NURS6630 Week 11 Final Exam Latest 2021 April

NURS6630 Week 11 Final Exam 

•  Question 1 Patient is a 10-year-old female with diagnosed ADHD who was started on Ritalin 5 mg twice a day over 2 months ago. She is still experiencing the triad of symptoms associated with ADHD (impaired attention, impulsivity, and excessive motor activity). Her mother reports that she is now having difficulty in falling asleep since starting the medication. She has been on no other anti-ADHD medications and the mother reports full compliance with medication regimen. What is the appropriate recommendation to make based on this scenario?                                     

•  Question 2 Drug addiction includes many prescription medications and illegal substances. Of the drugs listed, which ones can be withdrawn abruptly WITHOUT medical intervention to prevent withdraw seizures?                          

•  Question 3 Which medication below would you use in addition to benzodiazepine treatment if the patient is experiencing psychosis during alcohol withdrawal delirium?

•  Question 4 Select all the criteria for what is considered “At-Risk Drinking.”

I.             Women: > 7 drinks in any given week

II.            Men: > 4 drinks per day

III.           Women: > 4 drinks per day

IV.          Men: > 14 drinks per week         

•  Question 5 Of the following neurotransmitters, which one(s) are known to be severely disrupted in the disease Dementia with Lewy Bodies?

V.            Acetylcholine

VI.          Glutamate

VII.         Dopamine

VIII.        GABA

IX.           Norepinephrine                              

•  Question 6 A new patient presents to your clinic today. The patient is a 13-year-old boy who complains that he has no interest in anything. The patient states, “I just want to sleep more than I normally do, and I don’t care much for playing my video games anymore.” His mother states he cannot focus on anything for more than a few minutes at a time, and that he often gets in trouble at school because he cannot sit still. What would you recommend at this time?                      

•  Question 7 What should our treatment goal be with our patients when it comes to managing chronic pain?    

•  Question 8 In the pathophysiology of Alzheimer’s Disease, there are certain proteins that lead to the plaques and tangles that result in this progressive, irreversible brain disorder. Choose the appropriate protein with its corresponding pathology.

X.            Tau – tangles

XI.           Beta-amyloid – tangles

XII.         Tau – plaques

XIII.        Beta-amyloid – plaques               

•  Question 9 Which of the following alcohol screening tools lack sensitivity to detect hazardous/problem drinking?        

•  Question 10 SSRIs can be used in alcohol use disorder and offer modest drinking reduction through an anti-craving effect. 

•  Question 11 Of the following neurotransmitters, which ones play a critical role in modulating attention in ADHD?

XIV.        Dopamine

XV.         Epinephrine

XVI.        GABA

XVII.      Norepinephrine

XVIII.     Glutamate         

•  Question 12 Select the correct description of a somatoform disorder.               

•  Question 13 Which club drug is structurally similar to GABA?  

•  Question 14 The patient is a 16-year-old girl with a past history of substance use disorder. She has been known to abuse prescription opioids and smokes one pack of cigarettes every day. She has been in and out of recovery for the past year. During her last admission into a recovery center, she was diagnosed with ADHD, which may have contributed to her addictive personality. She presents to your clinic today to initiate pharmacotherapy for her new diagnosis. What would you recommend in this patient? Her current weight is 55 kg.               

•  Question 15 Which of the following drugs in the treatment of Alzheimer’s Disease requires administration with food?                               

•  Question 16 Patient is a 75-year-old female with a confirmed diagnosis of Alzheimer’s Disease. She is currently on Donepezil 10 mg daily. She is accompanied to your clinic today by her daughter, who informs you that her mother has recently had an increase in depressive symptoms. She has no history of mood disorders. She has a history of hypertension and tonic-clonic seizures, but both are controlled. Assuming this patient will be thoroughly evaluated for the diagnosis of depression, what would you recommend as initial therapy?                       

•  Question 17 What baseline levels should you perform before initiating an anti-ADHD medication?                      

•  Question 18 Of the axons involved in the transmission of pain, which one is thinly myelinated and conducts that first feeling of pain that is often felt as coming on as a sharp, rapid feeling?  

•  Question 19 Which of the following drugs in the treatment of Alzheimer’s Disease helps normalize glutamate by antagonizing the NMDA receptor?                                          

•  Question 20 Of the following medications, which one is contraindicated with stimulants such as Ritalin or Adderall?                                                     

•  Question 21 L. J. is a 55-year-old male who attended a funeral and found himself laughing during the service, but later that evening he was irritated with himself for what he had done. His wife said this was abnormal behavior and took him to his doctor to be evaluated. After L. J.’s MRI was reviewed, he was diagnosed with frontotemporal dementia. Which medication is recommended to help L. J. with his emotional outbursts?                

•  Question 22 Which neurotransmitters are likely involved in the pathophysiology of withdrawal seizures?

XIX.        Serotonin

XX.         Endorphins

XXI.        Glutamate

XXII.       GABA

XXIII.     Dopamine          

•  Question 23 If a patient suffers from a multitude of small strokes and later begins experiencing mood disturbances in an acute fashion that sometimes resolve, from what type of dementia would you think that patient may suffer?

