NURS-6630N-12,Approaches to Treatment.2020 Summer
Week 11 Final Exam
Question 1
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?
Question 2
Insomnia is caused by excessive nighttime arousal. The PMHNP is likely to prescribe which of the following to treat insomnia?
Question 3
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?
Question 4
Which of the following anticonvulsants increases serotonergic neurotransmission and GABAergic transmission, while decreasing glutamatergic neurotransmission?
Question 5
Alcohol enhances inhibition at ____________ synapses and reduces excitation at ______________ synapses.
Question 6
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?
Question 7
Naltrexone (Revia), an opioid antagonist, is a medication that is used for which of the following conditions?
Question 8
The PMHNP is treating a patient for fibromyalgia and is considering prescribing milnacipran (Savella). When prescribing this medication, which action is the PMHNP likely to choose?
Question 9
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?
Question 10
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?
Question 11
A patient calls the clinic to ask about an over-the-counter sleep aid. What is the best response?
Question 12
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)?
Question 13
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?
Question 14
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?
Question 15
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?
Question 16
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?
Question 17
An elderly woman with a history of Alzheimer’s disease, coronary artery disease, and myocardial infarction had a fall at home 3 months ago that resulted in her receiving an open reduction internal fixation. While assessing this patient, the PMHNP is made aware that the patient continues to experience mild to moderate pain. What is the PMHNP most likely to do?
Question 18
The PMHNP wishes to prescribe a medication that reduces glutamate transmission in an Alzheimer's patient. Which medication should the PMHNP prescribe?
Question 19
The PMHNP prescribes gabapentin (Neurontin) for a patient’s chronic pain. How does the PMHNP anticipate the drug to work?
Question 20
A patient is being prescribed bupropion and is concerned about the side effects. What will the PMHNP tell the patient regarding bupropion?
Question 21
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?
Question 22
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?
Question 23
Heather is admitted for opioid withdrawals and detoxification. The PMHNP decides to prescribe an alpha-2 adrenergic agonist to reduce the symptoms of autonomic hyperactivity during withdrawal and aid in the detoxification process. Which medication did the PMHNP prescribe?
Question 24
An 80-year-old female patient diagnosed with Stage II Alzheimer’s has a history of irritable bowel syndrome. Which cholinergic drug may be the best choice for treatment given the patient’s gastrointestinal problems?
Question 25
The PMHNP is caring for a patient with chronic insomnia who would benefit from taking hypnotics. The PMHNP wants to prescribe the patient a drug with an ultra-short half-life (1–3 hours). Which drug will the PMHNP prescribe?
Question 26
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?
Question 27
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?
Question 28
Which of these statements is correct?
Question 29
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:
Question 30
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:
Question 31
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?
Question 32
Why does the PMHNP avoid prescribing clozapine (Clozaril) as a first-line treatment to the patient with psychosis and aggression?
Question 33
Mike wants to quit smoking. He has tried nicotine replacement and varenicline without success. He has asked for another medication to help him kick his habit. The PMHNP decides to try a medication that increases dopamine by prescribing a medications that can increase both norepinephrine and dopamine. Which medication did the PMHNP prescribe?
Question 34
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?
Question 35
The PMHNP is assessing a patient who will be receiving phentermine + topiramate combination (QSYMIA). QSYMIA would be contraindicated in which patient?
Question 36
The PMHNP is caring for a patient who experiences too much overstimulation and anxiety during daytime hours. The patient agrees to a pharmacological treatment but states, “I don’t want to feel sedated or drowsy from the medicine.” Which decision made by the PMHNP demonstrates proper knowledge of this patient’s symptoms and appropriate treatment options?
Question 37
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?
Question 38
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?
Question 39
A nursing students asks the PMHNP the difference between impulsivity and compulsivity. Which of the following responses is correct?
Question 40
Which medication is an irreversible inhibitor of aldehyde dehydrogenase that creates a negative and aversive response following ingestion of alcohol?
