NR 508 Advanced pharmacology Quiz 4 (Fall 2021) Latest Complete Solutions Questions and
Answers
1. Common mistakes practitioners make in treating anxiety disorders include:
1. Switching medications after an 8- to 12-week trial
2. Maximizing dosing of antianxiety medications
3. Encouraging exercise and relaxation therapy before starting
medication 4. Thinking a partial response to medication is acceptable
2. An appropriate first-line drug to try for mild to moderate generalized anxiety
disorder would be:
1. Alprazolam (Xanax)
2. Diazepam (Valium)
3. Buspirone
(Buspar)
4. Amitriptyline (Elavil)
3. An appropriate drug to initially treat panic disorder is:
1. Alprazolam
(Xanax) 2. Diazepam
(Valium)
3. Buspirone (Buspar)
4. Amitriptyline (Elavil)
4. Prior to starting antidepressants, patients should have laboratory testing to rule out:
1. Hypothyroidism
2. Anemia
3. Diabetes mellitus
4. Low estrogen levels
5. David is a 34-year-old patient who is starting on paroxetine (Paxil) for depression.
David's education regarding his medication would include:
1. Paroxetine may cause intermittent diarrhea.
2. He may experience sexual dysfunction beginning a month after he starts therapy.
3. He may have constipation and he should increase fluids and fiber.
4. Paroxetine has a long half-life so he may occasionally skip a dose.
6. Jamison has been prescribed citalopram (Celexa) to treat his depression. Education
regarding how quickly selective serotonin reuptake inhibitor (SSRI) antidepressants
work would be:
1. Appetite and concentration improve in the first 1 to 2 weeks.
2. Sleep should improve almost immediately upon starting citalopram.
3. Full response to the SSRI may take 2 to 4 months after he reaches the full
therapeutic dose.
4. His dysphoric mood will improve in 1 to 2 weeks.
7. An appropriate drug for the treatment of depression with anxiety would be:
1. Alprazolam (Xanax)
2. Escitalopram (Lexapro)
, 3. Buspirone (Buspar)
4. Amitriptyline (Elavil)
8. An appropriate first-line drug for the treatment of depression with fatigue and
low energy would be:
1. Venlafaxine (Effexor)
2. Escitalopram (Lexapro)
3. Buspirone (Buspar)
4. Amitriptyline (Elavil)
9. The laboratory monitoring required when a patient is on a selective serotonin
reuptake inhibitor is:
1. Complete blood count every 3 to 4 months
2. Therapeutic blood levels every 6 months after a steady state is achieved
3. Blood glucose every 3 to 4 months
4. There is no laboratory monitoring required
10. Jaycee has been on escitalopram (Lexapro) for a year and is willing to try tapering off
of the selective serotonin reuptake inhibitor. What is the initial dosage adjustment
when starting a taper off antidepressants?
1. Change dose to every other day dosing for a
week 2. Reduce dose by 50% for 3 to 4 days
3. Reduce dose by 50% every other day
4. Escitalopram (Lexapro) can be stopped abruptly due to its long half-life
11. The longer-term Xanax patient comes in and states they need a higher dose of the
medication. They deny any additional, new, or accelerating triggers of their
anxiety. What is the probable reason?
1. They have become tolerant of the medication, which is characterized by the need
for higher and higher doses.
2. They are a drug seeker.
3. They are suicidal.
4. They only need additional counseling on lifestyle modification.
12. What "onset of action" symptoms should be reviewed with patients who have
been newly prescribed a selective serotonin reuptake inhibitor?
1. They will have insomnia for a week.
2. They can feel a bit of nausea, but this resolves in a week.
3. They will have an "onset seizure" but this is considered normal.
4. They will no longer dream.
13. Which of the following should not be taken with a selective serotonin
reuptake inhibitor?
1. Aged blue cheese
2. Grapefruit
3. Alcohol
, 4. Green leafy vegetables
14. Why is the consistency of taking paroxetine (Paxil) and never running out of
medication more important than with most other selective serotonin
reuptake inhibitors (SSRIs)?
1. It has a shorter half-life and withdrawal syndrome has a faster onset without taper.
2. It has the longest half-life and the withdrawal syndrome has a faster onset.
3. It is quasi-addictive in the dopaminergic reward system.
4. It is the most activating of SSRI medications and will cause the person to have
sudden deep sadness.
15. The patient shares with the provider that he is taking his Prozac at night before going to
bed. What is the best response?
1. This is a good idea because this class of medications generally makes people
sleepy. 2. Have you noticed that you are having more sleep issues since you started
that?
3. This a good way to remember to take your daily medications because it is near
your toothbrush.
4. This is a good plan because you can eat grapefruit if there is 8-12 hours difference in the
time each are ingested.
16. Nicotine withdrawal symptoms include:
1. Nervousness
2. Increased appetite
3. Difficulty concentrating
4. All of the above
17. If a patient wants to quit smoking, nicotine replacement therapy is recommended if
the patient:
