TEST BANK for Lisa Gorski, Phillips' Man of IV
Therapeutics 8th edition
A 25-year-old patient presents with panic attacks occurring two to three times
weekly. Symptoms that occur during the attacks include shortness of breath,
tachycardia, paresthesias, dizziness, and palpitations. Upon further questioning, the
patient states that the attacks occur during times of fear of talking with strangers,
writing a check in front of someone, or in any situation that they feel scrutinized by
others or likelihood of humiliation. Based on clinical presentation, the panic attacks
this patient is experiencing are most likely associated with which of the following
anxiety disorders?
A. Panic disorder
B. Social anxiety disorder
C. Generalized anxiety disorder
D. Obsessive-compulsive disorder - ANSWER:B
Which of the following brain structures is located in the temporal lobe and plays a
critical role in the assessment and learned response to fear?
A. Amydala
B. Hippocampus
C. Hypothalamus
D. Locus ceruleus - ANSWER:A
48-year-old patient with hypertension, rheumatoid arthritis, and gastroesophageal
reflux disease presents with symptoms of anxiety including palpitations, diaphoresis,
and jitteriness. The patient's medication regimen includes prednisone,
chlorthalidone, enalapril, and ranitidine. Which medication is most likely to
contribute to symptoms of anxiety?
A. Lisinopril
B. Ranitidine
C. Prednisone
D. Chlorthalidone - ANSWER:C
Patients with panic disorder should be started at one-fourth to one-half of the dose
of escitalopram used to treat depression in order to decrease the risk for which of
the following?
A. Weight gain
B. Sedative effects
C. Jitteriness syndrome
D. Sexual dysfunction - ANSWER:C
A 23-year-old construction worker presents for pharmacotherapy for a new
diagnosis of panic disorder. The patient has a history of opioid use disorder and
,asthma. Based on evidence-based guidelines, which of the following is most
appropriate regimen to recommend?
A. Buspirone 5 mg orally three times daily
B. Paroxetine 10 mg orally daily in the morning
C. Alprazolam extended- release 2 mg orally at bedtime
D. Atenolol 25 mg orally an hour before anticipated anxiety - ANSWER:B
A 26-year-old patient with generalized anxiety disorder who responds to acute
treatment with duloxetine should continue on it for at least what period of time?
A. 1 month
B. 3 months
C. 6 months
D. 12 months - ANSWER:D
A 35-year-old patient with panic disorder has been well-maintained on sertraline 150
mg daily and clonazepam 1 mg twice daily for 2 years. As a result of a recent
hospitalization, several medications have been added to the regimen, and the
patient is experiencing significant breakthrough anxiety. Which of the following new
medications is most likely to interact with the clonazepam and result in increased
anxiety?
A. Pantoprazole
B. Carbamazepine
C. Lithium carbonate
D. Warfarin sodium - ANSWER:B
A patient with panic disorder has been treated successfully with paroxetine 60 mg
daily for 6 months. The patient inquires about discontinuation of therapy. Which of
the following is the most appropriate plan for discontinuation of paroxetine?
A. Continue therapy for 6 more months, then attempt to taper the paroxetine over 4
to 6 months.
B. Add clonazepam to the regimen and attempt to taper paroxetine over 2 months.
C. Continue therapy for 3 more months, then attempt to taper paroxetine by
decreasing the dose 25% weekly.
D. Convert paroxetine to fluoxetine, then taper the fluoxetine after 6 months of
therapy. - ANSWER:A
A patient has been treated with clonazepam 1 mg three times daily for panic
disorder for 18 months. Upon discontinuation of therapy, the clonazepam should be
tapered over how many weeks to reduce the chance for relapse?
A. 2
B. 4
C. 6
,D. 12 - ANSWER:D
A patient with social anxiety disorder has failed therapy with sertraline and
paroxetine. Based on evidence-based treatment guidelines, which of the following
medications would be preferred for the next trial of pharmacotherapy?
A. Mirtazapine
B. Bupropion
C. Pregabalin
D. Venlafaxine - ANSWER:D
A 39-year-old patient is being treated for treatment-resistant generalized anxiety
disorder with escitalopram 30 mg daily and quetiapine XR 100 mg at bedtime. Which
of the following are the most appropriate monitoring parameters for this patient?
A. Liebowitz Social Anxiety Scale, weight, complete blood count
B. Hamilton Anxiety Scale, body mass index, fasting blood sugar
C. Fall risk, weight, complete blood count, basic metabolic panel
D. Suicidality risk, ophthalmic exam every 6 months, blood pressure - ANSWER:B
You are consulted on the case of a 70-year-old patient with newly diagnosed
generalized anxiety disorder who has severe anxiety requiring pharmacotherapy
with a quick onset of effect. You are asked to select the most appropriate
benzodiazepine and educate the patient that this agent is safer in the elderly
because of its route of metabolism. Which of the following benzodiazepines do you
recommend and provide education about to the patient?
