NURS 6630 Final exam psychopharmacology (GRADED A) Questions and Answer solutions | 100% Correct solutions.

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• Question 1 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 Ye Answer:... s • Question 2 1 out of 1 points The PMHNP understands that slow-dose extended release stimulants are most appropriate for which patient with ADHD? Selected Answer: c. 8-year-old patient • Question 3 1 out of 1 points Jordan is diagnosed with obsessive compulsive disorder. He has been trialed on several different SSRIs and is currently on high dose sertraline. He reports an inability to carry out responsibilities because of an obsession with handwashing. Which is the best treatment option for Jordan? Selected Answer: a. Maintain the same dose of sertraline and add quetiapine • Question 4 1 out of 1 points The PMHNP is discussing dopamine D2 receptor occupancy and its association with aggressive behaviors in patients with the student. Why does the PMHNP prescribe a standard dose of atypical antipsychotics? Selected Answer: c. The doses are based on achieving 60% D2 receptor occupancy. • Question 5 1 out of 1 points A 72-year-old male patient is in the early stages of Alzheimer’s disease. The PMHNP determines that improving memory is a key consideration in selecting a medication. Which of the following would be an appropriate choice? Selected Answer: c. All of these are correct • Question 6 1 out of 1 points A 71-year-old male patient comes to an appointment with his 65- year-old wife. They are both having concerns related to her memory and ability to recognize faces. The PMNHP is considering prescribing memantine (Namenda) based on the following symptoms: Selected Answer: c. Amnesia, apraxia, agnosia • Question 7 1 out of 1 points The PMHNP is working with the student to care for a patient with diabetic peripheral neuropathic pain. The student asks the PMHNP why SSRIs are not consistently useful in treating this particular patient’s pain. What is the best response by the PMHNP? Selected Answer: b. “SSRIs only increase serotonin levels.” • Question 8 1 out of 1 points The PMHNP is caring for a patient who openly admitted to drinking a quart of vodka daily. Prior to prescribing this patient disulfiram (Antabuse), it is important for the PMHNP to: Selected Answer: b. Evaluate the patient’s willingness to abstain from alcohol • Question 9 0 out of 1 points The PMHNP is meeting with the parents of an 8-year-old patient who is receiving an initial prescription for D-amphetamine. The PMHNP demonstrates appropriate prescribing practices when she prescribes the following dose: Selected Answer: a. The child will take 10–40 mg, daily. • Question 10 The PMHNP is assessing a patient who will be receiving 1 out of 1 points phentermine + topiramate combination (QSYMIA). QSYMIA would be contraindicated in which patient? Selected Answer: d. A 37-year-old female that is being treated with phenelzine • Question 11 0 out of 1 points Jacob is a 7-year-old pediatric patient who has significant oppositional symptoms associated with his ADHD diagnosis. What is the best treatment for this patient? Selected Answer: b. Prescribe a methylphenidate alone. • Question 12 1 out of 1 points The PMHNP is attempting to treat a patient’s chronic pain by having the agent bind the open channel conformation of VSCCs to block those channels with a “use-dependent” form of inhibition. Which agent will the PMHNP most likely select? Selected Answer: c. Pregabalin (Lyrica) • Question 13 1 out of 1 points An adult patient presents with a history of alcohol addiction and attention deficit hyperactivity disorder (ADHD). Given these comorbidities, the PMHNP determines which of the following medications may be the best treatment option? Selected Answer: c. Atomoxetine (Strattera) • Question 14 1 out of 1 points The PMHNP prescribes gabapentin (Neurontin) for a patient’s chronic pain. How does the PMHNP anticipate the drug to work? Selected Answer: b. It will bind to the alpha-2-delta ligand subunit of voltage-sensitive calcium channels. • Question 15 1 out of 1 points A PMHNP supervisor is discussing with a nursing student how stimulants and noradrenergic agents assist with ADHD symptoms. What is the appropriate response? Selected Answer: b. All of these are correct • Question 16 1 out of 1 points Kevin is an adolescent who has been diagnosed with kleptomania. His parents are interested in seeking pharmacological treatment. What does the PMHNP tell the parents regarding his treatment options? Selected Answer: a. “Naltrexone may be an appropriate