NURS 6630 PSYCHOPHARMACOLOGY MIDTERM EXAM – COMPLETE
1 1 1 1 11 1
TEST BANK WITH 100% CORRECT VERIFIED QUESTIONS, ANSWERS, AND R
1 1 1 1 1 1 1 1 1
ATIONALES 1
1
1
1
Purple1answers1were1marked1incorrect.1Red1answers1were1marked1correct.1
1
QUESTION111
1.1A1noncompliant1patient1states,1"Why1do1you1want1me1to1put1this1poison1in1my1body?"1Ident
ify1the1best1response1made1by1the1psychiatric-mental1health1nurse1practitioner1(PMHNP).1A.1
"You1have1to1take1your1medication1to1become1stable."1B.1
"Most1medications1will1increase1the1number1of1neurotransmitters1that1you1already1have1in
1 the1brain."1C.1
"Most1medications1used1in1treatment1are1either1increasing1or1decreasing1neurotransmitter
s1that1your1body1already1has."1D.1
"Why1do1you1believe1that1your1medication1is1poison?"1I1received10/11for1this1answer??111points1
QUESTION121
1.1Which1statement1about1neurotransmitters1and1medications1is1true?1My1correct1answer1w
as1several1psychiatric1meds1were1developed1after1discovery1of1endogenous1neurotransmitte
rs.1(The1answer1wording1is1different.1A.1
Natural1neurotransmitters1such1as1endorphins1have1been1discovered1after1the1development1of1medications
.1B.1
Some1medications1were1developed1after1the1discovery1and1known1action1of1the1neurotran
smitters1in1the1brain.1C.1
Neurotransmitters1receive1messages1from1most1medications.1D.1
The1neurotransmitter1serotonin1is1directly1linked1to1depression.1Following1this1discovery,1the1ant
idepressant1Prozac1was1developed.1
11points1
QUESTION131
1.1When1an1unstable1patient1asks1why1it1is1necessary1to1add1medications1to1his1current1regimen,1
the1PMHNP's1best1response1would1be:1A.1
"In1an1extreme1case1such1as1yours,1more1than1one1medication1is1often1needed."1B.1"Du
e1to1the1ineffectiveness1of1your1current1medication,1we1need1to1try1something1else1that
1can1possibly1potentiate1its1effects.1C.1
,"Medications1are1often1specific1to1the1neurotransmitter(s)1they1are1affecting1and,1due1to1more1th
an1one1neurotransmitter1involvement,1it1is1often1necessary1to1use1more1than1one1medication1to1i
mprove1symptoms."1D.1
"I1understand1your1concern.1We1can1discontinue1your1current1medication1and1switch1to1a1
different1one1that1may1better1manage1your1symptoms."1
11points1
QUESTION141?1
1.1During1gene1expression,1what1must1occur1prior1to1a1gene1being1expressed?1A.1Transcript
ion1factor1must1bind1to1the1regulatory1region1within1the1cell's1nucleus.1B.1
RNA1must1be1converted1to1mRNA.1C.1
The1coding1region1must1separate1from1the1regulatory1region.1This1is1wrong1D.1
RNA1polymerase1must1inhibit1the1process1of1changing1RNA1to1mRNA.1
11points1QUESTION151
1.1While1genes1have1potential1to1modify1behavior,1behavior1can1also1modify1genes.1How1do1gene
s1impact1this1process?1A.1
Genes1impact1neuron1functioning1directly.1
B.1
Changes1made1to1proteins1lead1to1changes1in1behavior.1C.1
Neurons1are1able1to1impact1protein1synthesis.1D.1
Genes1impact1the1DNA1of1a1cell,1leading1to1changes1in1behavior.1
11points1QUESTION161
1.1Though1medications1have1the1ability1to1target1neurotransmitters1in1the1synapse,1it1is1not1alway
s1necessary.1The1PMHNP1understands1that1this1is1because:1A.1
