COMPLETE REAL QUESTIONS WITH WELL ELABORATED
ANSWERS (VERIFIED SOLUTIONS) A NEW UPDATED
VERSION |ALREADY GRADED A+ (FULL REVISED)
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Mary returns 3 weeks later after participating in several therapy sessions.
She admits that she would like to cut down on her alcohol use but is fearful
of withdrawal effects. The PMHNP offers to prescribe which of the following
to help manage alcohol withdrawal symptoms?
Naltrexone
Clonidine
Disulfiram
Naloxone
Clonidine
Disulfiram is used to assist in maintaining abstinence from alcohol use by
causing noxious physical effects, such as nausea, vomiting, sweating and
headache, when alcohol is consumed (C). Naloxone is used to rapidly
reverse the effects of opioids during an overdose but would not be used for
alcohol withdrawal symptoms (D). Naltrexone is used to block the euphoric
feeling when alcohol or opioids are consumed but would not be helpful for
alcohol withdrawal symptoms (A).
,At the request of his partner, a 51-year-old man is being evaluated for
obsessive-compulsive disorder. He admits that he finds it difficult to leave
his apartment without checking that the lights and water are turned off. It
can take him up to 30 minutes to exit the apartment and this is putting a
strain on his relationship. In addition to recommending psychotherapy, the
PMHNP suggests initiating pharmacologic therapy with:
Duloxetine.
Bupropion.
Lurasidone.
Selegiline.
Duloxetine.
SSRIs and SNRIs such as duloxetine are the first-line treatments for
obsessive-compulsive disorder, with a response rate ranging from 50-70%
(A). High doses are often needed to achieve the desired effect. Second-line
treatment can include clomipramine, while treatment can be augmented
with the use of valproate, lithium, or carbamazepine.
,A 28-year-old man will initiate pharmacotherapy for generalized anxiety
disorder. His records show that he has chronic hepatitis B. Which of the
following agents should be avoided?
Sertraline
Duloxetine
Venlafaxine
Escitalopram
Duloxetine
Liver toxicity is not associated with the use of sertraline (A), venlafaxine (C),
or escitalopram (D) and these would be appropriate first-line agents for this
patient.
Which of the following antidepressants should be avoided in a patient with
moderate depression and who has expressed some thoughts about
suicide?
Fluoxetine
Desvenlafaxine
Nortriptyline
Escitalopram
Nortriptyline
SSRIs and SNRIs are generally safe even in overdose amounts and would
not likely achieve a lethal dose (A, B, D).
, A 26-year-old reports experiencing low-level depression for the past 3
years that impacts most days. He also reports decreased appetite, fatigue,
and hypersomnia. The most likely diagnosis is:
Major depressive disorder.
Bipolar II disorder.
Persistent depressive disorder.
Cyclothymic disorder.
Persistent depressive disorder.
Major depressive disorder is characterized by persistently depressed mood
lasting at least 2 weeks with markedly depressed mood and/or diminished
interest or pleasure in all or nearly all activities (A). Bipolar II disorder is
characterized by broad changes in mood that range from major depressive
episodes to hypomanic episodes (B). Similarly, cyclothymic disorder is
characterized by mood swings ranging from mild-to-moderate depression
to hypomanic episodes (D).