option to discuss.” • Question 17 0 out of 1 points The PMHNP is caring for a patient with chronic insomnia. The PMHNP wishes to prescribe a drug with an ultra-short half-life. Which drug will the PMHNP prescribe? Selected a. Answer: Zolpidem CR (AMBIEN CR) • Question 18 1 out of 1 points The parents of a 10 year old girl diagnosed with ADHD ask if the PMHNP can prescribe something to help their daughter’s ADHD that is not a stimulant. Which of the following responses is correct? Selected Answer: c. "I can prescribe atomoxetine for your daughter. This medication help ADHD symptoms and is not considered a stimulant." • Question 19 1 out of 1 points Parents of a 12-year-old boy want to consider attention deficit hyperactivity disorder (ADHD) medication for their son. Which medication would the PMHNP start? Selected Answer: b. All of these could potentially treat their son’s symptoms. • Question 20 1 out of 1 points The PMHNP is performing a quality assurance peer review of the chart of another PMHNP. Upon review, the PMHNP reviews the chart of an older adult patient in long-term care facility who has chronic insomnia. The chart indicates that the patient has been receiving hypnotics on a nightly basis. What does the PMHNP find problematic about this documentation? Selected Answer: b. Hypnotics have prolonged half-lives that can cause drug accumulation in the elderly. • Question 21 0 out of 1 points The PMHNP evaluates a patient presenting with symptoms of dementia. Before the PMHNP considers treatment options, the patient must be assessed for other possible causes of dementia. Which of the following answers addresses both possible other causes of dementia and a rational treatment option for Dementia? Selected Answer: a. Possible other causes: hypothyroidism, adrenal insufficiency, niacin deficiency Possible treatment option: risperidone • Question 22 1 out of 1 points A patient calls the clinic to ask about an over-the-counter sleep aid. What is the best response? Selected Answer: c. "Certain first-generation antihistamines may be used to help you sleep." • Question 23 1 out of 1 points The PMHNP prescribed a patient lamotrigine (Lamictal), 25 mg by mouth daily, for nerve pain 6 months ago. The patient suddenly presents to the office with the complaint that the medication is no longer working and complains of increased pain. What action will the PMHNP most likely take? Selected Answer: a. Increase the dose of lamotrigine (Lamictal) to 25 mg twice daily. • Question 24 1 out of 1 points An 8-year-old patient presents with severe hyperactivity, described as “ants in his pants.” Based on self-report from the patient, his parents, and his teacher; attention deficit hyperactivity disorder (ADHD) is suspected. What medication is the PMNHP most likely to prescribe? Selected Answer: b. Methylphenidate (Ritalin, Concerta) • Question 25 1 out of 1 points Which patient will receive a lower dose of guanfacine? Selected Answer: b. Patient with kidney disease • Question 26 1 out of 1 points Which of the following is a true statement regarding the use of stimulants to treat attention deficit hyperactivity disorder (ADHD)? Selected Answer: b. Signal strength output is increased by dialing up the release of dopamine (DA) and norepinephrine (NE). • Question 27 1 out of 1 points A patient with gambling disorder and no other psychiatric comorbidities is being treated with pharmacological agents. Which drug is the PMHNP most likely to prescribe? Selected Answer: a. Naltrexo ne • Question 28 1 out of 1 points An interneuron is a neuron that has its cell body, dendrites, and axon within the spinal cord. The neuron can be considered excitatory if it contains or inhibitory if it contains . Selected Answer: b. Glutamate / GABA • Question 29 1 out of 1 points The PMHNP is caring for a patient with chronic insomnia who is worried about pharmacological treatment because the patient does not want to experience dependence. Which pharmacological treatment approach will the PMHNP likely select for this patient for a limited duration, while searching and correcting the underlying pathology associated with the insomnia? Selected Answer: d. Non-benzodiazepine hypnotics • Question 30 1 out of 1 points A patient is being prescribed bupropion and is concerned about the side effects. What will the PMHNP tell the patient regarding bupropion? Selected Answer: c. It can cause cardiac arrhythmias. • Question 31 1 out of 1 points The PMHNP wishes to prescribe a medication that reduces glutamate transmission in an Alzheimer's patient. Which medication should the PMHNP prescribe? Selected