Neurotransmission1that1occurs1via1the1axon1allows1for1transport1of1a1neurotransmitter
.1B.1
Active1transport1is1a1different1type1of1energy1that1allows1the1transport1of1certain1neurotra
nsmitters.1C.1
Neurotransmitters1can1spread1by1diffusion.1D.1
The1postsynaptic1neuron1can1release1the1neurotransmitter.1
11points1QUESTION171
1.1
Why1is1the1cytochrome1P4501enzyme1system1of1significance1to1the1PMHNP?1
A.11
The1kidneys1play1a1role1with1excretion1of1the1medication,1and1if1a1patient1has1kidney1damage,1th
e1dose1must1be1increased1to1be1effective.1B.1
,The1bioavailability1of1the1medication1after1it1passes1through1the1stomach1and1liver1can1be1altered
.1Correct1answer1C.1
The1medication's1chemical1composition1changes1when1it1comes1in1contact1with1the1acid1in1th
e1stomach.1D.1
The1CYP1enzyme1system1is1a1steady1and1predictable1process1that1prescribers1must1understand1t
o1treat1conditions1effectively.1
11points1QUESTION181
1.1It1is1important1for1the1PMHNP1to1recognize1differences1in1pharmacokinetics1to1safely1pre
scribe1and1monitor1medications.1Which1of1the1following1statements1does1the1competent1P
MHNP1identify1as1true?1A.1
About111out1of151Asians1requires1lower-than-
normal1doses1of1some1antidepressants1and1antipsychotics.1B.1
The1term1polymorphic1refers1to1the1body's1ability1to1break1a1medication1down1several1ways,1an
d1this1patient1may1require1higher1doses1of1certain1antidepressants1and1antipsychotics.1C.1About1
11out1of1301Caucasians1requires1lower1doses1of1some1antidepressants1and1antipsychotics.1D.1
Most1enzyme1pathways1do1not1have1interactions1between1the1newer1medications.111point
s1
QUESTION191
1.1As1it1relates1to1G-
protein1linked1receptors,1what1does1the1PMHNP1understand1about1medications1that1are1
used1in1practice?1A.1
Most1medications1that1act1on1G-
protein1linked1receptors1have1antagonistic1traits.1B.1The1majority1of1medications1used1in1pr
actice1are1full1agonists1and1are1used1to1stimulate1the1body's1natural1neurotransmitters.1C.1
Most1medications1act1as1partial1agonists1because1they1allow1the1body1to1use1only1what1is1
needed.1D.1
Medications1used1in1practice1may1act1as1inverse1agonists1if1the1dosage1is1too1high.111points
1QUESTION1101
1.1 The1PMHNP1is1considering1prescribing1a149-year-
old1male1clozapine1(Clozaril)1to1treat1his1schizophrenia1and1suicidal1ideations.1The1PMHNP1is1awar
e1that1which1factor1may1impact1the1dose1needed1to1effectively1treat1his1condition:1A.1
The1patient1smokes1cigarettes.1 This1is1correct!1B.1
The1patient1has1hypertension.1C.1
The1patient1has1chronic1kidney1disease,1stage12.1D.1
The1patient1drinks1a1cup1of1coffee1a1day.1
, 11points1QUESTION1111
1.1
A1patient1is1diagnosed1with1bipolar1disorder1and1is1currently1taking1carbamazepine1(Tegretol),1a
ripiprazole1(Abilify),1and1melatonin.1The1PMHNP1has1just1written1an1order1to1discontinue1the1carb
amazepine1(Tegretol)1for1druginduced1thrombocytopenia.1The1PMHNP1is1aware1that1his1next1best
action1is1to:1A.1
1
Alert1staff1to1possible1seizures1B.1
Write1an1order1for1a1different1mood1stabilizer1 For1some1reason1I1got10/11points1for1this??1
C.1
