, NURS 6630 MIDTERM EXAM
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.
"Most medications will increase the number of neurotransmitters that you already have
in the brain."
C.
"Most medications used in treatment are either increasing or decreasing
neurotransmitters that your body already has."
D.
"Why do you believe that your medication is poison?"
QUESTION 2
1. Which statement about neurotransmitters and medications is true? My correct
answer was several psychiatric meds were developed after discovery of endogenous
neurotransmitters
A.
Natural neurotransmitters such as endorphins have been discovered after the
development of medications.
B.
Some medications were developed after the discovery and known action of the
neurotransmitters in the brain.
C.
Neurotransmitters receive messages from most medications.
D.
The neurotransmitter serotonin is directly linked to depression. Following this discovery,
the antidepressant Prozac was developed.
QUESTION 3
,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.
"In an extreme case such as yours, more than one medication is often needed."
B.
"Due to the ineffectiveness of your current medication, we need to try something else
that can possibly potentiate its effects.
C.
"Medications are often specific to the neurotransmitter(s) they are affecting and, due to
more than one neurotransmitter involvement, it is often necessary to use more than
one medication to improve symptoms."
D.
"I understand your concern. We can discontinue your current medication and switch to a
different one that may better manage your symptoms."
QUESTION 4
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.
QUESTION 5
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.
QUESTION 6
1. Though medications have the ability to target neurotransmitters in the synapse, it
is not always necessary. The PMHNP understands that this is because:
A.
Neurotransmission that occurs via the axon allows for transport of a neurotransmitter.
B.
Active transport is a different type of energy that allows the transport of certain
neurotransmitters.
C.
Neurotransmitters can spread by diffusion.
D.
The postsynaptic neuron can release the neurotransmitter.
QUESTION 7
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. Correct answer
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.
QUESTION 8
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.
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