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Timed Test This test has a time limit of 2 hours.You will be notified when
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13 minutes, 04 seconds.
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QUESTION 1
1. 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).
A.
“You have to take your medication to become stable.”
B. “ Medications work by increasing the types of neurotransmitters produced by the human brain.”
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 .”
D.
“Why do you believe that your medication is poison?”
1 points
QUESTION 2
1.
Ms. Hill is currently being treated for schizophrenia but has stopped taking
her medications due to some side effects she claims she was experiencing.
She presents to the clinic today with worsening symptoms. She is
experiencing anhedonia, agitation, attentional impairment, and affective
blunting. Which one of the symptoms mentioned is considered a positive
symptom of schizophrenia?
A.
Anhedonia
B.
Agitation
C.
Attentional Impairment
D.
Affective Blunting
1 points
QUESTION 3
1. Which statement about neurotransmitters and medications is true?
A.
Endorphins were discovered before morphine which lead to the use of the opioids for pain
control.
B.
Several psychiatric medications have been developed after discoveries of endogenous
neurotransmitters and defining their function in the brain. C.
Medications work by sending messages to neurotransmitters enabling them to work more
effectively.
D.
An imbalance of serotonin has been directly linked to depression. Following the discovery of this
neurotransmitter, pharmacologists were able to develop a well-known drug- Prozac as the first
medication used to restore the balance of serotonin.
1 points
QUESTION 4
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.
"More often than you would think, multiple medications should always be tried together to see
what happens.”
B. “Due to this being your first hospitalization after starting medication treatment for the first time
in your life, the only way to effectively manage your symptoms is by adding additional
medications in hopes that it will work for you."
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.”
D. “I understand your concerns. Often times, it is necessary to switch medications after short
periods of time to better manage your symptoms. We will discontinue your current regimen and
start another single drug agent.”
1 points
QUESTION 5
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.
D.
RNA polymerase must inhibit the process of changing RNA to
mRNA.
1 points
QUESTION 6
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 7
1. Though 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:
A.
Neurotransmission occurring along the axon is normally at a level to prevent symptoms of
mental illness and rarely require augmentation from medication therapy. B.
Neurotransmission is minimally affected by medication therapy when compared to the baseline
neurotransmitter release of a resting neuron. C.
Neurotransmitters can spread by diffusion.
D.
The post synaptic neuron can produce and release its’ own neurotransmitter allowing it to
function properly.
1 points
QUESTION 8
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.
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 9
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 10
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 11
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.
B.
The patient has hypertension.
C.
The patient has chronic kidney
disease, stage 2.
D The patient drinks a cup of coffee a
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