NURS 6630 Midterm Exam Guide
QUESTION 1
1. A noncompliant patient states, "Why do you want me to put this poison in my body?" Identify the best
... [Show More] 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 drug-induced 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
1 points
QUESTION 14
1. The PMHNP is caring for four patients. Which patient statement indicates that benzodiazepines would be beneficial?
A.
"I have trouble staying asleep in the middle of the night."
B.
"My spouse told me that I seem to have trouble remembering things sometimes."
C.
"I really want to stop smoking, but the cravings are too strong."
D.
"I feel nervous to go outside and be in large crowds."
1 points
QUESTION 15
1. Ms. Harlow is a 42-year-old patient who is prescribed a drug that acts on ionotropic receptors. She is curious about the effects of the drug and how it will act on her symptoms. Which statement made by the PMHNP demonstrates proper understanding of Ms. Harlow's prescription?
A.
"The drug will have an almost immediate effect."
B.
"The drug can take a while to build up in your system."
C.
"The drug is slow to release but lasts for a long time."
D.
"The drug will make a subtle difference in your symptoms."
1 points
QUESTION 16
1. A patient is seeking pharmacological treatment for smoking cessation. Which drug class does the PMHNP prescribe to the patient?
A.
Benzodiazepine
B.
Mirtazapine (Remeron)
C.
Ketamine
D.
Varenicline (Chantix)
1 points
QUESTION 17
1. The PMHNP is caring for a new patient who has been transferred from another office. When meeting with the new patient, the patient reports, "I feel like I am improving with the stabilizers." The PMHNP immediately recognizes that the patient is describing which kind of drug?
A.
Full agonists
B.
Antagonists
C.
Partial agonists
D.
Inverse agonists
1 points
QUESTION 18
1. A patient presents with frequent episodes of mania. Which statement describes an appropriate treatment approach for this patient?
A.
"The patient needs to have an inverse agonist."
B.
"The patient could benefit from an anticonvulsant."
C.
"The patient's calcium, sodium, chloride, and potassium levels must be regulated."
D.
"The patient should have a drug that acts on ligand-gated ion channels."
1 points
QUESTION 19
1. The PHMNP is caring for a patient who would benefit from nicotine cholinergic, serotonin 3, or glycine receptors. What kind of agent does the PHMNP want to prescribe for this patient?
A.
Ligand-gated ion channels with a pentameric structure
B.
Ligand-gated ion channels with a tetrameric structure
C.
Voltage-sensitive ion channels
D.
Anticonvulsants
1 points
QUESTION 20 ?
1. Which statement made by the patient suggests the patient will need to be treated with antipsychotics that target paranoid psychosis?
A.
"It's my fault that all of this is happening. I don't think I could ever forgive myself." Not correct
B.
"I have to talk to the President because I'm the only one who can help him."
C.
"I'm not sure why that lady is wearing a red jacket since it's the dogs who need food."
D.
"I don't know that I even want to go to that meeting. It doesn't seem worth it anymore."
1 points
QUESTION 21
1. A patient has been treated with a number of novel psychotropic drugs. How is it theoretically possible to identify cognitive improvement in the patient using neuropsychological assessment batteries after the pharmacologic therapy? I did not have this question
A.
Obtaining raw normative metrics and using them to assess functionality
B.
Having the patient report on cognitive function based on personal experiences
C.
Monitoring the patient in a controlled setting
D.
Measuring symptoms of psychosis
1 points
QUESTION 22
1. Mr. McCullin is 64 years old with Parkinson's disease. The PMHNP caring for Mr. McCullin wants to start him on a dopamine agonist to help manage and treat his condition. The PHMNP selects this agent because of which action it has on patients like Mr. McCullin?
A.
Dopamine is terminated through multiple mechanisms.
B.
The D2 autoreceptor regulates release of dopamine from the presynaptic neuron.
C.
MAO-B presents in the mitochondria within the presynaptic neuron.
D.
D2 receptors are the primary binding site for dopamine agonists. Correct answer
1 points
QUESTION 23
1. Mrs. Trevor is a 44-year-old patient who does not have a diagnosis of 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?
A.
"Amphetamines may help you, as they can alleviate psychotic conditions."
B.
"Amphetamines can inhibit negative symptoms of schizophrenia, so this might be a good choice for you."
C.
"Amphetamines can cause hallucinations, so I would advise against this type of prescription."Correct
D.
"Amphetamines can lead to a dopamine deficiency, so I will not prescribe this for you."
1 points
QUESTION 24
1. 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?
A.
Blocking the release of dopamine facilitates the onset of positive schizophrenia symptoms.
B.
Hyperactivity in the mesolimbic dopamine pathway mediates the positive symptoms of schizophrenia.
C.
