Exam (elaborations) NURS 6512N Review Test Submission Final Exam Week

Exam (elaborations) NURS 6512N Review Test Submission Final Exam Week 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: a. Decrease his SSRI and add buspirone (Buspar). Question 16 1 out of 1 points The PMHNP wants to use a symptom-based approach to treating a patient with Fbromyalgia. How does the PMHNP go about treating this patient? Selected b. Answer: Matching the patient’s symptoms with the malfunctioning brain circuits and neurotransmitters that might mediate those symptoms. Question 17 1 out of 1 points The PMHNP prescribes pregabalin (LYRICA) for a patient with chronic pain. How does pregabalin work to reduce pain? Selected a. Answer: It will block excitatory neurotransmission by blocking voltage-sensitive calcium channels. Question 18 1 out of 1 points 8/13/2020 Review Test Submission: Week 11 Final Exam – NURS-6630N-... Karen completes the Epworth sleepiness scale and scores abnormally high. She is diagnosed with narcolepsy. The PMHNP prescribes a wake-promoting agent that is a weak dopamine transporter antagonist. Which medication did the PMHNP prescribe? Selected Answer: a. Modafanil (PROVIGIL) Question 19 1 out of 1 points The PMHNP understands that slow-dose extended release stimulants are most appropriate for which patient with ADHD? Selected Answer: c. 8-year-old patient Question 20 1 out of 1 points Sharon is a 56-year-old female that presents to the clinic with pain after suGering a back injury several years ago. The patient states she feels a tingling sensation in her legs. What type of pain is Sharon likely experiencing? Selected Answer: c. Neuropathic pain Question 21 1 out of 1 points Antipsychotics are doses at a level that blocks ________% of D2 receptors. Selected Answer: d. 60-80 Question 22 0 out of 1 points Neal is complaining of restless leg syndrome and insomnia. Which Nrst-line medication should the PMHNP prescribe to treat both? Selected Answer: d. Gabapentin (NEURONTIN) Question 23 1 out of 1 points An 8-year-old patient presents with severe hyperactivity, described as “ants in his pants.” Based on self-report from the patient, his parents, and his teacher; attention deRcit hyperactivity disorder (ADHD) is suspected. What medication is the PMNHP most likely to prescribe? Selected Answer: a. Methylphenidate (Ritalin, Concerta) 8/13/2020 Review Test Submission: Week 11 Final Exam – NURS-6630N-... Question 24 0 out of 1 points Which of the following anticonvulsants increases serotonergic neurotransmission and GABAergic transmission, while decreasing glutamatergic neurotransmission? Selected Answer: c. Lamotrigine (LAMICTAL) Question 25 1 out of 1 points The nursing staU asks the PMHNP for additional education regarding the treatment of agitation in dementia patients. Which of the following is correct? Selected c. Answer: The nurse should attempt to determine how the patient's environment may be impacting the patient's mood. Question 26 1 out of 1 points The PMHNP is assessing a patient she has been treating with the diagnosis of chronic pain. During the assessment, the patient states that he has recently been having trouble getting to sleep and staying asleep. Based on this information, what action is the PMHNP most likely to take? Selected Answer: a. Order hydroxyzine (Vistaril), 50 mg PRN or as needed Question 27 1 out of 1 points The PMHNP wants to prescribe Mr. Barber a mood stabilizer that will target aggressive and impulsive symptoms by decreasing dopaminergic neurotransmission. Which mood stabilizer will the PMHNP select? Selected Answer: a. Lithium (Lithane) Question 28 1 out of 1 points A 75-year-old male patient diagnosed with Alzheimer’s disease presents with agitation and aggressive behavior. The PMHNP determines which of the following to be the best treatment option? Selected Answer: c. Citalopram (Celexa) or Escitalopram (Lexapro) Question 29 0 out of 1 points Harold complains of pain associated with his irritable bowel syndrome with constipation. The PMHNP decides to prescribe a medication that prevents pain signals from reaching the brain. Which agent does the PMHNP prescribe? 