. Question: L. J. is a 55-year-old male who attended a funeral and found himself laughing during the service, but later that evening he was irritated with himself for what he had done. His wife said this was abnormal behavior and took him to his doctor to

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Review Test Submission: Final
Exam - Week 11
User The Man from Estlandos

Course NURS-6630N-29,Approaches to Treatment.2020 Winter Qtr 11/30-
02/21-PT27

Test Final Exam - Week 11

Started 2/14/21

Submitted 2/14/21

Due Date 2/15/21

Status Completed

Attempt Score 66 out of 100 points

Time Elapsed 2 hours, 29 minutes out of 2 hours and 30 minutes

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 Question 1
L. J. is a 55-year-old male who attended a funeral and found himself laughing during the
service, but later that evening he was irritated with himself for what he had done. His
wife said this was abnormal behavior and took him to his doctor to be evaluated. After L.
J.’s MRI was reviewed, he was diagnosed with frontotemporal dementia. Which
medication is recommended to help L. J. with his emotional outbursts?


Response under Treatment subtitle: “The behavioral features are sometimes
Feedback: helped by SSRIs, and these are the best-studied treatments for these
disorders.”

 Question 2
When can buprenorphine be initiated in a patient who is suffering from an opioid
overdose?


Response “To avoid this problem, the initial buprenorphine dose should not be
Feedback: administered until the patient demonstrates mild-to-moderate
symptoms of withdrawal.”


 Question 3

, Of the following neurotransmitters, which one(s) are known to be severely disrupted in
the disease Dementia with Lewy Bodies?

I. Acetylcholine
II. Glutamate
III. Dopamine
IV. GABA
V. Norepinephrine
Response under pathophysiology subtitle: “It is clear that both the cholinergic
Feedback: and dopaminergic neurotransmitter systems are severely disrupted.”


 Question 4
Choose the correct statement regarding medications used for alcoholism


Response Table 15-3 has the three MOAs listed for the FDA-approved
Feedback: treatments of alcoholism.


 Question 5
Patient is a 75-year-old female with a confirmed diagnosis of Alzheimer’s Disease. She is
currently on Donepezil 10 mg daily. She is accompanied to your clinic today by her
daughter, who informs you that her mother has recently had an increase in depressive
symptoms. She has no history of mood disorders. She has a history of hypertension and
tonic-clonic seizures, but both are controlled. Assuming this patient will be thoroughly
evaluated for the diagnosis of depression, what would you recommend as initial therapy?


Response SSRIs are effective in treating depressive symptoms. Answer choices A &
Feedback: B are both TCAs and are advised against due to side effect profile and the
fact this person is treatment naive (learned from previous exam) and
answer choice D is contraindicated in a patient with seizures.

 Question 6
Which neurotransmitters are likely involved in the pathophysiology of withdrawal
seizures?

I. Serotonin
II. Endorphins
III. Glutamate
IV. GABA
V. Dopamine
Response “Thus when an individual suddenly ceases alcohol use, the decrease in
Feedback: inhibitory effects in combination with fewer GABA receptors and
increased glutamatergic discharge contributes to over-excitation and
possible withdrawal seizures.”

 Question 7
Which medication below should be routine for all suspected cases of alcohol intoxication
and dependence?


Response under Treatment of Wernicke’s encephalopathy: “Administration of the B

, Feedback: vitamin thiamine (IM or IV) should be routine for all suspected cases of
alcohol intoxication and dependence.”

 Question 8
T. C. is an 88-year-old male who is diagnosed at your clinic with Dementia with Lewy
Bodies. He currently has some debilitating gait issues, which makes his quality of life very
poor. His memory is still intact with minor deficits. Which medication would likely benefit
T. C. as his initial therapy?


Response “Low dosages of levodopa/carbidopa (dopamine replacement) are
Feedback: sometimes helpful for the motor symptoms of DLB, although higher
dosages of dopamine replacement therapy and direct dopamine agonists
may exacerbate neuropsychiatric symptoms.”
- Motor symptoms = gait issues

 Question 9
In the pathophysiology of Alzheimer’s Disease, there are certain proteins that lead to the
plaques and tangles that result in this progressive, irreversible brain disorder. Choose the
appropriate protein with its corresponding pathology.

I. Tau – tangles
II. Beta-amyloid – tangles
III. Tau – plaques
IV. Beta-amyloid – plaques



 Question 10
T. K. is a 72-year-old female who has suffered many strokes in the past, likely due to
uncontrolled hypertension and hyperlipidemia. She has now been diagnosed with
vascular dementia due to memory loss and motor system slowing. What is the
recommended treatment for T. K.?


Response “Treatment for vascular dementia involves control of vascular risk factors
Feedback: (e.g., hypercholesterolemia, hypertension, inactivity, diabetes, excess
alcohol use, cigarette smoking, hyperhomocysteinemia).” In addition to
treating these causes of CNS vascular disease, some literature indicates
that symptomatic treatments (such as cholinesterase inhibitors or
memantine) may be helpful for cognition.

 Question 11
Which of the following alcohol screening tools lack sensitivity to detect
hazardous/problem drinking?


Response “Compared to the SASQ or the AUDIT and AUDIT-C, the CAGE lacks
Feedback: sensitivity to detect hazardous/problem drinking.”


 Question 12
Which enzyme does disulfiram inhibit leading to a build-up of the ethanol metabolite
acetaldehyde?