A. Alprazolam
B. Lorazepam
C. Clorazepate
D. Chlordiazepoxide - ANSWER:B
The long-term goal of therapy in the treatment of generalized anxiety disorder, panic
disorder, and social anxiety disorder is which of the following?
A. Few to minimal core symptoms
B. Partial response after 12 weeks
C. Ability to taper adjunctive agent
D. Complete remission of symptoms - ANSWER:D
A 32-year-old patient presents with significant social anxiety disorder. The patient is
not interested in pharmacotherapy, but is agreeable to nonpharmacologic methods
of treatment. If nonpharmacologic methods are prescribed, which of the following
would be most appropriate?
A. Sympathectomy
B. Psychological debriefing
, C. Cognitive behavioral therapy
D. Transcranial neurostimulation - ANSWER:C
A 27-year-old patient with a history of substance abuse is being treated for panic
disorder. Which of the following medications is associated with the risk of
dependence with chronic and prolonged use?
A. Buspirone
B. Clonazpeam
C. Venlafaxine
D. Gabapentin - ANSWER:B
Which of the following statements is correct when considering the addition of an
SSRI to a medication regimen that includes a chronic NSAID prescription?
A. Combination must be avoided and is contraindicated
B. Use this combination with caution and monitor patient closely
C. Combination is associated with enhanced antidepressant efficacy
D. Combination is associated with increased risk for clot formation - ANSWER:B
According to a recent report from the CDC, one particular antidepressant medication
may be a 'safer' choice, in regards to antidepressant use early in pregnancy. Please
choose the MOST appropriate antidepressant:
A. Paroxetine
B. Fluoxetine
C. Bupropion
D. Sertraline - ANSWER:D
According to the British Association of Psychopharmacology (BAP) guidelines, which
of the following antidepressants may be associated with the BEST efficacy/adverse
effects ratio?
A. Bupropion
B. Sertraline
C. Vortioxetine
D. Vilazodone - ANSWER:B
Augmentation to some extent of activity in the following neurotransmitter systems
have been implicated in the pathophysiology of antidepressant-induced sexual
dysfunction:
A. Dopaminergic
B. Noradrenergic
C. Serotonergic
D. All of the above - ANSWER:C
Therapeutics 8th edition
A 25-year-old patient presents with panic attacks occurring two to three times
weekly. Symptoms that occur during the attacks include shortness of breath,
tachycardia, paresthesias, dizziness, and palpitations. Upon further questioning, the
patient states that the attacks occur during times of fear of talking with strangers,
writing a check in front of someone, or in any situation that they feel scrutinized by
others or likelihood of humiliation. Based on clinical presentation, the panic attacks
this patient is experiencing are most likely associated with which of the following
anxiety disorders?
A. Panic disorder
B. Social anxiety disorder
C. Generalized anxiety disorder
D. Obsessive-compulsive disorder - ANSWER:B
Which of the following brain structures is located in the temporal lobe and plays a
critical role in the assessment and learned response to fear?
A. Amydala
B. Hippocampus
C. Hypothalamus
D. Locus ceruleus - ANSWER:A
48-year-old patient with hypertension, rheumatoid arthritis, and gastroesophageal
reflux disease presents with symptoms of anxiety including palpitations, diaphoresis,
and jitteriness. The patient's medication regimen includes prednisone,
chlorthalidone, enalapril, and ranitidine. Which medication is most likely to
contribute to symptoms of anxiety?
A. Lisinopril
B. Ranitidine
C. Prednisone
D. Chlorthalidone - ANSWER:C
Patients with panic disorder should be started at one-fourth to one-half of the dose
of escitalopram used to treat depression in order to decrease the risk for which of
the following?
A. Weight gain
B. Sedative effects
C. Jitteriness syndrome
D. Sexual dysfunction - ANSWER:C
A 23-year-old construction worker presents for pharmacotherapy for a new
diagnosis of panic disorder. The patient has a history of opioid use disorder and
,asthma. Based on evidence-based guidelines, which of the following is most
appropriate regimen to recommend?
A. Buspirone 5 mg orally three times daily
B. Paroxetine 10 mg orally daily in the morning
C. Alprazolam extended- release 2 mg orally at bedtime
D. Atenolol 25 mg orally an hour before anticipated anxiety - ANSWER:B
A 26-year-old patient with generalized anxiety disorder who responds to acute
treatment with duloxetine should continue on it for at least what period of time?
