NURS 6630 Midterm. 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
... [Show More] response would be:
Selected 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 2 0 out of 1 points
The PMHNP is meeting with a new mother who would like to begin taking medication again to treat her bipolar depression; she is breastfeeding her 2-month old daughter. The PMHNP recognizes that which of the following medications is contraindicated for this patient?
Selected Answer:
C. Lithium (Lithobid)
Question 3 1 out of 1 points
Mr. Gordon is a middle-aged client who was started on antidepressant monotherapy for depression. After beginning this medication, the PMHNP noticed that this client seemed to swing into a hypomanic episode. What can the PMHNP infer from this behavior change? Selected Answer:
A. This client may have Bipolar III disorder
Question 4 1 out of 1 points
A patient presents with frequent episodes of mania. Which statement describes an appropriate treatment approach for this patient?
Selected Answer:
B. “The patient could benefit from an anticonvulsant.”
Question 5 1 out of 1 points The student inquires about antipsychotic medications. Whichresponse by the PMHNP describes the factors that contribute to
reduced risk of extrapyramidal symptoms (EPS) for patients who
take antipsychotics?
Selected
Answer:
B.
Those that are potent D2 antagonists with 5HT2A
antagonism properties
Question 6
1 out of 1 points
After ordering flumazenil (Rumazicon) the PMHNP cautions the staff to monitor for
which possible effect?
Selected
Answer:
D.
All of the
above
Question 7
1 out of 1 points
The PMHNP is caring for a patient who is taking antipsychotics
heard the psychiatrist tell the patient that the patient would be
placed on a different antipsychotic agent called an atypical
antipsychotic. What neurotransmitters will this new medication work on?
Selected
Answer:
A.
dopamine and serotonin
Question 8
1 out of 1 points
While genes have potential to modify behavior, behavior can also
modify genes. How do genes impact this process?
Selected
Answer:
B.
Changes made to proteins lead to changes in
behavior.
Question 9
1 out of 1 points
Mrs. Schwartzman is a 52-year-old client with schizophrenia and no
established history of depression. When meeting with the PMHNP, she
presents with apathy and withdrawn social behavior, and she reports a loss
of joy from enjoyable activities since starting her new medication. What does
the PMHNP infer from this encounter with the client?
Selected
Answer:
C.
The new medication is blocking D2 receptors in the mesolimbic
system
Question 10
1 out of 1 points
A nursing student is seeking clarification on the use of
anticonvulsants to treat depression and is unclear about most
effective outcomes. Which of the following agents does the PMHNP
convey as having uncertain outcomes?
Selected
Answer:
B.
Gabapentin
(Neurontin)
Question 11
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?
Selected
Answer:
A.
Most medications that act on G-protein linked
receptors have antagonistic traits.
Question 12
1 out of 1 points
A patient is seeking pharmacological treatment for smoking
cessation. Which drug class does the PMHNP prescribe to the
patient?
Selected
Answer:
D.
Varenicline
(Chantix)
Question 13
1 out of 1 points
The PMHNP is caring for a patient with schizophrenia and is
considering a variety of treatment approaches. The PHMNP selects
a viable treatment that is consistent with the “dopamine
hypothesis of schizophrenia.” What action does the PMHNP
anticipate this treatment having on the patient?
Selected
Answer:
B.
Hyperactivity in the mesolimbic dopamine pathway
mediates the positive symptoms of schizophrenia.
Question 14
1 out of 1 pointsThough 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:
Selected
Answer:
C.
Neurotransmitters can spread by
diffusion.
Question 15
1 out of 1 points
A patient is being prescribed a sedating antidepressant, but is
concerned about weight gain. Which medication is most likely to be
prescribed to addresses the patient’s concerns?
Selected
Answer:
D.
trazadone
(Oleptro)
Question 16
1 out of 1 points
The PMHNP is caring for several patients who present with various
symptoms and health issues. For which patient does the PMHNP
prescribe pregabalin (Lyrica)?
Selected
Answer:
B.
Patient with partial
seizures
Question 17
1 out of 1 points
Which statement about neurotransmitters and medications is true?
Selected
Answer:
B.
Several psychiatric medications have been developed after discoveries of endogenous
neurotransmitters and defining their function in the brain.
Question 18
1 out of 1 points
A patient is prescribed 50 mg of desvenlafaxine to take every other
day for major depressive disorder. What does the PMHNP
understand about this patient?
Selected
Answer:
C.
The patient has severe renal
impairment.
Question 19
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?
Selected
Answer:
A.
To promote the availability of
serotonin
Question 20
1 out of 1 points
A patient who was prescribed an MAO inhibitor is learning about
dietary modifications. Which statement made by the PMHNP
demonstrates proper teaching of the food-drug interactions for
MAO inhibitors?
