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2024 NR546 WEEK 7 EXAM WITH CORRECT ANSWERS
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2024 NR546 WEEK 7 EXAM WITH CORRECT ANSWERS
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2024 NR546 WEEK 7 EXAM WITHCORRECT ANSWERS
Neurotransmitters involved in ADHD - CORRECT-ANSWERSDopamine &
norepinephrine
-affect symptoms of inattention & hyperactivity
Pharmacologic Treatment of Sleep Disorders: - CORRECT-ANSWERSOver-the-
counter
Melatonin
Orexin receptor antagonists
Antidepressants
Z-drugs
Benzodiazepines
Sleep meds Lifespan Considerations: Pregnancy - CORRECT-ANSWERS-
Consider the risk-benefit ratio.
-Avoid z-drugs when possible
• use them for the shortest duration possible.
Sleep meds Lifespan Considerations: Older Adult - CORRECT-ANSWERS2019
American Geriatric Society (AGS) Beers Criteria include the following
recommendations:
-Consider nonpharmacologic strategies.
-Avoid combining z-drugs with other central nervous system (CNS)
medications to prevent falls.
-Avoid using z-drugs or antihistamines in clients with dementia, cognitive
impairment, or a history of falls.
-Consider melatonin as an alternative.
Scott is a 69-year-old with a history of major depressive disorder well
controlled with sertraline 50 mg daily. He complains that he has a hard time
falling asleep some nights and has been taking Benadryl 50 mg at bedtime
to help him sleep. He complains of dry mouth and dry eyes the mornings
after he takes Benadryl, and states sometimes he feels a little confused after
waking. He wonders if he should continue taking Benadryl for sleep. What
recommendations would you have for Scott? - CORRECT-ANSWERSNo
, Rationale: Scott is experiencing mild adverse effects from Benadryl most
likely due to the muscarinic antagonism which can cause anticholinergic
effects. Scott should discontinue the use of this medication.
Which of the following are other acceptable medication options for Scott?
Select all that apply. - CORRECT-ANSWERSmelatonin OTC
suvorexant (Belsomra)
limit caffeine intake to early in the day
Rationale: Other options for Scott include melatonin, suvorexant, and sleep
hygiene including limiting caffeine intake. Zolpidem is not recommended for
older adults. Amitriptyline may help induce sleep but would not be first-line
since his MDD is controlled with sertraline. Amitriptyline is also a tricyclic
antidepressant and is not well tolerated in the elderly due to its risks for falls.
Exercising before bed does not increase sleep, is stimulating, and may
further impact sleep.
A common cause of insomnia is ____________ - CORRECT-ANSWERSrestless
legs syndrome (RLS)
restless legs syndrome (RLS) - CORRECT-ANSWERStypically occurs in the
evening or at night
-causes uncomfortable uncontrollable urge to move the legs.
-may be idiopathic or associated with other conditions such as pregnancy,
end-stage renal disease, fibromyalgia, iron deficiency, arthritis, or peripheral
neuropathy
-Tx:
• Dopamine agonists: pramipexole (Mirapex), ropinirole (Requip)
• Iron
• Gabapentin/ pregabalin for severe or painful RLS
Jessica is a 28-year-old client with a diagnosis of generalized anxiety
disorder. Her anxiety is well-controlled with escitalopram and therapy. She
presents with new complaints of insomnia and states, "I have constant
itching and need to move my legs while I am in bed."
Which of the following diagnostic tests should be completed next? Select all
that apply.
caffeine intake
ferritin level
computerized tomography (CT) scan
pregnancy test
tyrosine intake - CORRECT-ANSWERScaffeine intake
ferritin level
pregnancy test
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