8/13/2020 Review Test Submission: Week 11 Final Exam – NURS-6630N-... Selected Answer: b. Venlafaxine (EFFEXOR) Question 30 0 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: d. The child’s dose will increase by 2.5 mg every other week. Question 31 1 out of 1 points A 71-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: a. Amnesia, apraxia, agnosia Question 32 1 out of 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 Answer: a. All of these are correct Question 33 1 out of 1 points The PMHNP is assessing 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 patient understands? Selected c. Answer: This medication has unwanted side eCects such as sedation, lack of coordination, and drowsiness. Question 34 1 out of 1 points Mrs. Rosen is a 49-year-old patient who is experiencing bro-fog. What does the PMHNP prescribe for Mrs. Rosen to improve this condition? Selected Answer: d. All of these are correct 8/13/2020 Review Test Submission: Week 11 Final Exam – NURS-6630N-... Question 35 1 out of 1 points The PMHNP is treating a patient with depression and bromyalgia. The PMHNP chooses to prescribe a treatment that may help treat the patient's bromyalgia and depressive symptoms. Which medication is the PMHNP likely to choose? Selected Answer: a. Amitriptyline (ELAVIL) Question 36 1 out of 1 points A patient on chronic opioids is currently on oxycodone ER (OxyContin). The PMHNP is consulted to treat underlying depression. Under which circumstance should the PMHNP order naloxone (NARCAN)? Selected Answer: a. The patient is somnolent and has 7 respirations per minute. Question 37 1 out of 1 points Jacob is a 7-year-old pediatric patient who has signiCcant oppositional symptoms associated with his ADHD diagnosis. What is the best treatment for this patient? Selected Answer: b. Prescribe methylphenidate and augment with guanfacine. Question 38 1 out of 1 points The PMHNP understands that bupropion (Wellbutrin) is an eWective way to assist patients with smoking cessation. Why is this medication e[ective for these patients? Selected b. Answer: Bupropion (Wellbutrin) blocks dopamine reuptake, enabling more availability of dopamine. Question 39 1 out of 1 points The PMHNP 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. Cardiovascular disease Question 40 1 out of 1 points The PMHNP is working with the student to care for a patient with diabetic peripheral neuropathic pain. The student asks the PMHNP why SSRIs are not consistently useful in treating this particular patient’s pain. What is the best response by the PMHNP? 8/13/2020 Review Test Submission: Week 11 Final Exam – NURS-6630N-... Selected Answer: d. “SSRIs only increase serotonin levels.” Question 41 1 out of 1 points A patient you have been evaluating was admitted to the hospital with some abnormal lab work. Hematology/oncology was consulted and diagnoses the patient with aplastic anemia and agranulocytosis. Which medication was likely the culprit? Selected Answer: c. Carbamazepine Question 42 1 out of 1 points A patient is being prescribed bupropion and is concerned about the side eKects. What will the PMHNP tell the patient regarding bupropion? Selected Answer: a. It can cause cardiac arrhythmias. Question 43 1 out of 1 points An adult patient presents with a history of alcohol addiction and attention de cit hyperactivity disorder (ADHD). Given these comorbidities, the PMHNP determines which of the following medications may be the best treatment option? Selected Answer: b. Atomoxetine (Strattera) Question 44 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 c. Answer: “The SNRI can increase noradrenergic neurotransmission in the descending spinal pathway to the dorsal horn.” Question 45 1 out of 1 points Why does the PMHNP avoid prescribing clozapine (Clozaril) as a Krst-line treatment to the patient with psychosis and aggression? Selected Answer: d. There is too high a risk of serious adverse side e ects. 9/15 8/13/2020 Review Test Submission: Week 11 Final Exam – NURS-6630N-... Question 46 0 out of 1 points A patient presents with psychotic aggression. Which treatment option is best for a patient presenting with psychotic aggression due to impaired top-down cortical control and excessive drive from striatal hyperactivity? Selected Answer: a. Antipsychotics Question 47 0 out of 1 points Sandra complains of constipation after being on quetiapine (SEROQUEL) for several weeks. Constipation is likely caused by the binding of quetiapine (SEROQUEL) to which receptor? Selected Answer: c. 5HT2A Question 48 0 out of 1 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 and a rational treatment option for Dementia? Selected a. Answer: Possible other causes: hypothyroidism, Cushing’s syndrome, multiple sclerosis Possible treatment option: memantine Question 49 0 out of 1 points Brandon is a non-compliant patient that presents to the clinic asking for help with his