NURS 6630 FINAL EXAM ELABORATIONS QUESTIO
AND ANSWERS NEWLY UPDATED (WALDEN
UNIVERSITY)
NURS 6630 FINAL EXAM: WALDEN UNIVERSITY
QUESTION 1
What will the PMHNP most likely prescribe to a client with psychotic aggression who
needs to manage the top-down cortical control and the excessive drive from striatal
hyperactivity?
• Stimulants
• Antidepressants
• Antipsychotics
• SSRIs
QUESTION 2
The PMHNP is selecting a medication treatment option for a client who is exhibiting
psychotic behaviors with poor impulse control and aggression. Of the available treatments,
which can help temper some of the adverse effects or symptoms that are normally caused by
D2 antagonism?
• First-generation, conventional antipsychotics
• First-generation, atypical antipsychotics
• Second-generation, conventional antipsychotics
• Second-generation, atypical antipsychotics
QUESTION 3
The PMHNP is discussing dopamine D2 receptor occupancy and its association with
aggressive behaviors in clients with the student. Why does the PMHNP prescribe a standard
dose of atypicalantipsychotics?
,• The doses are based on achieving 100% D2 receptor occupancy.
• The doses are based on achieving a minimum of 80% D2 receptor occupancy.
• The doses are based on achieving 60% D2 receptor occupancy.
• None of the above.
QUESTION 4
Why does the PMHNP avoid prescribing clozapine (Clozaril) as a first-line treatment to the
client with psychosis and aggression?
• There is too high a risk of serious adverse side effects.
• It can exaggerate the psychotic symptoms.
• Clozapine (Clozaril) should not be used as high-dose monotherapy.
• There is no documentation that clozapine (Clozaril) is effective for clients who are violent.
QUESTION 5
The PMHNP is caring for a client on risperidone (Risperdal). Which action made by the
PMHNPexhibits proper care for this client?
• Explaining to the client that there are no risks of EPS
• Prescribing the client 12 mg/dail
• Titrating the dose by increasing it every 5–7 days
• Writing a prescription for a higher dose of oral risperidone (Risperdal) to achieve
high D2receptor occupancy
QUESTION 6
The PMHNP wants to prescribe Mr. Barber a mood stabilizer that will target aggressive
and impulsive symptoms by decreasing dopaminergic neurotransmission. Which mood
stabilizer willthe PMHNP select?
• Lithium (Lithane)
, • Phenytoin (Dilantin)
• Valproate (Depakote)
• Topiramate (Topamax)
QUESTION 7
The parents of a 7-year-old client with ADHD are concerned about the effects of stimulants
on their child. The parents prefer to start pharmacological treatment with a non-stimulant.
Which medication will the PMHNP will most likely prescribe?
• Strattera
• Concerta
• Daytrana
• Adderall
QUESTION 8
The PMHNP understands that slow-dose extended release stimulants are most
appropriate forwhich client with ADHD?
• 8-year-old client
• 24-year-old client
• 55-year-old client
• 82-year-old client
QUESTION 9
A client is prescribed D-methylphenidate, 10-mg extended-release capsules. What
should thePMHNP include when discussing the side effects with the client?
• The formulation can have delayed actions when taken with food.
• Sedation can be a common side effect of the drug.
• The medication can affect your blood pressure.
• This drug does not cause any dependency.
QUESTION 10
AND ANSWERS NEWLY UPDATED (WALDEN
UNIVERSITY)
NURS 6630 FINAL EXAM: WALDEN UNIVERSITY
QUESTION 1
What will the PMHNP most likely prescribe to a client with psychotic aggression who
needs to manage the top-down cortical control and the excessive drive from striatal
hyperactivity?
• Stimulants
• Antidepressants
• Antipsychotics
• SSRIs
QUESTION 2
The PMHNP is selecting a medication treatment option for a client who is exhibiting
psychotic behaviors with poor impulse control and aggression. Of the available treatments,
which can help temper some of the adverse effects or symptoms that are normally caused by
D2 antagonism?
• First-generation, conventional antipsychotics
• First-generation, atypical antipsychotics
• Second-generation, conventional antipsychotics
• Second-generation, atypical antipsychotics
QUESTION 3
The PMHNP is discussing dopamine D2 receptor occupancy and its association with
aggressive behaviors in clients with the student. Why does the PMHNP prescribe a standard
dose of atypicalantipsychotics?
,• The doses are based on achieving 100% D2 receptor occupancy.
• The doses are based on achieving a minimum of 80% D2 receptor occupancy.
• The doses are based on achieving 60% D2 receptor occupancy.
• None of the above.
QUESTION 4
Why does the PMHNP avoid prescribing clozapine (Clozaril) as a first-line treatment to the
client with psychosis and aggression?
• There is too high a risk of serious adverse side effects.
• It can exaggerate the psychotic symptoms.
• Clozapine (Clozaril) should not be used as high-dose monotherapy.
• There is no documentation that clozapine (Clozaril) is effective for clients who are violent.
QUESTION 5
The PMHNP is caring for a client on risperidone (Risperdal). Which action made by the
PMHNPexhibits proper care for this client?
• Explaining to the client that there are no risks of EPS
• Prescribing the client 12 mg/dail
• Titrating the dose by increasing it every 5–7 days
• Writing a prescription for a higher dose of oral risperidone (Risperdal) to achieve
high D2receptor occupancy
QUESTION 6
The PMHNP wants to prescribe Mr. Barber a mood stabilizer that will target aggressive
and impulsive symptoms by decreasing dopaminergic neurotransmission. Which mood
stabilizer willthe PMHNP select?
• Lithium (Lithane)
, • Phenytoin (Dilantin)
• Valproate (Depakote)
• Topiramate (Topamax)
QUESTION 7
The parents of a 7-year-old client with ADHD are concerned about the effects of stimulants
on their child. The parents prefer to start pharmacological treatment with a non-stimulant.
Which medication will the PMHNP will most likely prescribe?
• Strattera
• Concerta
• Daytrana
• Adderall
QUESTION 8
The PMHNP understands that slow-dose extended release stimulants are most
appropriate forwhich client with ADHD?
• 8-year-old client
• 24-year-old client
• 55-year-old client
• 82-year-old client
QUESTION 9
A client is prescribed D-methylphenidate, 10-mg extended-release capsules. What
should thePMHNP include when discussing the side effects with the client?
• The formulation can have delayed actions when taken with food.
• Sedation can be a common side effect of the drug.
• The medication can affect your blood pressure.
• This drug does not cause any dependency.
QUESTION 10
