WALDEN UNIVERSITY NURS 6630 MIDTERM EXAM TEST BANK ADVANCED PRACTICE CARE OF ADULTS

WALDEN UNIVERSITY NURS 6630 MIDTERM EXAM TEST BANK ADVANCED PRACTICE CARE OF ADULTS NURS 6630 MIDTERM EXAM TEST BANK 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). Answer: C. “Most medications that work in the brain will result in restoring an imbalance of one or more neurotransmitters that your body already produces helping to alleviate your symptoms .” Question 2 1 out of 1 points Ms. Hill is currently being treated for schizophrenia but has stopped taking her medications due to some side effects she claims she was experiencing. She presents to the clinic today with worsening symptoms. She is experiencing anhedonia, agitation, attentional impairment, and affective blunting. Which one of the symptoms mentioned is considered a positive symptom of schizophrenia? Answer: B. Agitation Question 3 0 out of 1 points Which statement about neurotransmitters and medications is true? Answer: D. An imbalance of serotonin has been directly linked to depression. Following the discovery of this neurotransmitter, pharmacologists were able to develop a well-known drug- Prozac as the first medication used to restore the balance of serotonin. Question 4 1 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: Answer: C. “Many psychiatric illnesses involve several dys-functioning neurotransmitter systems in the brain. Often, a single medication may only effect one or two of the dys-functioning systems. The addition of another medication can work with the current medication in stabilizing multiple neurotransmitter systems and help to alleviate your symptoms.” Question 5 1 out of 1 points During gene expression, what must occur prior to a gene being expressed? Answers: A. Transcription factor must bind to the regulatory region within the cell’s nucleus. Question 6 1 out of 1 points While genes have potential to modify behavior, behavior can also modify genes. How do genes impact this process? Answer: B. Changes made to proteins lead to changes in behavior. Question 7 1 out of 1 points Though medications have the ability to target neurotransmitter release into the synapse by the presynaptic neuron it is not always necessary. The PMHNP understands that this is because: Answer: C. Neurotransmitters can spread by diffusion. Question 8 1 out of 1 points Why is the cytochrome P450 enzyme system of significance to the PMHNP? Answer: B. The bioavailability of the medication after it passes through the stomach and liver can be altered. Question 9 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? Answer: A. About 1 out of 5 Asians requires lower-than-normal doses of some antidepressants and antipsychotics. Question 10 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? Answer: A. Most medications that act on G-protein linked receptors have antagonistic traits. Question 11 1 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: Answer: A. The patient smokes cigarettes. Question 12 0 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: Answer: B. Write an order for a different mood stabilizer Question 13 1 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). When assessing the psychiatric medications and the reason for admission, what would be the best course of action for the PMHNP with this client? Answer : A. Review Amitriptyline (Elavil) level Question 14 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? Answer : D. To help decrease the amount of serotonin and dopamine Question 15 1 out of 1 points The PMHNP is caring for four patients. Which patient statement indicates that benzodiazepines would be beneficial? Answer: D. “I feel nervous to go outside and be in large crowds.”