•  Question 24 Y. R. is a 35-year-old woman who presents to your clinic today complaining of ankle pain. She said she was running the trail when she saw a snake. During a quick turn to run away from the snake, she twisted her ankle. Which of the following medications may be a good choice in helping Y. R. with her pain?  

•  Question 25 Which of the following drugs is often used in the management of opioid addiction due to its ceiling effect?                               

•  Question 26 Which features are consistent with delirium?

XXIV.     Acute onset

XXV.      Gradual onset

XXVI.     Course of disease fluctuates

XXVII.    Course of diseases does not fluctuate

XXVIII.  Impaired attention

XXIX.     Normal attention            

•  Question 27 T. C. is an 88-year-old male who is diagnosed at your clinic with Dementia with Lewy Bodies. He currently has some debilitating gait issues, which makes his quality of life very poor. His memory is still intact with minor deficits. Which medication would likely benefit T. C. as his initial therapy?                           

•  Question 28 A 59-year-old male has been admitted to the E. D. due to a methamphetamine overdose. The patient’s friend reported he ingested up to 2 grams because “he thought cops were coming to get him.” The patient’s vitals are all within normal limits, except his blood pressure is 180/110. What is the best recommendation to make at this time?        

•  Question 29 This medication cannot be used for more than 5 days, it is a non-steroidal, anti-inflammatory drug, and it is often substituted for morphine due to its rapid onset and high potency. What is this medication?            

•  Question 30 Which of the following psychiatric conditions is present in both domains (i.e., core psychopathology & pain-related psychological symptoms) of chronic pain that will likely lead to an outcome of disability, pain, and poor quality of life?                      

•  Question 31 T. K. is a 72-year-old female who has suffered many strokes in the past, likely due to uncontrolled hypertension and hyperlipidemia. She has now been diagnosed with vascular dementia due to memory loss and motor system slowing. What is the recommended treatment for T. K.?              

•  Question 32 E. B., a 55-year-old female, is a patient at your clinic today who has a past medical history significant for breast cancer, hypertension, hepatic cirrhosis, type 2 diabetes, and a recent diagnosis of alcohol use disorder. She has no known drug allergies. She states she is ready to quit drinking but fears the cravings that it may bring. Which medication would you recommend for E. B. to begin?           

•  Question 33 FILL IN THE BLANK: ___________ is the main neurotransmitter behind reward systems in the brain, which usually leads to addiction when altered in any way.        

•  Question 34 Choose the correct statement regarding an anti-ADHD medication and its respectful mechanism of action                               

•  Question 35 Which medication below should be routine for all suspected cases of alcohol intoxication and dependence?                               

•  Question 36 Daytrana is the MPH transdermal system of methylphenidate approved for the treatment of ADHD in children aged 6 years and older. What is the difference in terms of the metabolism compared to the other formulations in this class?           

•  Question 37 The experience of pain is ALWAYS subjective

•  Question 38 Which of the following drugs is structurally similar to tramadol; thus, its opioid-mediated analgesia can be reversed by naloxone in mice? 

•  Question 39 Choose the correct statement regarding medications used for alcoholism              

•  Question 40 When can buprenorphine be initiated in a patient who is suffering from an opioid overdose?      

•  Question 41 Which medication is a selective alpha-adrenergic agonist that works by mimicking norepinephrine binding in the pre-frontal cortex, which makes it particularly useful in the treatment of ADHD?      

•  Question 42 What is the difference between Ritalin and Focalin?         

•  Question 43 Disorientation, tremor, hyperactivity, fever, hallucinations, marked wakefulness, and increased autonomic tone are all features that are consistent with which part of alcohol withdrawal?

•  Question 44 If a patient is being managed for chronic pain and is not getting better after months of therapy with multiple agents (i.e., NSAIDs with opioids, muscle relaxants with NSAIDs, etc.), what should be your next step in helping the patient?

XXX.       Add a high-dose opioid if patient is not already on the maximum dose.

XXXI.     Assess for a co-morbid psychiatric condition.

XXXII.    Tell the patient you have exhausted all your options and there is nothing more you can do.

XXXIII.   Refer the patient for a second opinion.                                

•  Question 45 Which of the following is the only Black Box Warning associated with the medication atomoxetine?

•  Question 46 Select the correct treatment regarding drugs involved in addiction management and their corresponding mechanism of action.    

•  Question 47 Which medication(s) requires a test dose to determine accurate use of the drug (i.e., how addicted the patient truly is on a certain drug) before beginning a titration schedule to withdrawal the patient?

XXXIV.  Butalbital

XXXV.    Lorazepam

XXXVI.  Hydrocodone                                   

•  Question 48 Disulfiram has been proven effective in the treatment of alcoholism, but recently it has been trialed in the management of cocaine addiction. What is the mechanism of action that likely helps produce these aversive effects?   

•  Question 49 There are many different types of dementia. Which dementia is NOT a direct result of disrupted neurotransmitters, but a result of degeneration of different regions in the brain? Onset of the disease is typically before the age of 60, and very rare after the age of 75.

•  Question 50 Benzodiazepines can be withdrawn abruptly despite duration of therapy/abuse.                                               

•  Question 51 When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?