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NURS 6630 MIDTERM EXAM 4 – QUESTION AND ANSWERS

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A noncompliant patient states, “Why do you want me to put this poison in my body?” Identify the best response made by the psychiatric-mental health nurse practitioner (PMHNP). Selected Answer: D. “Why do you believe that your medication is poison?” Which statement about neurotransmitters and medications is true? Selected Answer: D. The neurotransmitter serotonin is directly linked to depression. Following this discovery, the antidepressant Prozac was developed. When an unstable patient asks why it is necessary to add medications to his current regimen, the PMHNP’s best response would be: Selected Answer: B. “Due to the ineffectiveness of your current medication, we need to try something else that can possibly potentiate its effects. During gene expression, what must occur prior to a gene being expressed? Selected Answers: A. Transcription factor must bind to the regulatory region within the cell’s nucleus. B. RNA must be converted to mRNA. While genes have potential to modify behavior, behavior can also modify genes. How do genes impact this process? Selected Answer: B. Changes made to proteins lead to changes in behavior. Though medications have the ability to target neurotransmitters in the synapse, it is not always necessary. The PMHNP understands that this is because: Selected Answer: C. Neurotransmitters can spread by diffusion. Why is the cytochrome P450 enzyme system of significance to the PMHNP? Selected Answer: C. The medication’s chemical composition changes when it comes in contact with the acid in the stomach. It is important for the PMHNP to recognize differences in pharmacokinetics to safely prescribe and monitor medications. Which of the following statements does the competent PMHNP identify as true? Selected Answer: A. About 1 out of 5 Asians requires lower-than-normal doses of some antidepressants and antipsychotics. As it relates to G-protein linked receptors, what does the PMHNP understand about medications that are used in practice? Selected Answer: A. Most medications that act on G-protein linked receptors have antagonistic traits. The PMHNP is considering prescribing a 49-year-old male clozapine (Clozaril) to treat his schizophrenia and suicidal ideations. The PMHNP is aware that which factor may impact the dose needed to effectively treat his condition: Selected Answer: D. The patient drinks a cup of coffee a day. A patient is diagnosed with bipolar disorder and is currently taking carbamazepine (Tegretol), aripiprazole (Abilify), and melatonin. The PMHNP has just written an order to discontinue the carbamazepine (Tegretol) for drug-induced thrombocytopenia. The PMHNP is aware that his next best action is to: Selected Answer: B. Write an order for a different mood stabilizer A patient recently transferred following a suicide attempt has a history of schizophrenia, depression, and fibromyalgia. He is currently taking Amitriptyline (Elavil), Lisinopril, aspirin, and fluoxetine (Prozac). Which is the best action for the PMHNP to take for this patient? Selected Answer: B. Order a liver function test A patient with schizophrenia is given an inverse agonist that acts on the receptor 5HT and neurotransmitter serotonin. What is the rationale for prescribing a medication such as this? Selected Answer: C. To indirectly increase the amount of dopamine in the body The PMHNP is caring for four patients. Which patient statement indicates that benzodiazepines would be beneficial? Selected Answer: A. “I have trouble staying asleep in the middle of the night.” Ms. Harlow is a 42-year-old patient who is prescribed a drug that acts on ionotropic receptors. She is curious about the effects of the drug and how it will act on her symptoms. Which statement made by the PMHNP demonstrates proper understanding of Ms. Harlow’s prescription? Selected Answer: A. “The drug will have an almost immediate effect.”

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Voorbeeld van de inhoud

• Question 1
1 out of 1 points
A noncompliant patient states, “Why do you want me to put this poison in my body?”
Identify the best response made by the psychiatric-mental health nurse practitioner
(PMHNP).


Selected D.
Answer: “Why do you believe that your medication is
poison?”

• Question 2
0 out of 1 points
Which statement about neurotransmitters and medications is true?