Selected
Answer:
A.
“You must avoid soy products, such
as tofu.”
Question 21
1 out of 1 points
The PMHNP evaluates the patient for “fear conditioning” when he
asks:
Selected
Answer:
A.
Have you ever experienced any type of
trauma?
Question 22
0 out of 1 points
The PMHNP recognizes that which patient would be contraindicated
for antidepressant monotherapy?
Selected
Answer:
A.
Patient with a bipolar I
designation
Question 23
0 out of 0 points
When completing this exam, did you comply with Walden University’s Code of
Conduct including the expectations for academic integrity?
Selected
YeAnswer:
s
Question 24
0 out of 1 points
Mr. Gordon is a middle-aged patient who is taking antipsychotics.
When meeting with the PMHNP, he reports positive responses to
the medication, stating, “I really feel as though the effects of my
depression are going away.” Which receptor action in antipsychotic
medications is believed to be the most beneficial in producing the
effects described by Mr. Gordon?
Selected
Answer:
D.
D2 partial
agonist
Question 25
1 out of 1 points
The PMHNP understands that which mechanism contributes to a
worse tolerability profile for patients taking tricyclic
antidepressants (TCAs)?
Selected
Answer:
B.
Muscarinic M1 receptor blockade causes
blurred vision.
Question 26
1 out of 1 points
The PMHNP is assessing a client in the emergency room. The client shares that he
has been on lithium for many years. What blood test does the PMHNP order?
Selected
Answer:
A.
Thyroid Stimulating Hormone
Question 27
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).
Selected
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 28
1 out of 1 points
Mrs. Trevor is a 44-year-old patient who does not have a diagnosisof schizophrenia but occasionally reports symptoms of psychosis,
followed by severe fatigue. Mrs. Trevor inquires about the use of
amphetamines to help with her energy levels. Which response
made by the PMHNP is most appropriate?
Selected
Answer:
C.
“Amphetamines can cause hallucinations, so I would
advise against this type of prescription.”
Question 29
1 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:
Selected
Answer:
C.
Decrease the amount prescribed for aripiprazole
(Abilify)
Question 30
1 out of 1 points
A 25-year-old female patient is being prescribed milnacipran to
treat fibromyalgia, and expresses concern regarding “how she will
feel and look” from taking the medicine. Which statement correctly
describes the side effects as a result of taking this medication?
Selected
Answer:
D.
Weight gain is
unusual.
Question 31
1 out of 1 points
What is accurate about the clinical description of psychosis?
Selected
Answer:
C.
It is a syndrome that can be associated with a number of psychiatric
disorders.
Question 32
1 out of 1 points
The nurse education knows that teaching was effective when one of the
students compares fluvoxamine to sertraline and notes which of the following
similarities?Selected
Answer:
D.
Both have actions at sigma receptors which contribute to both
anxiolytic and antipsychotic effects.
Question 33
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:
Selected
Answer:
A.
The patient smokes
cigarettes.
Question 34
1 out of 1 points
Mr. Gutier is 72 years old with anxiety and depressive symptoms.
His PMHNP is prescribing lorazepam (Ativan). What does the
PMHNP understand regarding this prescription?
Selected
Answer:
A.
The PMHNP will prescribe less than 2-6 mg for Mr.
Gutier to take daily.
Question 35
1 out of 1 points
A patient diagnosed with PTSD is prescribed propranolol (Inderal)
and the PMHNP understands that he was prescribed this
medication for what purpose:
Selected
Answer:
B.
Beta blockers are linked to
reconsolidation.
Question 36
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?
Selected
Answer:
A.
Review Amitriptyline (Elavil)level Question 37 1 out of 1 points
Which statement made by the PMHNP exemplifies correct teaching of physiological effects in the body?
Selected Answer:
D.
D2 partial agonists are associated with increased efficacy in treating positive symptoms of schizophrenia.
Question 38 0 out of 1 points
During assessment a patient states “Why are you asking me about my heart, I am here for my head”, the PMHNP’s best response is:
Selected Answer:
A. “Some medications can cause heart issues so it is
necessary to rule those out before you begin medication.”
Question 39 1 out of 1 points
Mrs. Schwartzman is a 52-year-old patient with schizophrenia and no established history of depression. When meeting with the PMHNP, she presents with apathy and withdrawn social behavior, and she reports a loss of joy from enjoyable activities. What does the PMHNP infer from this encounter with the patient?
Selected Answer:
B. The recent change of a 2nd generation antipsychotic to a conventional one
Question 40 1 out of 1 points
The PMHNP is meeting with a new mother who would like to begin taking medication again to treat her bipolar depression; she is breastfeeding her 2-month old daughter. The PMHNP recognizes that which of the following medications is contraindicated for this client?
Selected Answer:
C. [Show Less]