Decrease1the1amount1prescribed1for1aripiprazole1(Abilify)1D.1
Explain1to1the1patient1that1it1will1be1more1difficult1to1control1his1temper1
11points1QUESTION1121
1.1A1patient1recently1transferred1following1a1suicide1attempt1has1a1history1of1schizophrenia,1de
pression,1and1fibromyalgia.1He1is1currently1taking1Amitriptyline1(Elavil),1Lisinopril,1aspirin,1and1fl
uoxetine1(Prozac).1Which1is1the1best1action1for1the1PMHNP1to1take1for1this1patient?1A.1
Review1Amitriptyline1(Elavil)1level1Correct1answer1B.1
Order1a1liver1function1test1C.1
Check1the1patient's1blood1pressure1and1pulse1D.1
Order1a1stat1platelet1count1
11points1QUESTION1131
1.1A1patient1with1schizophrenia1is1given1an1inverse1agonist1that1acts1on1the1receptor15HT1and1neu
rotransmitter1serotonin.1What1is1the1rationale1for1prescribing1a1medication1such1as1this?1A.1
To1promote1the1availability1of1serotonin1B.1
To1decrease1serotonin1C.1
To1indirectly1increase1the1amount1of1dopamine1in1the1body1D.1
To1help1decrease1the1amount1of1serotonin1and1dopamine1
11points1QUESTION1141
1.1The1PMHNP1is1caring1for1four1patients.1Which1patient1statement1indicates1that1benzodiazepine
s1would1be1beneficial?1A.1
"I1have1trouble1staying1asleep1in1the1middle1of1the1night."1B.1
"My1spouse1told1me1that1I1seem1to1have1trouble1remembering1things1sometimes."1C.1
"I1really1want1to1stop1smoking,1but1the1cravings1are1too1strong."1D.1
"I1feel1nervous1to1go1outside1and1be1in1large1crowds."1
11points1QUESTION1151
1.1Ms.1Harlow1is1a142-year-
old1patient1who1is1prescribed1a1drug1that1acts1on1ionotropic1receptors.1She1is1curious1about
1 1 1 1 11 1
TEST BANK WITH 100% CORRECT VERIFIED QUESTIONS, ANSWERS, AND R
1 1 1 1 1 1 1 1 1
ATIONALES 1
1
1
1
Purple1answers1were1marked1incorrect.1Red1answers1were1marked1correct.1
1
QUESTION111
1.1A1noncompliant1patient1states,1"Why1do1you1want1me1to1put1this1poison1in1my1body?"1Ident
ify1the1best1response1made1by1the1psychiatric-mental1health1nurse1practitioner1(PMHNP).1A.1
"You1have1to1take1your1medication1to1become1stable."1B.1
"Most1medications1will1increase1the1number1of1neurotransmitters1that1you1already1have1in
1 the1brain."1C.1
"Most1medications1used1in1treatment1are1either1increasing1or1decreasing1neurotransmitter
s1that1your1body1already1has."1D.1
"Why1do1you1believe1that1your1medication1is1poison?"1I1received10/11for1this1answer??111points1
QUESTION121
1.1Which1statement1about1neurotransmitters1and1medications1is1true?1My1correct1answer1w
as1several1psychiatric1meds1were1developed1after1discovery1of1endogenous1neurotransmitte
rs.1(The1answer1wording1is1different.1A.1
Natural1neurotransmitters1such1as1endorphins1have1been1discovered1after1the1development1of1medications
.1B.1
Some1medications1were1developed1after1the1discovery1and1known1action1of1the1neurotran
smitters1in1the1brain.1C.1
Neurotransmitters1receive1messages1from1most1medications.1D.1
The1neurotransmitter1serotonin1is1directly1linked1to1depression.1Following1this1discovery,1the1ant
idepressant1Prozac1was1developed.1
11points1
QUESTION131
1.1When1an1unstable1patient1asks1why1it1is1necessary1to1add1medications1to1his1current1regimen,1
