NURS 6630
PSYCHOPHARMACOLOGY
MIDTERM EXAM TEST BANK
Purple answers were marked incorrect. Red answers were marked correct.
QUESTION 1
1. 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).
A.
"You have to take your medication to become stable." B.
"Most medications will increase the number of neurotransmitters that you already have in
the brain." C.
"Most medications used in treatment are either increasing or decreasing
neurotransmitters that your body already has." D.
"Why do you believe that your medication is poison?" I received 0/1 for this answer?? 1 points
QUESTION 2
1. Which statement about neurotransmitters and medications is true? My correct answer
was several psychiatric meds were developed after discovery of endogenous
neurotransmitters. (The answer wording is different. A.
Natural neurotransmitters such as endorphins have been discovered after the development of
medications. B.
Some medications were developed after the discovery and known action of the
neurotransmitters in the brain. C.
Neurotransmitters receive messages from most medications. D.
The neurotransmitter serotonin is directly linked to depression. Following this discovery, the
antidepressant Prozac was developed.
,1 points
QUESTION 3
1. When an unstable patient asks why it is necessary to add medications to his current
regimen, the PMHNP's best response would be: A.
"In an extreme case such as yours, more than one medication is often needed." B.
"Due to the ineffectiveness of your current medication, we need to try something else
that can possibly potentiate its effects. C.
"Medications are often specific to the neurotransmitter(s) they are affecting and, due to more
than one neurotransmitter involvement, it is often necessary to use more than one medication
to improve symptoms." D.
"I understand your concern. We can discontinue your current medication and switch to a
different one that may better manage your symptoms."
1 points
QUESTION 4 ?
1. During gene expression, what must occur prior to a gene being expressed? A.
Transcription factor must bind to the regulatory region within the cell's nucleus. B.
RNA must be converted to mRNA. C.
The coding region must separate from the regulatory region. This is wrong
D.
RNA polymerase must inhibit the process of changing RNA to mRNA.
1 points QUESTION 5
1. While genes have potential to modify behavior, behavior can also modify genes. How do
genes impact this process? A.
Genes impact neuron functioning directly.
B.
Changes made to proteins lead to changes in behavior. C.
Neurons are able to impact protein synthesis. D.
Genes impact the DNA of a cell, leading to changes in behavior.
1 points QUESTION 6
1. Though medications have the ability to target neurotransmitters in the synapse, it is not
always necessary. The PMHNP understands that this is because: A.
Neurotransmission that occurs via the axon allows for transport of a
neurotransmitter. B.
Active transport is a different type of energy that allows the transport of certain
neurotransmitters. C.
Neurotransmitters can spread by diffusion. D.
,The postsynaptic neuron can release the neurotransmitter.
1 points QUESTION 7
1. Why is the cytochrome P450 enzyme system of significance to the
PMHNP?
A.
The kidneys play a role with excretion of the medication, and if a patient has kidney damage,
the dose must be increased to be effective. B.
The bioavailability of the medication after it passes through the stomach and liver can be
altered. Correct answer C.
The medication's chemical composition changes when it comes in contact with the acid in
the stomach. D.
The CYP enzyme system is a steady and predictable process that prescribers must understand
to treat conditions effectively.
1 points QUESTION 8
1. 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? A.
About 1 out of 5 Asians requires lower-than-normal doses of some
antidepressants and antipsychotics. B.
The term polymorphic refers to the body's ability to break a medication down several ways,
and this patient may require higher doses of certain antidepressants and antipsychotics. C.
About 1 out of 30 Caucasians requires lower doses of some antidepressants and
antipsychotics. D.
Most enzyme pathways do not have interactions between the newer medications. 1
points
QUESTION 9
1. As it relates to G-protein linked receptors, what does the PMHNP understand
about medications that are used in practice? A.
Most medications that act on G-protein linked receptors have antagonistic traits. B.
The majority of medications used in practice are full agonists and are used to stimulate the
body's natural neurotransmitters. C.
Most medications act as partial agonists because they allow the body to use only what is
needed. D.
Medications used in practice may act as inverse agonists if the dosage is too high. 1 points
, QUESTION 10
1. 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: A.
The patient smokes cigarettes. This is correct! B.
The patient has hypertension. C.
The patient has chronic kidney disease, stage 2. D.
The patient drinks a cup of coffee a day.
1 points QUESTION 11
1. 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 druginduced thrombocytopenia. The PMHNP is
aware that his next best action is to: A.
Alert staff to possible seizures B.
Write an order for a different mood stabilizer For some reason I got 0/1 points for this??
C.
Decrease the amount prescribed for aripiprazole (Abilify) D.
Explain to the patient that it will be more difficult to control his temper
1 points QUESTION 12
1. 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? A.
Review Amitriptyline (Elavil) level Correct answer B.
Order a liver function test C.
Check the patient's blood pressure and pulse D.
Order a stat platelet count
1 points QUESTION 13
1. 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? A.
To promote the availability of serotonin B.
To decrease serotonin C.
To indirectly increase the amount of dopamine in the body D.
