Exam (elaborations) NURS 6630 Final Exam with Answers

Exam (elaborations) NURS 6630 Final Exam with Answers The parents of a 10 year old girl diagnosed with ADHD ask if the PMHNP can prescribe something to help their daughter’s ADHD that is not a stimulant. Which of the following responses is correct? Selected Answer: c. "I can prescribe atomoxetine for your daughter. This medication help ADHD symptoms and is not considered a stimulant."  Question 2 1 out of 1 points A patient with chronic insomnia asks the PMHNP if they can first try an over-the-counter (OTC) medication before one that needs to be prescribed to help the patient sleep. Which is the best response by the PMHNP? Selected Answer: d. “You can get melatonin over the counter, which will help with sleep onset.”  Question 3 0 out of 1 points Methylphenidate, amphetamine, and cocaine are alike because all three _____________________. Selected Answer: c. act as depressants.  Question 4 0 out of 1 points An elderly woman with a history of Alzheimer’s disease, coronary artery disease, and myocardial infarction had a fall at home 3 months ago that resulted in her receiving an open reduction internal fixation. While assessing this patient, the PMHNP is made aware that the patient continues to experience mild to moderate pain. What is the PMHNP most likely to do? NURS 6630 Final Exam with Answers Selected Answer: b. Order an X-ray because it is possible that she dislocated her hip.  Question 5 1 out of 1 points The PMHNP is caring for a patient who openly admitted to drinking a quart of vodka daily. Prior to prescribing this patient disulfiram (Antabuse), it is important for the PMHNP to: Selected Answer: c. Evaluate the patient’s willingness to abstain from alcohol  Question 6 0 out of 1 points Insomnia is caused by excessive nighttime arousal. The PMHNP is likely to prescribe which of the following to treat insomnia? Selected Answer: d. A negative allosteric modulator of GABA-A receptors  Question 7 1 out of 1 points The nursing staff asks the PMHNP for additional education regarding the treatment of agitation in dementia patients. Which of the following is correct? Selected Answer: b. The nurse should attempt to determine how the patient's environment may be impacting the patient's mood.  Question 8 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: d. Prescribe desvenlafaxine (Pristiq), 50 mg daily  Question 9 1 out of 1 points The PMHNP is caring for a patient who reports excessive arousal at nighttime. What could the PMHNP use for a time-limited duration to shift the patient’s brain from a hyperactive state to a sleep state? Selected Answer: b. Benzodiazepi nes  Question 10 1 out of 1 points Which of these characteristics does NOT meet the criteria for probably Alzheimer's dementia? Selected Answer: b. Sudden onset  Question 11 0 out of 1 points 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 Answer: c. Sertraline increases norepinephrine and serotonin. You need a medication that only increases serotonin.  Question 12 1 out of 1 points Daniel is a 33 year old patient with ADHD and multiple comorbidities: mood disorder, alcohol abuse, ADHD, and nicotine dependence. Which comorbidity should be treated first? Selected Answer: c. Alcohol abuse disorder  Question 13 1 out of 1 points Parents of a 12-year-old boy want to consider attention deficit hyperactivity disorder (ADHD) medication for their son. Which medication would the PMHNP start? Selected Answer: a. All of these could potentially treat their son’s symptoms.  Question 14 0 out of 1 points Which of the following is considered as a disruptive/impulse control behavior? Selected Answer: a. Skin picking  Question 15 1 out of 1 points The PMHNP is performing a quality assurance peer review of the chart of another PMHNP. Upon review, the PMHNP reviews the chart of an older adult patient in long-term care facility who has chronic insomnia. The chart indicates that the patient has been receiving hypnotics on a nightly basis. What does the PMHNP find problematic about this documentation? Selected Answer: a. Hypnotics have prolonged half-lives that can cause drug accumulation in the elderly.  Question 16 1 out of 1 points The PMHNP understands that slow-dose extended release stimulants are most appropriate for which patient with ADHD? Selected Answer: d. 8-year-old patient  Question 17 1 out of 1 points Mr. Peterson is meeting with the PMHNP to discuss healthier dietary habits. With a BMI of 33, Mr. Peterson is obese and needs to modify his food intake. “Sometimes I think I’m addicted to food the way some people are addicted to drugs,” he says. Which statement best describes the neurobiological parallels between food and drug addiction? Selected Answer: c. There is decreased activation of the prefrontal cortex.  