Answer: b. Memantine (NAMENDA) • Question 32 1 out of 1 points A 43-year-old male patient is seeking clarification about treating attention deficit hyperactivity disorder (ADHD) in adults and how it differs from treating children, since his son is on medication to treat ADHD. The PMHNP conveys a major difference is which of the following? Selected Answer: b. Comorbidities are more common in adults, impacting the prescription of additional agents. • Question 33 1 out of 1 points Karen completes the Epworth sleepiness scale and scores abnormally high. She is diagnosed with narcolepsy. The PMHNP prescribes a wake-promoting agent that is a weak dopamine transporter antagonist. Which medication did the PMHNP prescribe? Selected Answer: c. Modafanil (PROVIGIL) • Question 34 1 out of 1 points The PMHNP is assessing a 49-year-old male with a history of depression, post-traumatic stress disorder (PTSD), alcoholism with malnutrition, diabetes mellitus type 2, and hypertension. His physical assessment is unremarkable with the exception of peripheral edema bilaterally to his lower extremities and a chief complaint of pain with numbness and tingling to each leg 5/10. The PMHNP starts this patient on a low dose of doxepin (Sinequan). What is the next action that must be taken by the PMHNP? Selected Answer: a. Order liver function tests. • Question 35 1 out of 1 points The PMHNP is assessing a patient who has expressed suicidal intent and is now stating that he is hearing voices and sees people chasing him. The PMHNP identifies these symptoms to be associated with which of the following? Selected Answer: b. “Bath salt” intoxication • Question 36 Which of these statements is correct? 0 out of 1 points Selected Answer: d. Weight gain is common with aripiprazole (ABILIFY) • Question 37 1 out of 1 points A patient addicted to heroin is receiving treatment for detoxification. He begins to experience tachycardia, tremors, and diaphoresis. What medication will the PMHNP prescribe for this patient? Selected Answer: a. Clonidine (Catapres) • Question 38 1 out of 1 points A nursing student asks the PMHNP about the difference between the use of stimulants in the treatment of ADHD and the abuse of stimulants in substance-use disorders. Which is the correct response? Selected Answer: c. All of these are correct. • Question 39 1 out of 1 points A patient diagnosed with obsessive compulsive disorder has been taking a high-dose SSRI and is participating in therapy twice a week. He reports an inability to carry out responsibilities due to consistent interferences of his obsessions and compulsions. The PMHNP knows that the next step would be which of the following? Selected Answer: a. Decrease his SSRI and add buspirone (Buspar). • Question 40 1 out of 1 points You have been consulted to evaluate a patient who presents with symptoms of dementia. The patient is experiencing memory deficit, aphasia, apraxia, and agnosia. Which treatment option is best for this patient? Selected Answer: c. Donepezil (ARICEPT) • Question 41 1 out of 1 points A 26-year-old female patient with nicotine dependence and a history of anxiety presents with symptoms of attention deficit hyperactivity disorder (ADHD). Based on the assessment, what does the PMHNP consider? Selected Answer: b. ADHD is often not the focus of treatment in adults with comorbid conditions. • Question 42 1 out of 1 points Why does the PMHNP avoid prescribing clozapine (Clozaril) as a first-line treatment to the patient with psychosis and aggression? Selected Answer: c. There is too high a risk of serious adverse side effects. • Question 43 1 out of 1 points The PMHNP is caring for a patient with fibromyalgia. Which second-line treatment does the PMHNP select that may be effective for managing this patient’s pain? Selected Answer: b. Imipramine (Tofranil) • Question 44 1 out of 1 points The PMHNP understands that varenicline (CHANTIX) is an effective way to assist patients with smoking cessation. Why is this medication effective for these patients? Selected Answer: c. Varenicline is a selective nicotinic acetylcholine receptor partial agonist • Question 45 1 out of 1 points A nursing students asks the PMHNP the difference between impulsivity and compulsivity. Which of the following responses is correct? Selected Answer: d. Impulsivity is defined as acting without forethought and compulsivity is defined as actions that are inappropriate to the situation but persist. • Question 46 1 out of 1 points The PMHNP is assessing a patient who presents with elevated levels of brain amyloid as noted by positron emission tomography (PET). What other factors will the PMHNP consider before prescribing medication for this patient, and what medication would the PMHNP want to avoid given these other factors? Selected Answer: b. ApoE4 genotype and avoid antihistamines if possible and Type 2 diabetes and avoid olanzapine • Question 47 1 out of 1 points A patient addicted to heroin is receiving treatment for detoxification. He begins to experience autonomic hyperactivity during the drug withdrawal period. What medication will the PMHNP prescribe for this patient? Selected Answer: b. Clonidine (CATAPRES) • Question 48 1 out of 1 points Which of these characteristics does NOT meet the criteria for probably Alzheimer's dementia? Selected Answer: a. Sudden onset • Question 49 1 out of 1 points The PMHNP is assessing a female patient who has been taking lamotrigine (Lamictal) for migraine prophylaxis. After discovering that the patient has reached the maximum dose of this medication, the PMHNP decides to change the patient’s medication to zonisamide (Zonegran). In addition to evaluating this patient’s day-to-day activities, what should the PMHNP ensure that this patient understands? Selected Answer: a. This medication has unwanted side effects such as sedation, lack of coordination, and drowsiness. • Question 50 Even though both of these medications are useful in the 1 out of 1 points treatment of ADHD, their actions are different. Atomoxetine is a selective reuptake inhibitor, while bupropion is a selective reuptake inhibitor. Selected Answer: d. Norepinephrine / norepinephrine- dopamine • Question 51 1 out of 1 points A patient with irritable bowel syndrome reports chronic stomach pain. The PMHNP wants to prescribe the patient an agent that will cause irrelevant nociceptive inputs from the pain to be ignored and no longer perceived as painful. Which drug will the PMHNP prescribe? Selected Answer: c. Duloxetine (Cymbalta) • Question 52 1 out of 1 points The PMHNP is teaching a patient with a sleep disorder about taking diphenhydramine (Benadryl). The patient is concerned about the side effects of the drug. What can the PMHNP teach the patient about this treatment approach? Selected Answer: c. “It can cause blurred vision.” • Question 53 1 out of 1 points The PMHNP wants to prescribe Mr. Barber a mood stabilizer that will target aggressive and impulsive symptoms by decreasing dopaminergic neurotransmission. Which mood stabilizer will the PMHNP select? Selected Answer: b. Lithium (Lithane) • Question 54 0 out of 1 points A group of nursing students seeks further clarification from the PMHNP on how cholinesterase inhibitors are beneficial for Alzheimer’s disease patients. What is the appropriate response? Selected Answer: [None Given] • Question 55 1 out of 1 points The PMHNP prescribes an obese patient phentermine (Adipex- p)/topiramate ER (Topamax) (Qsymia), Why is topiramate (Topamax) often prescribed with phentermine (Adipex-P)? Selected Answer: c. Phentermine (Adipex-P) works by suppressing appetite while topiramate (Topamax) acts by inhibiting appetite. • Question 56 The PMHNP is treating a patient for fibromyalgia and is 1 out of 1 points considering prescribing milnacipran (Savella). When prescribing this medication, which action is the PMHNP likely to choose? Selected Answer: b. Split the daily dose into two doses after the first day. • Question 57 1 out of 1 points An opioid-naive patient is taking MS Contin (morphine sulfate) to treat his pain that is secondary to cancer. Under what circumstances would the PMHNP order naloxone (Narcan) IM/SQ? Selected Answer: c. The patient’s vital signs are 98.4F temp, 88 pulse, 104/62 blood pressure, and 8 respirations. • Question 58 1 out of 1 points The PMHNP prescribes pregabalin (LYRICA) for a patient with chronic pain. How does pregabalin work to reduce pain? Selected Answer: a. It will block excitatory neurotransmission by blocking voltage-sensitive calcium channels. • Question 59 1 out of 1 points All drugs that lead to addiction increase in the ventral striatum, which is also called the . Selected Answer: c. Dopamine / nucleus accumbens • Question 60 1 out of 1 points The novel neurotransmitter adenosine is responsible for the sleep- wake cycle by increasing throughout the day and diminishing during night. Which of the follow is an antagonist of adenosine? Selected Answer: b. Caffei ne • Question 61 0 out of 1 points A patient presents with psychotic aggression. Which treatment option is best for a patient presenting with psychotic aggression due to impaired top-down cortical control and excessive drive from striatal