To help decrease the amount of serotonin and dopamine
PSYCHOPHARMACOLOGY
MIDTERM EXAM TEST BANK
Purple answers were marked incorrect. Red answers were marked correct.
QUESTION 1
1. 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).
A.
"You have to take your medication to become stable." B.
"Most medications will increase the number of neurotransmitters that you already have in
the brain." C.
"Most medications used in treatment are either increasing or decreasing
neurotransmitters that your body already has." D.
"Why do you believe that your medication is poison?" I received 0/1 for this answer?? 1 points
QUESTION 2
1. Which statement about neurotransmitters and medications is true? My correct answer
was several psychiatric meds were developed after discovery of endogenous
neurotransmitters. (The answer wording is different. A.
Natural neurotransmitters such as endorphins have been discovered after the development of
medications. B.
Some medications were developed after the discovery and known action of the
neurotransmitters in the brain. C.
Neurotransmitters receive messages from most medications. D.
The neurotransmitter serotonin is directly linked to depression. Following this discovery, the
antidepressant Prozac was developed.
,1 points
QUESTION 3
1. When an unstable patient asks why it is necessary to add medications to his current
regimen, the PMHNP's best response would be: A.
"In an extreme case such as yours, more than one medication is often needed." B.
"Due to the ineffectiveness of your current medication, we need to try something else
that can possibly potentiate its effects. C.
"Medications are often specific to the neurotransmitter(s) they are affecting and, due to more
than one neurotransmitter involvement, it is often necessary to use more than one medication
to improve symptoms." D.
"I understand your concern. We can discontinue your current medication and switch to a
different one that may better manage your symptoms."
1 points
QUESTION 4 ?
1. During gene expression, what must occur prior to a gene being expressed? A.
Transcription factor must bind to the regulatory region within the cell's nucleus. B.
RNA must be converted to mRNA. C.
The coding region must separate from the regulatory region. This is wrong
D.
RNA polymerase must inhibit the process of changing RNA to mRNA.
1 points QUESTION 5
1. While genes have potential to modify behavior, behavior can also modify genes. How do
genes impact this process? A.
Genes impact neuron functioning directly.
B.
Changes made to proteins lead to changes in behavior. C.
Neurons are able to impact protein synthesis. D.
Genes impact the DNA of a cell, leading to changes in behavior.
1 points QUESTION 6
1. Though medications have the ability to target neurotransmitters in the synapse, it is not
always necessary. The PMHNP understands that this is because: A.
Neurotransmission that occurs via the axon allows for transport of a
neurotransmitter. B.
Active transport is a different type of energy that allows the transport of certain
neurotransmitters. C.
Neurotransmitters can spread by diffusion. D.
,The postsynaptic neuron can release the neurotransmitter.
1 points QUESTION 7
1. Why is the cytochrome P450 enzyme system of significance to the
PMHNP?
A.
The kidneys play a role with excretion of the medication, and if a patient has kidney damage,
the dose must be increased to be effective. B.
The bioavailability of the medication after it passes through the stomach and liver can be
altered. Correct answer C.
The medication's chemical composition changes when it comes in contact with the acid in
the stomach. D.
The CYP enzyme system is a steady and predictable process that prescribers must understand
to treat conditions effectively.
1 points QUESTION 8
1. 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? A.
About 1 out of 5 Asians requires lower-than-normal doses of some
antidepressants and antipsychotics. B.
The term polymorphic refers to the body's ability to break a medication down several ways,
and this patient may require higher doses of certain antidepressants and antipsychotics. C.
About 1 out of 30 Caucasians requires lower doses of some antidepressants and
antipsychotics. D.
Most enzyme pathways do not have interactions between the newer medications. 1
points
QUESTION 9
1. As it relates to G-protein linked receptors, what does the PMHNP understand
about medications that are used in practice? A.
Most medications that act on G-protein linked receptors have antagonistic traits. B.
The majority of medications used in practice are full agonists and are used to stimulate the
body's natural neurotransmitters. C.
Most medications act as partial agonists because they allow the body to use only what is
needed. D.
Medications used in practice may act as inverse agonists if the dosage is too high. 1 points
, QUESTION 10
1. 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: A.
The patient smokes cigarettes. This is correct! B.
The patient has hypertension. C.
The patient has chronic kidney disease, stage 2. D.
The patient drinks a cup of coffee a day.
1 points QUESTION 11
1. 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 druginduced thrombocytopenia. The PMHNP is
aware that his next best action is to: A.
Alert staff to possible seizures B.
Write an order for a different mood stabilizer For some reason I got 0/1 points for this??
C.
Decrease the amount prescribed for aripiprazole (Abilify) D.
Explain to the patient that it will be more difficult to control his temper
1 points QUESTION 12
1. 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? A.
Review Amitriptyline (Elavil) level Correct answer B.
Order a liver function test C.
Check the patient's blood pressure and pulse D.
Order a stat platelet count
1 points QUESTION 13
1. 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? A.
To promote the availability of serotonin B.
To decrease serotonin C.
To indirectly increase the amount of dopamine in the body D.
To help decrease the amount of serotonin and dopamine