Selected D.
Answer: The neurotransmitter serotonin is directly linked to depression. Following
this discovery, the antidepressant Prozac was developed.

• Question 3
0 out of 1 points
When an unstable patient asks why it is necessary to add medications to his current
regimen, the PMHNP’s best response would be:


Selected B.
Answer: “Due to the ineffectiveness of your current medication, we need to try
something else that can possibly potentiate its effects.

• Question 4
0 out of 1 points
During gene expression, what must occur prior to a gene being expressed?


Selected A.
Answers: Transcription factor must bind to the regulatory region within the
cell’s nucleus.
B.
RNA must be converted to mRNA.

• Question 5
1 out of 1 points
While genes have potential to modify behavior, behavior can also modify genes. How do
genes impact this process?


Selected B.
Answer: Changes made to proteins lead to changes in
behavior.

• Question 6
1 out of 1 points
Though medications have the ability to target neurotransmitters in the synapse, it is not

, always necessary. The PMHNP understands that this is because:


Selected C.
Answer: Neurotransmitters can spread by
diffusion.

• Question 7
0 out of 1 points
Why is the cytochrome P450 enzyme system of significance to the PMHNP?


Selected C.
Answer: The medication’s chemical composition changes when it comes in
contact with the acid in the stomach.

• Question 8
1 out of 1 points
It is important for the PMHNP to recognize differences in pharmacokinetics to safely
prescribe and monitor medications. Which of the following statements does the
competent PMHNP identify as true?


Selected A.
Answer: About 1 out of 5 Asians requires lower-than-normal doses of some
antidepressants and antipsychotics.

• Question 9
1 out of 1 points
As it relates to G-protein linked receptors, what does the PMHNP understand about
medications that are used in practice?


Selected A.
Answer: Most medications that act on G-protein linked receptors have
antagonistic traits.

• Question 10
0 out of 1 points
The PMHNP is considering prescribing a 49-year-old male clozapine (Clozaril) to treat his
schizophrenia and suicidal ideations. The PMHNP is aware that which factor may impact
the dose needed to effectively treat his condition:


Selected D.
Answer: The patient drinks a cup of coffee
a day.

• Question 11
1 out of 1 points
A patient is diagnosed with bipolar disorder and is currently taking carbamazepine
(Tegretol), aripiprazole (Abilify), and melatonin. The PMHNP has just written an order to
discontinue the carbamazepine (Tegretol) for drug-induced thrombocytopenia. The
PMHNP is aware that his next best action is to:

, Selected B.
Answer: Write an order for a different
mood stabilizer

• Question 12
0 out of 1 points
A patient recently transferred following a suicide attempt has a history of schizophrenia,
depression, and fibromyalgia. He is currently taking Amitriptyline (Elavil), Lisinopril,
aspirin, and fluoxetine (Prozac). Which is the best action for the PMHNP to take for this
patient?


Selected B.
Answer: Order a liver function
test

• Question 13
0 out of 1 points
A patient with schizophrenia is given an inverse agonist that acts on the receptor 5HT
and neurotransmitter serotonin. What is the rationale for prescribing a medication such
as this?


Selected C.
Answer: To indirectly increase the amount of dopamine in
the body

• Question 14
0 out of 1 points
The PMHNP is caring for four patients. Which patient statement indicates that
benzodiazepines would be beneficial?


Selected A.
Answer: “I have trouble staying asleep in the middle of
the night.”

• Question 15
1 out of 1 points
Ms. Harlow is a 42-year-old patient who is prescribed a drug that acts on ionotropic
receptors. She is curious about the effects of the drug and how it will act on her
symptoms. Which statement made by the PMHNP demonstrates proper understanding
of Ms. Harlow’s prescription?


Selected A.
Answer: “The drug will have an almost
immediate effect.”

• Question 16
0 out of 1 points
A patient is seeking pharmacological treatment for smoking cessation. Which drug class
does the PMHNP prescribe to the patient?

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