the1PMHNP's1best1response1would1be:1A.1
"In1an1extreme1case1such1as1yours,1more1than1one1medication1is1often1needed."1B.1"Du
e1to1the1ineffectiveness1of1your1current1medication,1we1need1to1try1something1else1that
1can1possibly1potentiate1its1effects.1C.1
,"Medications1are1often1specific1to1the1neurotransmitter(s)1they1are1affecting1and,1due1to1more1th
an1one1neurotransmitter1involvement,1it1is1often1necessary1to1use1more1than1one1medication1to1i
mprove1symptoms."1D.1
"I1understand1your1concern.1We1can1discontinue1your1current1medication1and1switch1to1a1
different1one1that1may1better1manage1your1symptoms."1
11points1
QUESTION141?1
1.1During1gene1expression,1what1must1occur1prior1to1a1gene1being1expressed?1A.1Transcript
ion1factor1must1bind1to1the1regulatory1region1within1the1cell's1nucleus.1B.1
RNA1must1be1converted1to1mRNA.1C.1
The1coding1region1must1separate1from1the1regulatory1region.1This1is1wrong1D.1
RNA1polymerase1must1inhibit1the1process1of1changing1RNA1to1mRNA.1
11points1QUESTION151
1.1While1genes1have1potential1to1modify1behavior,1behavior1can1also1modify1genes.1How1do1gene
s1impact1this1process?1A.1
Genes1impact1neuron1functioning1directly.1
B.1
Changes1made1to1proteins1lead1to1changes1in1behavior.1C.1
Neurons1are1able1to1impact1protein1synthesis.1D.1
Genes1impact1the1DNA1of1a1cell,1leading1to1changes1in1behavior.1
11points1QUESTION161
1.1Though1medications1have1the1ability1to1target1neurotransmitters1in1the1synapse,1it1is1not1alway
s1necessary.1The1PMHNP1understands1that1this1is1because:1A.1
Neurotransmission1that1occurs1via1the1axon1allows1for1transport1of1a1neurotransmitter
.1B.1
Active1transport1is1a1different1type1of1energy1that1allows1the1transport1of1certain1neurotra
nsmitters.1C.1
Neurotransmitters1can1spread1by1diffusion.1D.1
The1postsynaptic1neuron1can1release1the1neurotransmitter.1
11points1QUESTION171
1.1
Why1is1the1cytochrome1P4501enzyme1system1of1significance1to1the1PMHNP?1
A.11
The1kidneys1play1a1role1with1excretion1of1the1medication,1and1if1a1patient1has1kidney1damage,1th
e1dose1must1be1increased1to1be1effective.1B.1
,The1bioavailability1of1the1medication1after1it1passes1through1the1stomach1and1liver1can1be1altered
.1Correct1answer1C.1
The1medication's1chemical1composition1changes1when1it1comes1in1contact1with1the1acid1in1th
e1stomach.1D.1
The1CYP1enzyme1system1is1a1steady1and1predictable1process1that1prescribers1must1understand1t
o1treat1conditions1effectively.1
11points1QUESTION181
1.1It1is1important1for1the1PMHNP1to1recognize1differences1in1pharmacokinetics1to1safely1pre
scribe1and1monitor1medications.1Which1of1the1following1statements1does1the1competent1P
MHNP1identify1as1true?1A.1
About111out1of151Asians1requires1lower-than-
normal1doses1of1some1antidepressants1and1antipsychotics.1B.1
The1term1polymorphic1refers1to1the1body's1ability1to1break1a1medication1down1several1ways,1an
d1this1patient1may1require1higher1doses1of1certain1antidepressants1and1antipsychotics.1C.1About1
11out1of1301Caucasians1requires1lower1doses1of1some1antidepressants1and1antipsychotics.1D.1