hyperactivity? Selected Answer: d. Antipsychoti cs • Question 62 1 out of 1 points Mrs. Rosen is a 49-year-old patient who is experiencing fibro-fog. What does the PMHNP prescribe for Mrs. Rosen to improve this condition? Selected Answer: b. All of these are correct • Question 63 1 out of 1 points Naltrexone (Revia), an opioid antagonist, is a medication that is used for which of the following conditions? Selected Answer: d. Alcoholis m • Question 64 0 out of 1 points Sandra complains of constipation after being on quetiapine (SEROQUEL) for several weeks. Constipation is likely caused by the binding of quetiapine (SEROQUEL) to which receptor? Selected Answer: d. 5HT2 A • Question 65 1 out of 1 points Neal is complaining of restless leg syndrome and insomnia. Which first-line medication should the PMHNP prescribe to treat both? Selected Answer: d. Ripinirole (REQUIP) • Question 66 0 out of 1 points A 9-year-old female patient presents with symptoms of both attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder. In evaluating her symptoms, the PMHNP determines that which of the following medications may be beneficial in augmenting stimulant medication? Selected Answer: c. Methylphenidate (Ritalin, Concerta) • Question 67 0 out of 1 points The PMHNP has been asked to provide an in-service training to include attention to the use of antipsychotics to treat Alzheimer’s. What does the PMHNP convey to staff? Selected Answer: a. A good option in treating agitation and psychosis in Alzheimer’s patients is haloperidol (Haldol). • Question 68 1 out of 1 points A 75-year-old male patient diagnosed with Alzheimer’s disease presents with agitation and aggressive behavior. The PMHNP determines which of the following to be the best treatment option? Selected Answer: b. Citalopram (Celexa) or Escitalopram (Lexapro) • Question 69 1 out of 1 points A patient on chronic opioids is currently on oxycodone ER (OxyContin). The PMHNP is consulted to treat underlying depression. Under which circumstance should the PMHNP order naloxone (NARCAN)? Selected Answer: a. The patient is somnolent and has 7 respirations per minute. • Question 70 1 out of 1 points A 63-year-old patient presents with the following symptoms. The PMHNP determines which set of symptoms warrant prescribing a medication? Select the answer that is matched with an appropriate treatment. Selected Answer: d. Impairment in the ability to learn and retain new information is most problematic, and an appropriate treatment option would be donepezil. • Question 71 1 out of 1 points The PMHNP is evaluating a 30-year-old female patient who states that she notices pain and a drastic change in mood before the start of her menstrual cycle. The patient states that she has tried diet and lifestyle changes but nothing has worked. What will the PMHNP most likely do? Selected Answer: d. Prescribe desvenlafaxine (Pristiq), 50 mg daily • Question 72 0 out of 1 points Harold complains of pain associated with his irritable bowel syndrome with constipation. The PMHNP decides to prescribe a medication that prevents pain signals from reaching the brain. Which agent does the PMHNP prescribe? Selected Answer: c. Venlafaxine (EFFEXOR) • Question 73 1 out of 1 points Brandon is a non-compliant patient that presents to the clinic asking for help with his alcohol dependence. The PMHNP evaluates the patient and determines a long-acting injection that blocks the mu-receptors would be the best treatment option for Brandon. Which medication should the PMHNP prescribe? Selected Answer: a. Naltrexone (VIVITROL) • Question 74 1 out of 1 points Mr. Peterson is meeting with the PMHNP to discuss healthier dietary habits. With a BMI of 33, Mr. Peterson is obese and needs to modify his food intake. “Sometimes I think I’m addicted to food the way some people are addicted to drugs,” he says. Which statement best describes the neurobiological parallels between food and drug addiction? Selected Answer: a. There is decreased activation of the prefrontal cortex. • Question 75 1 out of 1 points The nursing staff asks the PMHNP for additional education regarding the treatment of agitation in dementia patients. Which of the following is correct? Selected Answer: b. The nurse should attempt to determine how the patient's environment may be impacting the patient's mood. • Question 76 The PMHNP is teaching parents about their child’s new 1 out of 1 points prescription for Ritalin. What will the PMHNP include in the teaching? Selected Answer: a. The second dose should be taken at lunch. [Show More]

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