NRNP 6630 Final Exam
• Question I1
1 Iout Iof I1 Ipoints
Why Idoes Ithe IPMHNP Iavoid Iprescribing Iclozapine I(Clozaril) Ias Ia Ifirst-line Itreatment Ito
Ithe Ipatient Iwith
Ipsychosis Iand Iaggression?
Selected IAnswer: A. I
There Iis Itoo Ihigh Ia Irisk Iof Iserious Iadverse Iside
I effects.
• Question I2
1 Iout Iof I1 Ipoints
A I75-year-old Imale Ipatient Idiagnosed Iwith IAlzheimer’s Idisease Ipresents Iwith Iagitation Iand
Iaggressive Ibehavior.
IThe IPMHNP Idetermines Iwhich Iof Ithe Ifollowing Ito Ibe Ithe Ibest Itreatment Ioption?
Selected IAnswer: D. I
Citalopram I(Celexa) Ior IEscitalopram I(Lexapro)
• Question I3
1 Iout Iof I1 Ipoints
A Igroup Iof Inursing Istudents Iseeks Ifurther Iclarification Ifrom Ithe IPMHNP Ion Ihow
Icholinesterase Iinhibitors Iare
Ibeneficial Ifor IAlzheimer’s Idisease Ipatients. IWhat Iis Ithe Iappropriate Iresponse?
Selected IAnswer: D. I
Both
I“A” I& I“C.”
A. IAcetylcholine I(ACh) Idestruction Iis Iinhibited Iby Iblocking Ithe Ienzyme
Iacetylcholinesterase. IB. IEffectiveness Iof Ithese Iagents Ioccurs Iin Iall Istages Iof
IAlzheimer’s Idisease. IC. IBy Iincreasing Iacetylcholine, Ithe Idecline Iin Isome Ipatients Imay Ibe
Iless Irapid.
• Question I4
1 Iout Iof I1 Ipoints
The IPMHNP Iunderstands Ithat Islow-dose Iextended Irelease Istimulants Iare Imost Iappropriate
Ifor Iwhich Ipatient Iwith
IADHD?
Selected IAnswer: A. I
8 -year-old Ipatient
,• Question I5
1 Iout Iof I1 Ipoints
An I8-year-old Ipatient Ipresents Iwith Isevere Ihyperactivity, Idescribed Ias I“ants Iin Ihis Ipants.”
IBased Ion Iself-report Ifrom Ithe Ipatient, Ihis Iparents, Iand Ihis Iteacher; Iattention Ideficit
Ihyperactivity Idisorder I(ADHD) Iis Isuspected. IWhat
Imedication Iis Ithe IPMNHP Imost Ilikely Ito Iprescribe?
Selected IAnswer: A. I Methylphenidate I(Ritalin, IConcerta)
• Question I6
1 Iout Iof I1 Ipoints
A Ipatient Iwith Ifibromyalgia Iand Imajor Idepression Ineeds Ito Ibe Itreated Ifor Isymptoms Iof
Ipain. IWhich Iis Ithe
IPMHNP Imost Ilikely Ito Iprescribe Ifor Ithis Ipatient?
Selected IAnswer: Duloxetine I(Cymbalta)
• Question I7
1 Iout Iof I1 Ipoints
Mrs. IKenner Iis Iconcerned Ithat Iher Iteenage Idaughter Ispends Itoo Imuch Itime Ion Ithe IInternet.
IShe Iinquires Iabout Ipossible Itreatments Ifor Iher Idaughter’s Iaddiction. IWhich Iresponse Iby
Ithe IPMHNP Idemonstrates Iunderstanding Iof Ipharmacologic Iapproaches Ifor Icompulsive
Idisorders?
Selected D. I
IAnswer: “There Iare Ino Ievidence-based Itreatments Ifor IInternet Iaddiction, Ibut Ithere Iare
Ibehavioral Itherapies Iyour Idaughter Ican Itry.”
• Question I8
1 Iout Iof I1 Ipoints
An Iadult Ipatient Ipresents Iwith Ia Ihistory Iof Ialcohol Iaddiction Iand Iattention Ideficit
Ihyperactivity Idisorder
I(ADHD). IGiven Ithese Icomorbidities, Ithe IPMHNP Idetermines Iwhich Iof Ithe Ifollowing
Imedications Imay Ibe Ithe
Ibest Itreatment Ioption? I
Selected IAnswer: C. I
Atomoxetine I(Strattera)
• Question I9
1 Iout Iof I1 Ipoints
Which Iof Ithe Ifollowing Iis Ia Itrue Istatement Iregarding Ithe Iuse Iof Istimulants Ito Itreat
Iattention Ideficit Ihyperactivity I disorder I(ADHD)?
Selected B. I
IAnswer: Signal Istrength Ioutput Iis Iincreased Iby Idialing Iup Ithe Irelease Iof Idopamine I(DA)
Iand Inorepinephrine I(NE).