Antipsychotic drugs that open D2 receptor pathways can treat schizophrenia.
D.
The neuroanatomy of dopamine neuronal pathways can explain symptoms of schizophrenia.
1 points
QUESTION 25
1. A patient is diagnosed with schizophrenia. What increases the patient's potential to mediate the cognitive symptoms of the disease?
A.
Achieving underactivity of the mesocorticol projections to the prefrontal cortex
B.
Achieving overactivity of the mesocorticol projections to the ventromedial prefrontal cortex
C.
Achieving underactivity of the mesocortical projections to the ventromedial prefrontal cortex
D.
Achieving overactivity of the mesocorticol projections to the prefrontal cortex
1 points
QUESTION 26
1. The PMNHP is assessing a 29-year-old patient who takes antipsychotics that block D2 receptors. What patient teaching should the PMHNP include related to the possible side effects of this type of drug?
A.
Hypersexuality
B.
Amenorrhea
C.
Dystonia
D.
Tardive dyskinesia correct answer
A.
1 points
• Question 15
1 out of 1 points
Ms. Harlow is a 42-year-old patient who is prescribed a drug that acts on ionotropic receptors. She is curious about the effects of the drug and how it will act on her symptoms. Which statement made by the PMHNP demonstrates proper understanding of Ms. Harlow’s prescription?
Selected Answer: A.
“The drug will have an almost immediate effect.”
• Question 16
0 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: C.
Ketamine
• Question 17
0 out of 1 points
The PMHNP is caring for a new patient who has been transferred from another office. When meeting with the new patient, the patient reports, “I feel like I am improving with the stabilizers.” The PMHNP immediately recognizes that the patient is describing which kind of drug?
Selected Answer: B.
Antagonists
• Question 18
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 19
1 out of 1 points
The PHMNP is caring for a patient who would benefit from nicotine cholinergic, serotonin 3, or glycine receptors. What kind of agent does the PHMNP want to prescribe for this patient?
Selected Answer: A.
Ligand-gated ion channels with a pentameric structure
• Question 20
0 out of 1 points
Which statement made by the patient suggests the patient will need to be treated with antipsychotics that target paranoid psychosis?
Selected Answer: D.
“I don’t know that I even want to go to that meeting. It doesn’t seem worth it anymore.”
• Question 21
1 out of 1 points
A patient has been treated with a number of novel psychotropic drugs. How is it theoretically possible to identify cognitive improvement in the patient using neuropsychological assessment batteries after the pharmacologic therapy?
Selected Answer: A.
Obtaining raw normative metrics and using them to assess functionality
• Question 22
0 out of 1 points
Mr. McCullin is 64 years old with Parkinson’s disease. The PMHNP caring for Mr. McCullin wants to start him on a dopamine agonist to help manage and treat his condition. The PHMNP selects this agent because of which action it has on patients like Mr. McCullin?
Selected Answer: C.
MAO-B presents in the mitochondria within the presynaptic neuron.
• Question 23
0 out of 1 points
Mrs. Trevor is a 44-year-old patient who does not have a diagnosis of 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: D.
“Amphetamines can lead to a dopamine deficiency, so I will not prescribe this for you.”
• Question 24
0 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: A.
Blocking the release of dopamine facilitates the onset of positive schizophrenia symptoms.
• Question 25
1 out of 1 points
A patient is diagnosed with schizophrenia. What increases the patient’s potential to mediate the cognitive symptoms of the disease?
Selected Answer: D.
Achieving overactivity of the mesocorticol projections to the prefrontal cortex
• Question 26
1 out of 1 points
The PMNHP is assessing a 29-year-old patient who takes antipsychotics that block D2 receptors. What patient teaching should the PMHNP include related to the possible side effects of this type of drug?
Selected Answer: C.
Dystonia
• Question 27
0 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. Which of the following requires the longest transition time for therapeutic benefit?
Selected Answer: C.
Aripripazole to ziprasidone
• Question 28
0 out of 1 points
The PMHNP is assessing a patient who has cirrhosis of the liver and anticipates that the patient will be prescribed an antipsychotic. Which medication does the PMHNP suspect will be ordered for this patient?
Selected Answer: D.
Clozapine
• Question 29
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 30
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: D.
All of the above
• Question 31
0 out of 1 points
The PMHNP is taking a history on a patient who has been on antipsychotics for many years. Which risk factors are most likely to contribute to a person developing tardive dyskinesia (TD)?
Selected Answer: D.
A and C
• Question 32
0 out of 1 points
The student inquires about antipsychotic medications. Which response by the PMHNP describes the factors that contribute to reduced risk of extrapyramidal symptoms (EPS) for patients who take antipsychotics?
Selected Answer: D.