Most1enzyme1pathways1do1not1have1interactions1between1the1newer1medications.111point
s1
QUESTION191
1.1As1it1relates1to1G-
protein1linked1receptors,1what1does1the1PMHNP1understand1about1medications1that1are1
used1in1practice?1A.1
Most1medications1that1act1on1G-
protein1linked1receptors1have1antagonistic1traits.1B.1The1majority1of1medications1used1in1pr
actice1are1full1agonists1and1are1used1to1stimulate1the1body's1natural1neurotransmitters.1C.1
Most1medications1act1as1partial1agonists1because1they1allow1the1body1to1use1only1what1is1
needed.1D.1
Medications1used1in1practice1may1act1as1inverse1agonists1if1the1dosage1is1too1high.111points
1QUESTION1101
1.1 The1PMHNP1is1considering1prescribing1a149-year-
old1male1clozapine1(Clozaril)1to1treat1his1schizophrenia1and1suicidal1ideations.1The1PMHNP1is1awar
e1that1which1factor1may1impact1the1dose1needed1to1effectively1treat1his1condition:1A.1
The1patient1smokes1cigarettes.1 This1is1correct!1B.1
The1patient1has1hypertension.1C.1
The1patient1has1chronic1kidney1disease,1stage12.1D.1
The1patient1drinks1a1cup1of1coffee1a1day.1
, 11points1QUESTION1111
1.1
A1patient1is1diagnosed1with1bipolar1disorder1and1is1currently1taking1carbamazepine1(Tegretol),1a
ripiprazole1(Abilify),1and1melatonin.1The1PMHNP1has1just1written1an1order1to1discontinue1the1carb
amazepine1(Tegretol)1for1druginduced1thrombocytopenia.1The1PMHNP1is1aware1that1his1next1best
action1is1to:1A.1
1
Alert1staff1to1possible1seizures1B.1
Write1an1order1for1a1different1mood1stabilizer1 For1some1reason1I1got10/11points1for1this??1
C.1
Decrease1the1amount1prescribed1for1aripiprazole1(Abilify)1D.1
Explain1to1the1patient1that1it1will1be1more1difficult1to1control1his1temper1
11points1QUESTION1121
1.1A1patient1recently1transferred1following1a1suicide1attempt1has1a1history1of1schizophrenia,1de
pression,1and1fibromyalgia.1He1is1currently1taking1Amitriptyline1(Elavil),1Lisinopril,1aspirin,1and1fl
uoxetine1(Prozac).1Which1is1the1best1action1for1the1PMHNP1to1take1for1this1patient?1A.1
Review1Amitriptyline1(Elavil)1level1Correct1answer1B.1
Order1a1liver1function1test1C.1
Check1the1patient's1blood1pressure1and1pulse1D.1
Order1a1stat1platelet1count1
11points1QUESTION1131
1.1A1patient1with1schizophrenia1is1given1an1inverse1agonist1that1acts1on1the1receptor15HT1and1neu
rotransmitter1serotonin.1What1is1the1rationale1for1prescribing1a1medication1such1as1this?1A.1
To1promote1the1availability1of1serotonin1B.1
To1decrease1serotonin1C.1
To1indirectly1increase1the1amount1of1dopamine1in1the1body1D.1
To1help1decrease1the1amount1of1serotonin1and1dopamine1
11points1QUESTION1141
1.1The1PMHNP1is1caring1for1four1patients.1Which1patient1statement1indicates1that1benzodiazepine
s1would1be1beneficial?1A.1
"I1have1trouble1staying1asleep1in1the1middle1of1the1night."1B.1
"My1spouse1told1me1that1I1seem1to1have1trouble1remembering1things1sometimes."1C.1
"I1really1want1to1stop1smoking,1but1the1cravings1are1too1strong."1D.1
"I1feel1nervous1to1go1outside1and1be1in1large1crowds."1
11points1QUESTION1151
1.1Ms.1Harlow1is1a142-year-
old1patient1who1is1prescribed1a1drug1that1acts1on1ionotropic1receptors.1She1is1curious1about