alcohol dependence. The PMHNP evaluates the patient and determines a long-acting injection that blocks the mu-receptors would be the best treatment option for Brandon. Which medication should the PMHNP prescribe? Selected Answer: b. Acamprosate (CAMPRAL) Question 50 1 out of 1 points Individuals who su er from an addiction often increase the dose of medication to achieve the desired eTect. The need to increase the dose to reach the safe e ect is due to __________________. Selected Answer: a. tolerance Question 51 1 out of 1 points 8/13/2020 Review Test Submission: Week 11 Final Exam – NURS-6630N-... A patient with a new diagnosis of diabetic peripheral neuropathy is switched from sertraline (ZOLOFT) to duloxetine (CYMBALTA). The patient asks why they are switching treatment. What is the best response? Selected a. Answer: Sertraline only increases serotonin levels. You need a medication that increases both serotonin and norepinephrine. Question 52 1 out of 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 eGects? Selected Answer: d. Give the medicine at night and lower the dose Question 53 1 out of 1 points Mrs. 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 b. Answer: “There are no evidence-based treatments for Internet addiction, but there are behavioral therapies your daughter can try.” Question 54 1 out of 1 points An interneuron is a neuron that has its cell body, dendrites, and axon within the spinal cord. The neuron can be considered excitatory if it contains ____________ or inhibitory if it contains ____________. Selected Answer: a. Glutamate / GABA Question 55 1 out of 1 points A patient is prescribed D-methylphenidate, 10-mg extended-release capsules. What should the PMHNP include when discussing the side e ects with the patient? Selected Answer: c. The medication can a ect your blood pressure. Question 56 1 out of 1 points The PMHNP is discussing dopamine D2 receptor occupancy and its association with aggressive behaviors in patients with the student. Why does the PMHNP prescribe a standard dose of 8/13/2020 Review Test Submission: Week 11 Final Exam – NURS-6630N-... atypical antipsychotics? Selected Answer: c. The doses are based on achieving 60% D2 receptor occupancy. Question 57 1 out of 1 points Which of the following substances has the highest probability of becoming dependent after a single use? Selected Answer: d. Nicotine Question 58 1 out of 1 points The PMHNP prescribed a patient lamotrigine (Lamictal), 25 mg by mouth daily, for nerve pain 6 months ago. The patient suddenly presents to the o ce with the complaint that the medication is no longer working and complains of increased pain. What action will the PMHNP most likely take? Selected Answer: a. Increase the dose of lamotrigine (Lamictal) to 25 mg twice daily. Question 59 1 out of 1 points The PMHNP is caring for a 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? Selected Answer: b. Non-benzodiazepine hypnotics Question 60 1 out of 1 points All drugs that lead to addiction increase __________________in the ventral striatum, which is also called the _______________. Selected Answer: b. Dopamine / nucleus accumbens Question 61 1 out of 1 points A group of nursing students seeks further clariGcation from the PMHNP on how cholinesterase inhibitors are beneUcial for Alzheimer’s disease patients. What is the appropriate response? Selected c. Answer: Acetylcholine (ACh) destruction is inhibited by blocking the enzyme acetylcholinesterase and by increasing acetylcholine, the decline in some patients may be less rapid. 8/13/2020 Review Test Submission: Week 11 Final Exam – NURS-6630N-... Question 62 1 out of 1 points Naltrexone (Revia), an opioid antagonist, is a medication that is used for which of the following conditions? Selected Answer: b. Alcoholism Question 63 1 out of 1 points The PMHNP is treating a patient for bromyalgia and is considering prescribing milnacipran (Savella). When prescribing this medication, which action is the PMHNP likely to choose? Selected Answer: b. Split the daily dose into two doses after the rst day. Question 64 1 out of 1 points The PMHNP is evaluating a 30-year-old female patient who states that she notices pain and a drastic change in mood before the start of her menstrual cycle. The patient states that she has tried diet and lifestyle changes but nothing has worked. What will the PMHNP most likely do? Selected Answer: a. Prescribe desvenlafaxine (Pristiq), 50 mg daily Question 65 1 out of 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