The PMHNP knows that the study of how the body absorbs, distributes, metabolizes, and excretes a medication is known as:
A. breakdown
B.
... [Show More] pharmacokinetics
C. pharmacodynamics
D. first-pass effect - B. pharmacokinetics
After the drug is absorbed the substrate binds to protein for transport. Which portion of the drug is available for therapeutic effects?
A. Bound
B. Unbound
C. Metabolized
D. Excreted - B. Unbound
A 19 y/o male is referred to the PMHNP by the student health office for alcohol use disorder. The patient states on one occasion that he passed out much sooner than usually would with far less then he would usually drink. Upon further interview, the patient reveals the time he passed out was during a fraternity hazing in which he was butt-chugging (receiving a beet and vodka enema). What pharmacokinetic process was bypassed by this rectal administration route?
A. Excretion
B. Absorption
C. Distribution
D. First-pass effect - D. First-pass effect
The PMHNP is monitoring a serum drug level for a medication with a 24 hour half life. How many hours will it take to reach steady state?
A. 48 hours
B. 72 hours
C. 96 hours
D. 120 hours - D. 120 hours
A patient with schizophrenia was discharged from the hospital on olanzapine 5 mg twice a day. he immediately resumed smoking cigarettes and escalated to one pack per day. Upon presenting for his 1-week follow-up appointment, the patient reports he is having trouble sleeping and the voices have started to return. which of the following actions should the PMHNP take?
A. Send the patient to the ED for stabilization
B. Change to another antipsychotic medication, and refer to a psychiatrist
C. Increase his olanzapine, and schedule for a follow-up visit in 2 days
D. Tell him to stop smoking and give him a nicotine patch - C. Increase his olanzapine, and schedule for a follow-up visit in 2 days
A patient who has been stable on quetiapine (Seroquel XR) for 3 months has decided to start to drink grapefruit juice twice daily because she has heard it helps with weight loss. She calls to report that since her new diet she has been feeling fatigued and difficulty waking up in the morning. What is the best response by the PMHNP?
A. "I will put in a new prescription for a lower dose of your medication"
B. "Stop drinking the grapefruit juice, and schedule an appointment to discuss the matter further"
C. "I will prescribe you a stimulant, and see you in 2 weeks"
D. "You should make an appointment with your primary care provider for evaluation" - B. "Stop drinking the grapefruit juice, and schedule an appointment to discuss the matter further"
A 79 y/o female with no past psychiatric history is admitted with new onset auditory hallucinations. The patient states her most bothersome symptom is the voices have kept her from sleeping through the night for the last 3 weeks, and as a result, she is tired and irritable. Which medication should the PMHNP order for bedtime for sleep?
A. Olanzapine 2.5mg PO
B. Lorazepam 1mg PO
C. Chlorpromazine 50mg PO
D. Sertraline 50 mg PO - A. Olanzapine 2.5mg PO
A 16 y/o male with history of smoking cigarettes and marijuana is being evaluated at the request of the school and parents. The child states the reason he smokes is it "helps calm him down" as he is anxious all the time. Which of the following medications would be the best choice?
A. Fluoxetine 20mg PO daily
B. Clonazepam 0.5mg PO daily
C. Vortioxetine 20mg daily
D. Citalopram 5mg PO daily - A. Fluoxetine 20mg PO daily
A patient has had a pharmacogenomic test which reveals he is an extensive metabolizer on CYP450, 1A2, 2D6, and 3A4. The PMHNP should prescribe:
A. A lower than usual dose
B. The usual dose
C. A higher than usual dose
D. A different medication - B. The usual dose
A woman in her 20th week of pregnancy has been resumed on lithium for bipolar disorder. The PMHNP knows that the patient may become subtherapeutic despite taking the medication as prescribed due to: [Show Less]