1. Smokes more than 10 cigarettes a day
2. Smokes within 30 minutes of awakening in the morning
3. Smokes when drinking alcohol
4. All of the above
18. Instructions for a patient who is starting nicotine replacement therapy include:
1. Smoke less than 10 cigarettes a day when starting nicotine replacement.
2. Nicotine replacement will help with the withdrawal cravings associated with quitting tobacco.
3. Nicotine replacement can be used indefinitely.
4. Nicotine replacement therapy is generally safe for all patients.
19. Nicotine replacement therapy should not be used in which patients?
1. Pregnant women
2. Patients with worsening angina pectoris
3. Patients who have just suffered an acute myocardial
infarction 4. All of the above
20. Instructions for the use of nicotine gum include:
1. Chew the gum quickly to get a peak effect.
Answers
1. Common mistakes practitioners make in treating anxiety disorders include:
1. Switching medications after an 8- to 12-week trial
2. Maximizing dosing of antianxiety medications
3. Encouraging exercise and relaxation therapy before starting
medication 4. Thinking a partial response to medication is acceptable
2. An appropriate first-line drug to try for mild to moderate generalized anxiety
disorder would be:
1. Alprazolam (Xanax)
2. Diazepam (Valium)
3. Buspirone
(Buspar)
4. Amitriptyline (Elavil)
3. An appropriate drug to initially treat panic disorder is:
1. Alprazolam
(Xanax) 2. Diazepam
(Valium)
3. Buspirone (Buspar)
4. Amitriptyline (Elavil)
4. Prior to starting antidepressants, patients should have laboratory testing to rule out:
1. Hypothyroidism
2. Anemia
3. Diabetes mellitus
4. Low estrogen levels
5. David is a 34-year-old patient who is starting on paroxetine (Paxil) for depression.
David's education regarding his medication would include:
1. Paroxetine may cause intermittent diarrhea.
2. He may experience sexual dysfunction beginning a month after he starts therapy.
3. He may have constipation and he should increase fluids and fiber.
4. Paroxetine has a long half-life so he may occasionally skip a dose.
6. Jamison has been prescribed citalopram (Celexa) to treat his depression. Education
regarding how quickly selective serotonin reuptake inhibitor (SSRI) antidepressants
work would be:
1. Appetite and concentration improve in the first 1 to 2 weeks.
2. Sleep should improve almost immediately upon starting citalopram.
3. Full response to the SSRI may take 2 to 4 months after he reaches the full
therapeutic dose.
4. His dysphoric mood will improve in 1 to 2 weeks.
7. An appropriate drug for the treatment of depression with anxiety would be:
1. Alprazolam (Xanax)
2. Escitalopram (Lexapro)
, 3. Buspirone (Buspar)
4. Amitriptyline (Elavil)
8. An appropriate first-line drug for the treatment of depression with fatigue and
low energy would be:
1. Venlafaxine (Effexor)
2. Escitalopram (Lexapro)
3. Buspirone (Buspar)
4. Amitriptyline (Elavil)
9. The laboratory monitoring required when a patient is on a selective serotonin
reuptake inhibitor is:
1. Complete blood count every 3 to 4 months
2. Therapeutic blood levels every 6 months after a steady state is achieved
3. Blood glucose every 3 to 4 months
4. There is no laboratory monitoring required
10. Jaycee has been on escitalopram (Lexapro) for a year and is willing to try tapering off
of the selective serotonin reuptake inhibitor. What is the initial dosage adjustment
when starting a taper off antidepressants?
1. Change dose to every other day dosing for a
week 2. Reduce dose by 50% for 3 to 4 days
3. Reduce dose by 50% every other day
4. Escitalopram (Lexapro) can be stopped abruptly due to its long half-life
11. The longer-term Xanax patient comes in and states they need a higher dose of the
medication. They deny any additional, new, or accelerating triggers of their
anxiety. What is the probable reason?
1. They have become tolerant of the medication, which is characterized by the need
for higher and higher doses.
2. They are a drug seeker.
3. They are suicidal.
4. They only need additional counseling on lifestyle modification.
12. What "onset of action" symptoms should be reviewed with patients who have
been newly prescribed a selective serotonin reuptake inhibitor?
1. They will have insomnia for a week.
2. They can feel a bit of nausea, but this resolves in a week.
3. They will have an "onset seizure" but this is considered normal.
4. They will no longer dream.
13. Which of the following should not be taken with a selective serotonin
reuptake inhibitor?
1. Aged blue cheese
2. Grapefruit
3. Alcohol
, 4. Green leafy vegetables
14. Why is the consistency of taking paroxetine (Paxil) and never running out of
medication more important than with most other selective serotonin
reuptake inhibitors (SSRIs)?
1. It has a shorter half-life and withdrawal syndrome has a faster onset without taper.
2. It has the longest half-life and the withdrawal syndrome has a faster onset.
3. It is quasi-addictive in the dopaminergic reward system.
4. It is the most activating of SSRI medications and will cause the person to have
sudden deep sadness.
15. The patient shares with the provider that he is taking his Prozac at night before going to
bed. What is the best response?
1. This is a good idea because this class of medications generally makes people
sleepy. 2. Have you noticed that you are having more sleep issues since you started
that?
3. This a good way to remember to take your daily medications because it is near
your toothbrush.
4. This is a good plan because you can eat grapefruit if there is 8-12 hours difference in the
time each are ingested.
16. Nicotine withdrawal symptoms include:
1. Nervousness
2. Increased appetite
3. Difficulty concentrating
4. All of the above
17. If a patient wants to quit smoking, nicotine replacement therapy is recommended if
the patient:
1. Smokes more than 10 cigarettes a day
2. Smokes within 30 minutes of awakening in the morning
3. Smokes when drinking alcohol
4. All of the above
18. Instructions for a patient who is starting nicotine replacement therapy include:
1. Smoke less than 10 cigarettes a day when starting nicotine replacement.
2. Nicotine replacement will help with the withdrawal cravings associated with quitting tobacco.
3. Nicotine replacement can be used indefinitely.
4. Nicotine replacement therapy is generally safe for all patients.
19. Nicotine replacement therapy should not be used in which patients?
1. Pregnant women
2. Patients with worsening angina pectoris
3. Patients who have just suffered an acute myocardial
infarction 4. All of the above
20. Instructions for the use of nicotine gum include:
1. Chew the gum quickly to get a peak effect.