A. 1 month
B. 3 months
C. 6 months
D. 12 months - ANSWER:D
A 35-year-old patient with panic disorder has been well-maintained on sertraline 150
mg daily and clonazepam 1 mg twice daily for 2 years. As a result of a recent
hospitalization, several medications have been added to the regimen, and the
patient is experiencing significant breakthrough anxiety. Which of the following new
medications is most likely to interact with the clonazepam and result in increased
anxiety?
A. Pantoprazole
B. Carbamazepine
C. Lithium carbonate
D. Warfarin sodium - ANSWER:B
A patient with panic disorder has been treated successfully with paroxetine 60 mg
daily for 6 months. The patient inquires about discontinuation of therapy. Which of
the following is the most appropriate plan for discontinuation of paroxetine?
A. Continue therapy for 6 more months, then attempt to taper the paroxetine over 4
to 6 months.
B. Add clonazepam to the regimen and attempt to taper paroxetine over 2 months.
C. Continue therapy for 3 more months, then attempt to taper paroxetine by
decreasing the dose 25% weekly.
D. Convert paroxetine to fluoxetine, then taper the fluoxetine after 6 months of
therapy. - ANSWER:A
A patient has been treated with clonazepam 1 mg three times daily for panic
disorder for 18 months. Upon discontinuation of therapy, the clonazepam should be
tapered over how many weeks to reduce the chance for relapse?
A. 2
B. 4
C. 6
,D. 12 - ANSWER:D
A patient with social anxiety disorder has failed therapy with sertraline and
paroxetine. Based on evidence-based treatment guidelines, which of the following
medications would be preferred for the next trial of pharmacotherapy?
A. Mirtazapine
B. Bupropion
C. Pregabalin
D. Venlafaxine - ANSWER:D
A 39-year-old patient is being treated for treatment-resistant generalized anxiety
disorder with escitalopram 30 mg daily and quetiapine XR 100 mg at bedtime. Which
of the following are the most appropriate monitoring parameters for this patient?
A. Liebowitz Social Anxiety Scale, weight, complete blood count
B. Hamilton Anxiety Scale, body mass index, fasting blood sugar
C. Fall risk, weight, complete blood count, basic metabolic panel
D. Suicidality risk, ophthalmic exam every 6 months, blood pressure - ANSWER:B
You are consulted on the case of a 70-year-old patient with newly diagnosed
generalized anxiety disorder who has severe anxiety requiring pharmacotherapy
with a quick onset of effect. You are asked to select the most appropriate
benzodiazepine and educate the patient that this agent is safer in the elderly
because of its route of metabolism. Which of the following benzodiazepines do you
recommend and provide education about to the patient?
A. Alprazolam
B. Lorazepam
C. Clorazepate
D. Chlordiazepoxide - ANSWER:B
The long-term goal of therapy in the treatment of generalized anxiety disorder, panic
disorder, and social anxiety disorder is which of the following?
A. Few to minimal core symptoms
B. Partial response after 12 weeks
C. Ability to taper adjunctive agent
D. Complete remission of symptoms - ANSWER:D
A 32-year-old patient presents with significant social anxiety disorder. The patient is
not interested in pharmacotherapy, but is agreeable to nonpharmacologic methods
of treatment. If nonpharmacologic methods are prescribed, which of the following
would be most appropriate?
A. Sympathectomy
B. Psychological debriefing
, C. Cognitive behavioral therapy
D. Transcranial neurostimulation - ANSWER:C
A 27-year-old patient with a history of substance abuse is being treated for panic
disorder. Which of the following medications is associated with the risk of
dependence with chronic and prolonged use?
A. Buspirone
B. Clonazpeam
C. Venlafaxine
D. Gabapentin - ANSWER:B
Which of the following statements is correct when considering the addition of an
SSRI to a medication regimen that includes a chronic NSAID prescription?
A. Combination must be avoided and is contraindicated
B. Use this combination with caution and monitor patient closely
C. Combination is associated with enhanced antidepressant efficacy
D. Combination is associated with increased risk for clot formation - ANSWER:B
According to a recent report from the CDC, one particular antidepressant medication
may be a 'safer' choice, in regards to antidepressant use early in pregnancy. Please
choose the MOST appropriate antidepressant:
A. Paroxetine
B. Fluoxetine
C. Bupropion
D. Sertraline - ANSWER:D
According to the British Association of Psychopharmacology (BAP) guidelines, which
of the following antidepressants may be associated with the BEST efficacy/adverse
effects ratio?
A. Bupropion
B. Sertraline
C. Vortioxetine
D. Vilazodone - ANSWER:B
Augmentation to some extent of activity in the following neurotransmitter systems
have been implicated in the pathophysiology of antidepressant-induced sexual
dysfunction:
A. Dopaminergic
B. Noradrenergic
C. Serotonergic
D. All of the above - ANSWER:C