Potent D2 antagonists that block the muscarinic anti-M1 cholinergic receptors
• Question 33
1 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: B.
D2 antagonism
• Question 34
1 out of 1 points
A patient who was recently admitted to the psychiatric nursing unit is being treated for bipolar disorder. Which neurotransmitter is the PMHNP most likely to target with pharmaceuticals?
Selected Answer: E.
All of the above
• Question 35
1 out of 1 points
Ms. Ryerson is a 28-year-old patient with a mood disorder. She recently requested to transfer to a new PMHNP, after not getting along well with her previous provider. The new PHMNP is reviewing Ms. Ryerson’s medical chart prior to their first appointment. Upon review, the PMHNP sees that the former provider last documented “patient had rapid poop out.” What does the PMHNP infer about the patient’s prescription based on this documentation?
Selected Answer: A.
The patient has an unsustained response to antidepressants.
• Question 36
1 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 37
1 out of 1 points
Why does the PMHNP avoid treating a patient with cyclothymia, and has major depressive episodes, with antidepressant monotherapy?
Selected Answer: D.
The patient may experience increased mood cycling.
• Question 38
1 out of 1 points
The PMHNP is caring for a patient with the s genotype of SERT. What does the PMHNP understand regarding this patient’s response to selective serotonin reuptake inhibitor (SSRI)/SNRI treatment?
Selected Answer: D.
The patient may be less responsive or tolerant to the treatment.
• Question 39
0 out of 1 points
Ms. Boeckh is a 42-year-old patient with major depression. The PMHNP understands that which action of norepinephrine will affect Ms. Boeckh’s serotonin levels?
Selected Answer: D.
Norepinephrine potentiates 5HT release through a1 and a2 receptors.
• Question 40
0 out of 1 points
Which statement made by the PMHNP correctly describes the relationship between NE neurons and pharmaceutical treatment?
Selected Answer: A.
“Drugs inhibit the release of NE.”
• Question 41
1 out of 1 points
The PMHNP is assessing a patient in the psychiatric emergency room. The patient tells the PMHNP that he does not understand why his depression has not lifted after being on four different antidepressants over the course of a year. Which of the following symptoms can be residual symptoms for patients who do not achieve remission with major depressive disorder?
Selected Answer: D.
A and C
• Question 42
0 out of 1 points
Fluoxetine (Prozac) has been prescribed for a patient. Which of the following statements is true regarding the action of this medication?
Selected Answer: C.
Upon the acute administration of a SSRI, 5HT decreases.
• Question 43
1 out of 1 points
The nurse educator 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 are known for causing severe withdrawal symptoms such as dizziness, restlessness, and akathisia.
• Question 44
1 out of 1 points
A 45-year-old female patient with allergic rhinitis and normal blood pressure has had no reduction in depressive symptoms after trying bupropion, paroxetine, and venlafaxine. What precautions are needed in considering monoamine oxidase inhibitors (MAOI) in treating her depression?
Selected Answer: D.
The patient will need to minimize dietary intake of foods such as tap and unpasteurized beer, aged cheeses, and soy products/tofu.
• Question 45
1 out of 1 points
After sitting in on an interdisciplinary treatment team meeting, the student nurse asks the instructor to explain a system-based approach to the treatment of depression. What is the appropriate response?
Selected Answer: D.
All of the above.
• Question 46
0 out of 1 points
A 51-year-old female patient presents with symptoms of depression, including lack of motivation and difficulty sleeping. What risk factors would increase her vulnerability for a diagnosis of depression?
Selected Answer: C.
Premenstrual syndrome
• Question 47
1 out of 1 points
A nurse overhears that a patient has failed single therapy with an SSRI and SNRI. She also learns that the patient has been on dual SSRI/SNRI therapy without adequate symptom control. She approaches the PMHNP and asks what the next treatment option could be in this seemingly treatment-resistant patient. The PMHNP tells the nurse she will treat the patient with the following regimen:
Selected Answer: B.
SSRI/SNRI plus NDRI
• Question 48
0 out of 1 points
Mrs. Radcliff is a 42-year-old patient who is considering stopping paroxetine. Why does her PMHNP advise against this abrupt discontinuation of the medicine?
Selected Answer: B.
She may experience increased trauma.
• Question 49
1 out of 1 points
A patient is prescribed fluoxetine but is concerned about the side effects. Which statement demonstrates accurate patient teaching when discussing the side effects associated with fluoxetine?
Selected Answer: C.
Induction of mania is rare.
• Question 50
0 out of 1 points
The PMHNP is caring for a patient with anxiety who develops mild to moderate hepatic impairment. Which action does the PMHNP take regarding the use of venlafaxine?
Selected Answer: C.