Selected IAnswer:
, • Question
out of 1 points
I I I I
• Question I10
1 Iout Iof I1 Ipoints
A I71-year-old Imale Ipatient Icomes Ito Ian Iappointment Iwith Ihis I65-year-old Iwife. IThey Iare
Iboth Ihaving Iconcerns Irelated Ito Iher Imemory Iand Iability Ito Irecognize Ifaces. IThe IPMNHP
Iis Iconsidering Iprescribing Imemantine I(Namenda) Ibased Ion Ithe Ifollowing
Isymptoms:
Selected IAnswer: C. I
Amnesia, Iapraxia, Iagnosia
• Question I11
1 Iout Iof I1 Ipoints
The IPMHNP Iis Imeeting Iwith Ithe Iparents Iof Ian I8-year-old Ipatient Iwho Iis Ireceiving Ian
Iinitial Iprescription Ifor IDamphetamine. IThe IPMHNP Idemonstrates Iappropriate Iprescribing
Ipractices Iwhen Ishe Iprescribes Ithe Ifollowing
Idose: I I A. I
The Ichild Iwill Ibe Iprescribed I2.5 Img.
I12
1
The IPMHNP Iis Iassessing Ia Ipatient Iwho Ipresents Iwith Ielevated Ilevels Iof Ibrain Iamyloid Ias
Inoted Iby Ipositron Iemission Itomography I(PET). IWhat Iother Ifactors Iwill Ithe IPMHNP
Iconsider Ibefore Iprescribing Imedication Ifor I this Ipatient, Iand Iwhat Imedication Iwould Ithe
IPMHNP Iwant Ito Iavoid Igiven Ithese Iother Ifactors?
Selected IAnswer: D. I
Both I“A”
I& I“B”
A. IApoE4 Igenotype Iand Iavoid Iantihistamines Iif Ipossible IB. IType I2 Idiabetes Iand
Iavoid Iolanzapine IC. IAnxiety Iand Iavoid Imethylphenidate
• Question I13
0 Iout Iof I1 Ipoints
The IPMHNP Iis Iattempting Ito Itreat Ia Ipatient’s Ichronic Iinsomnia Iand Iwishes Ito Istart Iwith
Ian Iinitial Iprescription
Ithat Ihas Ia Ihalf-life Iof Iapproximately I1–2 Ihours. IWhat Iis Ithe Imost Iappropriate Iprescription
Ifor Ithe IPMHNP Ito
Imake? I
Selected IAnswer: B. I
Quazepam I(Doral)
A. ITriazolam I(Halcion)correct
• Question I14
1 Iout Iof I1 Ipoints
• Question I1
1 Iout Iof I1 Ipoints
Why Idoes Ithe IPMHNP Iavoid Iprescribing Iclozapine I(Clozaril) Ias Ia Ifirst-line Itreatment Ito
Ithe Ipatient Iwith
Ipsychosis Iand Iaggression?
Selected IAnswer: A. I
There Iis Itoo Ihigh Ia Irisk Iof Iserious Iadverse Iside
I effects.
• Question I2
1 Iout Iof I1 Ipoints
A I75-year-old Imale Ipatient Idiagnosed Iwith IAlzheimer’s Idisease Ipresents Iwith Iagitation Iand
Iaggressive Ibehavior.
IThe IPMHNP Idetermines Iwhich Iof Ithe Ifollowing Ito Ibe Ithe Ibest Itreatment Ioption?
Selected IAnswer: D. I
Citalopram I(Celexa) Ior IEscitalopram I(Lexapro)
• Question I3
1 Iout Iof I1 Ipoints
A Igroup Iof Inursing Istudents Iseeks Ifurther Iclarification Ifrom Ithe IPMHNP Ion Ihow
Icholinesterase Iinhibitors Iare
Ibeneficial Ifor IAlzheimer’s Idisease Ipatients. IWhat Iis Ithe Iappropriate Iresponse?
Selected IAnswer: D. I
Both
I“A” I& I“C.”
A. IAcetylcholine I(ACh) Idestruction Iis Iinhibited Iby Iblocking Ithe Ienzyme
Iacetylcholinesterase. IB. IEffectiveness Iof Ithese Iagents Ioccurs Iin Iall Istages Iof
IAlzheimer’s Idisease. IC. IBy Iincreasing Iacetylcholine, Ithe Idecline Iin Isome Ipatients Imay Ibe
Iless Irapid.
• Question I4
1 Iout Iof I1 Ipoints
The IPMHNP Iunderstands Ithat Islow-dose Iextended Irelease Istimulants Iare Imost Iappropriate
Ifor Iwhich Ipatient Iwith
IADHD?
Selected IAnswer: A. I
8 -year-old Ipatient
,• Question I5
1 Iout Iof I1 Ipoints
An I8-year-old Ipatient Ipresents Iwith Isevere Ihyperactivity, Idescribed Ias I“ants Iin Ihis Ipants.”
IBased Ion Iself-report Ifrom Ithe Ipatient, Ihis Iparents, Iand Ihis Iteacher; Iattention Ideficit
Ihyperactivity Idisorder I(ADHD) Iis Isuspected. IWhat
Imedication Iis Ithe IPMNHP Imost Ilikely Ito Iprescribe?
