pharmacological treatment because the patient does not want to experience dependence. Which pharmacological treatment approach will the PMHNP likely select for this patient for a limited duration, while searching and correcting the underlying pathology associated with the insomnia? [Date] | | association with aggressive behaviors in patients with the student. Why does the PMHNP prescribe a standard dose of atypical antipsychotics? Selected C. Answer: The doses are based on achieving 60% D2 receptor occupancy. 46 Question 47 1 out of 1 points The PMHNP understands that bupropion (Wellbutrin) is an effective way to assist patients with smoking cessation. Why is this medication effective for these patients? Selected C. Answer: Bupropion (Wellbutrin) blocks dopamine reuptake, enabling more availability of dopamine. 47 Question 48 1 outof 1 points a. group of nursing students secks further clarification from the PMHNP on how cholinesterase inhibitors are beneficial for Alzheimer’s disease patients. What is the appropriate response? Selected Answer: D. Both“A” &“C.” 48 Question 49 1 outof 1 points A patient with chronic insomnia and depression is taking trazodone (Oleptro) but complains of feeling drowsy during the day. What can the PMHNP do to reduce the drug’s daytime sedating effects? Selected Answer: C. Give the medicine at night and lower the dose [Date] | | 49 Question 50 1 outof 1 points The PMHMP isassessing a 49-year-old male witha history of depression, post-traumatic stress disorder(PTSD), alcoholism with malnutrition, diabetes mellitus type 2, and hypertension. His physical assessment is unremarkable with the exception of peripheral edema bilaterally to his lower extremities anda chief complaint of pain with numbness and tingling to each leg 5/10. The PMHNP starts this patient on a low dose of doxepin (Sinequan). What is the next action that must be taken by the PMHNP? Selected Answer: A. Orders liver function tests. 50 Question 51 1 outof | points What will the PMHNP most likely prescribe toa patient with psychotic aggression who needs to manage the top-down cortical control and the excessive drive from striatal hyperactivity? Selected Answer: C. Antipsychotics 51 Question 52 Ooutof | points The PMHMP is assessing a patient who will be receiving phentermine (Adipex-P)/topiramate (Topamax) (Qsymia). Which of the following conditions/diseases will require further evaluation before this medication can be prescribed? Selected Answer: A. Kidney disease stage II [Date] | | Imipramine (Tofranil) 55 Question 56 1 outof 1 points A patient addicted to heroin is receiving treatment for detoxification. He begins to experience tachycardia, tremors, and diaphoresis. What medication willthe PMHNP prescribe for this patient? Selected Answer: D. Clonidine (Catapres) 56 Question 57 1 outof 1 points The PMHMP is providing a workshop for pediatric nurses, anda question is posed about noradrenergic agents to treat ADHD. Which of the following noradrenergic agents have norepinephrine reuptake inhibitor (NRI) properties that can treat ADHD? Selected Answer: D. Both “A” &“C” 57 Question 58 1 outof 1 points Mts. Kenner is concerned that her teenage daughter spends too much time on the Internet. She inquires about possible treatments for her daughter’s addiction. Which response by the PMHNP demonstrates understanding of pharmacologic approaches for compulsive disorders? Selected D. Answer: “There are no evidence-based treatments for Internet addiction, but there are behavioral therapies your daughter can try.” [Date] | | 58 Question 59 1 out of 1 points A patient is being prescribed bupropion and is concerned about the side effects. What will the PMHNP tell the patient regarding bupropion? Selected Answer: C. It can cause cardiac arrhythmias. 59 Question 60 1 outof 1 points a. patient with gambling disorder and no other psychiatric comorbidities is being treated with pharmacological agents. Which drug is the PMHNP most likely to prescribe? Selected Answer: D. Naltrexone 60 Question 61 1 outof 1 points Anadult patient presents with a history ofalcohol addiction and attention deficit hyperactivity disorder (ADHD). Given these comorbidities, the PMHNP determines which of the following medications may be the best treatment option? Selected Answer: C. Atomoxetine (Strattera) 61 Question 62 1 outof | points Which patient will receive a lower dose of guanfacine? [Date] | | 