Lower the dose of venlafaxine by 25–40%
• Question 51
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 52
1 out of 1 points
Mr. Ruby is a 33-year-old single father who is requesting pharmacological intervention to treat his fibromyalgia. The PMHNP sees in the medical chart that he has a recent diagnosis of arrhythmia and a BMI of 29. During his assessment, the PMHNP learns that Mr. Ruby works 40–50 hours a week as a contractor and “manages his stress” by smoking 3–4 cigarettes a day and having 8–10 drinks of alcohol each week. Why would duloxetine be contraindicated for Mr. Ruby?
Selected Answer: C.
He uses alcohol.
• Question 53
1 out of 1 points
A patient is prescribed sertraline to treat panic disorder. Knowing that sertraline can initially cause anxiety or insomnia, what should the PMHNP do?
Selected Answer: B.
Prescribe short-acting benzodiazepine for 2 weeks, then discontinue.
• Question 54
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 55
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 56
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 57
0 out of 1 points
A patient who is prescribed MAO inhibitors asks about whether he can continue taking pseudoephedrine to relieve his congestion. Which response by the PMHNP indicates proper understanding of drug-drug interactions?
Selected Answer: B.
“Decongestants are okay to take with MAO inhibitors in moderation.”
• Question 58
1 out of 1 points
Ms. Skidmore presents for a follow-up appointment after being prescribed phenelzine (Nardil), and reports “I take my 45 mg pill, three times a day, just like I’m supposed to.” What does the PMHNP understand about this patient?
Selected Answer: C.
Ms. Skidmore is taking too much of the phenelzine (Nardil); she should be taking the 45 mg in three doses.
• Question 59
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 60
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 61
0 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: C.
alprazolam (Xanax)
• Question 62
1 out of 1 points
A patient who was diagnosed with bipolar disorder without mania, asks the PMHNP why he is being prescribed a mood stabilizer. What is the appropriate response?
Selected Answer: C.
Mood stabilizers can target mania and mania relapse and also reduce symptoms of bipolar depression and relapse of bipolar depression symptoms but no drug has been proven to target all four therapeutic actions
• Question 63
1 out of 1 points
The PMHNP is assessing a patient in the emergency room. The patient shares that he has been on lithium (Lithobid) for many years. What blood tests does the PMHMP order?
Selected Answer: A.
Thyroid Stimulating Hormone (TSH)
• Question 64
0 out of 1 points
A 39-year old female patient presently on lithium would like to try a new medication to treat her bipolar disorder. She has had concerns about side effects from lithium and wants to learn more about Lamotrigine (Lamictal) as a treatment option. The PMHNP conveys some of the unique aspects of this agent, including which of the following?
Selected Answer: D.
There is a risk for amenorrhea and polycystic ovarian disease in women of childbearing age
• Question 65
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 66
1 out of 1 points
A 46-year old male patient mentions several alternative treatments to Carbamazepine (Tegretol) as a way to manage symptoms of his bipolar depression. Which of the following does the PMHNP indicate would not be an agent to treat bipolar depression?
Selected Answer: B.
Soybean lecithin
• Question 67
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 patient?
Selected Answer: C.
Lithium (Lithobid)
• Question 68
1 out of 1 points
The PMHNP assesses a 10-year old male child in the ER and suspects mania. Which of the following symptoms and recommendations for follow-up evaluation are appropriate?
Selected Answer: B.
Irritability, violent outbursts, hyperactivity; the child should also be evaluated further for ADHD
• Question 69
0 out of 1 points
A patient was diagnosed with GAD 4 weeks ago and was placed on Clonazepam (klonopin) twice a day and citalopram (citalopram (celexa)) once daily. When he asks the PMHNP why it is necessary to wean him off of the Clonazepam (klonopin) the best response is:
Selected Answer: B.
Clonazepam (klonopin) is not recommended for long term use due to possible sedation
• Question 70
1 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 71
1 out of 1 points
The PMHNP understands that the potential of alcohol abuse in the anxious patient is higher for the following reason:
Selected Answer: D.
Alcohol increases serotonin at the synapse and the patient may temporarily feel happy
• Question 72
1 out of 1 points
After ordering flumazenil (Rumazicon) the PMHNP cautions the staff to monitor for which possible effect?
Selected Answer: c.
Sweating and nausea
• Question 73
1 out of 1 points
A patient is prescribed escitalopram (Lexapro) for his anxiety. When he asks why he was given an antidepressant the PMHNP’s best response is:
Selected Answer: A.
“SSRIs are used to treat anxiety because serotonin has been proven to help with feelings of fear and worry.”
• Question 74
0 out of 1 points
The PMHNP evaluates the patient for “fear conditioning” when he asks:
Selected Answer: B.
What do you do when you feel fear?
• Question 75
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. [Show Less]