Selected IAnswer: A. I Methylphenidate I(Ritalin, IConcerta)
• Question I6
1 Iout Iof I1 Ipoints
A Ipatient Iwith Ifibromyalgia Iand Imajor Idepression Ineeds Ito Ibe Itreated Ifor Isymptoms Iof
Ipain. IWhich Iis Ithe
IPMHNP Imost Ilikely Ito Iprescribe Ifor Ithis Ipatient?
Selected IAnswer: Duloxetine I(Cymbalta)
• Question I7
1 Iout Iof I1 Ipoints
Mrs. IKenner Iis Iconcerned Ithat Iher Iteenage Idaughter Ispends Itoo Imuch Itime Ion Ithe IInternet.
IShe Iinquires Iabout Ipossible Itreatments Ifor Iher Idaughter’s Iaddiction. IWhich Iresponse Iby
Ithe IPMHNP Idemonstrates Iunderstanding Iof Ipharmacologic Iapproaches Ifor Icompulsive
Idisorders?
Selected D. I
IAnswer: “There Iare Ino Ievidence-based Itreatments Ifor IInternet Iaddiction, Ibut Ithere Iare
Ibehavioral Itherapies Iyour Idaughter Ican Itry.”
• Question I8
1 Iout Iof I1 Ipoints
An Iadult Ipatient Ipresents Iwith Ia Ihistory Iof Ialcohol Iaddiction Iand Iattention Ideficit
Ihyperactivity Idisorder
I(ADHD). IGiven Ithese Icomorbidities, Ithe IPMHNP Idetermines Iwhich Iof Ithe Ifollowing
Imedications Imay Ibe Ithe
Ibest Itreatment Ioption? I
Selected IAnswer: C. I
Atomoxetine I(Strattera)
• Question I9
1 Iout Iof I1 Ipoints
Which Iof Ithe Ifollowing Iis Ia Itrue Istatement Iregarding Ithe Iuse Iof Istimulants Ito Itreat
Iattention Ideficit Ihyperactivity I disorder I(ADHD)?
Selected B. I
IAnswer: Signal Istrength Ioutput Iis Iincreased Iby Idialing Iup Ithe Irelease Iof Idopamine I(DA)
Iand Inorepinephrine I(NE).
Selected IAnswer:
, • Question
out of 1 points
I I I I
• Question I10
1 Iout Iof I1 Ipoints
A I71-year-old Imale Ipatient Icomes Ito Ian Iappointment Iwith Ihis I65-year-old Iwife. IThey Iare
Iboth Ihaving Iconcerns Irelated Ito Iher Imemory Iand Iability Ito Irecognize Ifaces. IThe IPMNHP
Iis Iconsidering Iprescribing Imemantine I(Namenda) Ibased Ion Ithe Ifollowing
Isymptoms:
Selected IAnswer: C. I
Amnesia, Iapraxia, Iagnosia
• Question I11
1 Iout Iof I1 Ipoints
The IPMHNP Iis Imeeting Iwith Ithe Iparents Iof Ian I8-year-old Ipatient Iwho Iis Ireceiving Ian
Iinitial Iprescription Ifor IDamphetamine. IThe IPMHNP Idemonstrates Iappropriate Iprescribing
Ipractices Iwhen Ishe Iprescribes Ithe Ifollowing
Idose: I I A. I
The Ichild Iwill Ibe Iprescribed I2.5 Img.
I12
1
The IPMHNP Iis Iassessing Ia Ipatient Iwho Ipresents Iwith Ielevated Ilevels Iof Ibrain Iamyloid Ias
Inoted Iby Ipositron Iemission Itomography I(PET). IWhat Iother Ifactors Iwill Ithe IPMHNP
Iconsider Ibefore Iprescribing Imedication Ifor I this Ipatient, Iand Iwhat Imedication Iwould Ithe
IPMHNP Iwant Ito Iavoid Igiven Ithese Iother Ifactors?
Selected IAnswer: D. I
Both I“A”
I& I“B”
A. IApoE4 Igenotype Iand Iavoid Iantihistamines Iif Ipossible IB. IType I2 Idiabetes Iand
Iavoid Iolanzapine IC. IAnxiety Iand Iavoid Imethylphenidate
• Question I13
0 Iout Iof I1 Ipoints
The IPMHNP Iis Iattempting Ito Itreat Ia Ipatient’s Ichronic Iinsomnia Iand Iwishes Ito Istart Iwith
Ian Iinitial Iprescription
Ithat Ihas Ia Ihalf-life Iof Iapproximately I1–2 Ihours. IWhat Iis Ithe Imost Iappropriate Iprescription
Ifor Ithe IPMHNP Ito
Imake? I
Selected IAnswer: B. I
Quazepam I(Doral)
A. ITriazolam I(Halcion)correct
• Question I14
1 Iout Iof I1 Ipoints