Question 41
The PMHNP is caring for a patient who reports excessive arousal at nighttime. What could the PMHNP use for a time-limited duration to shift the patient’s brain from a hyperactive state to a sleep state?
Question 42
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?
Question 43
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?
Question 44
The PMHNP is teaching parents about their child’s new prescription for Ritalin. What will the PMHNP include in the teaching?
Question 45
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?
Question 46
Even though both of these medications are useful in the treatment of ADHD, their actions are different. Atomoxetine is a selective ______________________ reuptake inhibitor, while bupropion is a selective __________________ reuptake inhibitor.
Question 47
A patient with hypersexual disorder is being assessed for possible pharmacologic treatment. Why does the PMHNP prescribe an antiandrogen for this patient?
Question 48
The PMHNP is consulted to evaluate a patient in a long-term care facility that is having difficulties participating in group therapy each morning after breakfast. What is the likely cause of excessive daytime sleepiness?
Question 49
What will the PMHNP most likely prescribe to a patient with psychotic aggression who needs to manage the top-down cortical control and the excessive drive from striatal hyperactivity?
Question 50
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?
Question 51
Antipsychotics are doses at a level that blocks ________% of D2 receptors.
Question 52
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?
Question 53
The PMHNP understands that varenicline (CHANTIX) is an effective way to assist patients with smoking cessation. Why is this medication effective for these patients?
Question 54
The PMHNP understands that bupropion (Wellbutrin) is an effective way to assist patients with smoking cessation. Why is this medication effective for these patients?
Question 55
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.
Question 56
Which medication below inhibits serotonin and norepinephrine reuptake and is an antagonist of histamine 1, muscarinic 1, and alpha-1 adrenergic receptors at high doses, but only retains activity for histamine 1 receptors at very low doses?
Question 57
The PMHNP is caring for a patient on risperidone (Risperdal). Which action made by the PMHNP exhibits proper care for this patient?
Question 58
A 14-year-old patient is prescribed Strattera and asks when the medicine should be taken. What does the PMHNP understand regarding the drug’s dosing profile?
Question 59
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?
Question 60
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?
Question 61
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?
Question 62
Which statement best describes a pharmacological approach to treating patients for impulsive aggression?
Question 63
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?
Question 64
Which of these characteristics does NOT meet the criteria for probably Alzheimer's dementia?
Question 65
You decide to start a patient on lurasidone (LATUDA). Which of these counseling points is correct?
Question 66
A young patient is prescribed Vyvanse. During the follow-up appointment, which comment made by the patient makes the PMHNP think that the dosing is being done incorrectly?
Question 67
The parents of a 7-year-old patient with ADHD are concerned about the effects of stimulants on their child. The parents prefer to start pharmacological treatment with a non-stimulant. Which medication will the PMHNP will most likely prescribe?
Question 68
Antihistamines may cause side effects such as blurred vision, constipation, memory problems, and dry mouth. This is due to the _______________ effects of antihistamines.
Question 69
The PMHNP is assessing a patient she has been treating with the diagnosis of chronic pain. During the assessment, the patient states that he has recently been having trouble getting to sleep and staying asleep. Based on this information, what action is the PMHNP most likely to take?
Question 70
The PMHNP prescribes an obese patient phentermine (Adipex-p)/topiramate ER (Topamax) (Qsymia), Why is topiramate (Topamax) often prescribed with phentermine (Adipex-P)?
Question 71
A 72-year-old male patient is diagnosed with frontotemporal dementia and presents with aggression and agitation. The PMHNP is consulted and decided to prescribe which of the following?
Question 72
Molly is a 52-year-old female that has a diagnosis of fibromyalgia. She complains of fatigue and cognitive difficulties. Which medication is the PMHNP most likely to prescribe?
Question 73
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?
Question 74
All drugs that lead to addiction increase __________________in the ventral striatum, which is also called the _______________.
Question 75
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?
Question 76
When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?
