NUR 104 FINAL EXAM WEEK 11 FINAL 2022/2023
Walden University
FINAL EXAM WEEK
11
98/100
•
•
•
•
• Question 1
FILL IN THE BLANK: is the main neurotransmitter behind reward systems in
the brain, which usually leads to addiction when altered in any way. DOPAMINE
Response “Distribution of the endogenous reward systems in the brain is a
Feedback: common feature of drug abuse; most addictive drugs act by
disrupting central nervous system (CNS) dopamine circuits.”
- Table 16-1 as well all the drug types show alterations of
dopamine pathways in some way
• Question 2
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? ESCITALOPRAM
Response under Treatment subtitle: “The behavioral features are sometimes
Feedback: helped by SSRIs, and these are the best-studied treatments for these
disorders.”
• Question 3
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 and IV
I. Tau – tangles
II. Beta-amyloid – tangles
III. Tau – plaques
IV. Beta-amyloid – plaques
• Question 4
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? FLUOXETINE
, NUR 104 FINAL EXAM WEEK 11 FINAL 2022/2023
Walden University
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 5
The experience of pain is ALWAYS subjective YES IT IS ALWAYS SUBJECTIVE
Response “The experience of pain is always
Feedback: subjective.”
• Question 6
Of the following neurotransmitters, which ones play a critical role in modulating
attention in ADHD? C . I and IV
I. Dopamine
II. Epinephrine
III. GABA
IV. Norepinephrine
V. Glutamate
Response
"Stimulants increase intra-synaptic concentrations of dopamine
Feedback: (DA) and norepinephrine (NE)”
• Question 7
There are many different types of dementia. Which dementia is NOT a direct result of
disrupted neurotransmitters, but a result of degeneration of different regions in the
brain? Onset of the disease is typically before the age of 60, and very rare after the age
of 75.
Alzheimer Disease
Response under subtitle “Epidemiology and genetic
Feedback: risk factors”
• Question 8
This medication cannot be used for more than 5 days, it is a non-steroidal, anti-
inflammatory drug, and it is often substituted for morphine due to its rapid onset and
high potency. What is this medication? KETOROLAC, DUH
Response under non-steroidal, anti-
Feedback: inflammatory drugs
• Question 9
Benzodiazepines can be withdrawn abruptly despite duration of therapy/abuse. FALSE
, NUR 104 FINAL EXAM WEEK 11 FINAL 2022/2023
Walden University
FALSE FALSE
Response Benzodiazepines should never be stopped suddenly; Page 194
Feedback: “Under no circumstances should benzodiazepines be stopped
abruptly.”
• Question 10
B.
Choose the correct statement regarding medications used for alcoholism
Naltrexone: μ-opioid receptor antagonist that reduces
the reinforcement/euphoria produced by alcohol (Maybe
Response Table 15-3 has the three MOAs listed for the FDA-approved
Feedback: treatments of alcoholism.
• Question 11
If a patient is being managed for chronic pain and is not getting better after months of
therapy with multiple agents (i.e., NSAIDs with opioids, muscle relaxants with NSAIDs,
etc.), what should be your next step in helping the patient?
I. Add a high-dose opioid if patient is not already on the maximum dose.
II. Assess for a co-morbid psychiatric condition.
III. Tell the patient you have exhausted all your options and there is nothing
more you can do.
IV. Refer the patient for a second opinion.
Response
Both are good options. If the patient has never been assessed for a
Feedback: psychiatric condition, then it needs to be done to treat the underlying
cause of his or her pain. And doing a referral will help get a second set
of eyes on the patient to see where something may have been missed
when initially treating the patient.
- Page 208, Box 17-1 has a blurb: If treated with opioids for more than 3
months then get a second opinion.
- Page 209 under conclusions: It explains how if the patient has a co-
morbid psychiatric condition, it will worsen their pain and disability
and should be addressed in addition to treating the pain.