Question 18 0 out of 1 points Which of the following substances has the highest probability of becoming dependent after a single use? Selected Answer: a. Heroi n  Question 19 1 out of 1 points A patient recovering from shingles presents with tenderness and sensitivity to the upper back. He states it is bothersome to put a 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 in a recliner for 3 hours feeling this uncomfortable. What will be the PMHNP’s priority? Selected Answer: d. Prescribe lidocaine 5%  Question 20 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 effects with the patient? Selected Answer: a. The medication can affect your blood pressure.  Question 21 0 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: b. Seratonin / Dopamine  Question 22 1 out of 1 points The PMHNP is treating a patient with depression and fibromyalgia. The PMHNP chooses to prescribe a treatment that may help treat the patient's fibromyalgia and depressive symptoms. Which medication is the PMHNP likely to choose? Selected Answer: c. Amitriptyline (ELAVIL)  Question 23 1 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. Naltrexone (VIVITROL)  Question 24 1 out of 1 points Which patient will receive a lower dose of guanfacine? Selected Answer: a. Patient with kidney disease  Question 25 1 out of 1 points Alcohol enhances inhibition at ____________ synapses and reduces excitation at ______________ synapses. Selected Answer: b. GABA / Glutamate  Question 26 1 out of 1 points An opioid-naive patient is taking MS Contin (morphine sulfate) to treat his pain that is secondary to cancer. Under what circumstances would the PMHNP order naloxone (Narcan) IM/SQ? Selected Answer: a. The patient’s vital signs are 98.4F temp, 88 pulse, 104/62 blood pressure, and 8 respirations.  Question 27 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: c. The child will be prescribed 2.5 mg.  Question 28 1 out of 1 points The PMHNP is treating a patient for fibromyalgia and is considering prescribing milnacipran (Savella). When prescribing this medication, which action is the PMHNP likely to choose? Selected Answer: c. Split the daily dose into two doses after the first day.  Question 29 1 out of 1 points An adult patient presents with a history of alcohol 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: b. Atomoxetine (Strattera)  Question 30 0 out of 1 points The PMHNP is evaluating a 7 year old pediatric patient for the treatment of ADHD. The PMHNP decides to prescribe a medication that is selective for alpha-2A receptors that has a lower incidence of sedation and hypotension. Which agent did the PMHNP prescribe? Selected Answer: a. Atomoxetine (STRATTERA)  Question 31 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 atypical antipsychotics? Selected Answer: a. The doses are based on achieving 60% D2 receptor occupancy.  Question 32 1 out of 1 points Antihistamines may cause side effects such as blurred vision, constipation, memory problems, and dry mouth. This is due to the _______________ effects of antihistamines. Selected Answer: b. Anticholiner gic  Question 33 1 out of 1 points The PMHNP is assessing 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: d. “Bath salt” intoxication  Question 34 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.  Question 35 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 Answer: a. “The SNRI can increase noradrenergic neurotransmission in the descending spinal pathway to the dorsal horn.”  Question 36 1 out of 1 points Mike wants to quit smoking. He has tried nicotine replacement and varenicline without success. He has asked for another medication to help him kick his habit. The PMHNP decides to try a medication that increases dopamine by prescribing a medications that can increase both norepinephrine and dopamine. Which medication did the PMHNP prescribe? Selected Answer: c. Bupropion (ZYBAN)  Question 37 1 out of 1 points Individuals who suffer from an addiction often increase the dose of medication to achieve the desired effect. The need to increase the dose to reach the safe effect is due to __________________. Selected Answer: b. toleran ce  Question 38 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: d. Carbamazepi ne  Question 39 1 out of 1 points A 26-year-old female patient with nicotine dependence and a history of anxiety presents with symptoms of attention deficit hyperac