• Question 12
Of the following neurotransmitters, which one(s) are known to be severely disrupted in
the disease Dementia with Lewy Bodies? I and III Acetylcholine and DOpamine
I. Acetylcholine
II. Glutamate
III. Dopamine
IV. GABA
V. Norepinephrine
Walden University
FINAL EXAM WEEK
11
98/100
•
•
•
•
• Question 1
FILL IN THE BLANK: is the main neurotransmitter behind reward systems in
the brain, which usually leads to addiction when altered in any way. DOPAMINE
Response “Distribution of the endogenous reward systems in the brain is a
Feedback: common feature of drug abuse; most addictive drugs act by
disrupting central nervous system (CNS) dopamine circuits.”
- Table 16-1 as well all the drug types show alterations of
dopamine pathways in some way
• Question 2
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? ESCITALOPRAM
Response under Treatment subtitle: “The behavioral features are sometimes
Feedback: helped by SSRIs, and these are the best-studied treatments for these
disorders.”
• Question 3
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 and IV
I. Tau – tangles
II. Beta-amyloid – tangles
III. Tau – plaques
IV. Beta-amyloid – plaques
• Question 4
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? FLUOXETINE
, NUR 104 FINAL EXAM WEEK 11 FINAL 2022/2023
Walden University
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 5
The experience of pain is ALWAYS subjective YES IT IS ALWAYS SUBJECTIVE
Response “The experience of pain is always
Feedback: subjective.”
• Question 6
Of the following neurotransmitters, which ones play a critical role in modulating
attention in ADHD? C . I and IV
I. Dopamine
II. Epinephrine
III. GABA
IV. Norepinephrine
V. Glutamate
Response
"Stimulants increase intra-synaptic concentrations of dopamine
Feedback: (DA) and norepinephrine (NE)”
• Question 7
There are many different types of dementia. Which dementia is NOT a direct result of
disrupted neurotransmitters, but a result of degeneration of different regions in the
brain? Onset of the disease is typically before the age of 60, and very rare after the age
of 75.
Alzheimer Disease
Response under subtitle “Epidemiology and genetic
Feedback: risk factors”
• Question 8
This medication cannot be used for more than 5 days, it is a non-steroidal, anti-
inflammatory drug, and it is often substituted for morphine due to its rapid onset and
high potency. What is this medication? KETOROLAC, DUH
Response under non-steroidal, anti-
Feedback: inflammatory drugs
• Question 9
Benzodiazepines can be withdrawn abruptly despite duration of therapy/abuse. FALSE
, NUR 104 FINAL EXAM WEEK 11 FINAL 2022/2023
Walden University
FALSE FALSE
Response Benzodiazepines should never be stopped suddenly; Page 194
Feedback: “Under no circumstances should benzodiazepines be stopped
abruptly.”
• Question 10
B.
Choose the correct statement regarding medications used for alcoholism
Naltrexone: μ-opioid receptor antagonist that reduces
the reinforcement/euphoria produced by alcohol (Maybe
Response Table 15-3 has the three MOAs listed for the FDA-approved
Feedback: treatments of alcoholism.
• Question 11
If a patient is being managed for chronic pain and is not getting better after months of
therapy with multiple agents (i.e., NSAIDs with opioids, muscle relaxants with NSAIDs,
etc.), what should be your next step in helping the patient?
I. Add a high-dose opioid if patient is not already on the maximum dose.
II. Assess for a co-morbid psychiatric condition.
III. Tell the patient you have exhausted all your options and there is nothing
more you can do.
IV. Refer the patient for a second opinion.
Response
Both are good options. If the patient has never been assessed for a
Feedback: psychiatric condition, then it needs to be done to treat the underlying
cause of his or her pain. And doing a referral will help get a second set
of eyes on the patient to see where something may have been missed
when initially treating the patient.
- Page 208, Box 17-1 has a blurb: If treated with opioids for more than 3
months then get a second opinion.
- Page 209 under conclusions: It explains how if the patient has a co-
morbid psychiatric condition, it will worsen their pain and disability
and should be addressed in addition to treating the pain.
• Question 12
Of the following neurotransmitters, which one(s) are known to be severely disrupted in
the disease Dementia with Lewy Bodies? I and III Acetylcholine and DOpamine
I. Acetylcholine
II. Glutamate
III. Dopamine
IV. GABA
V. Norepinephrine
