NURS 663 Exam 2024 Complete
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KLS - ANSWER ✔ Which sleep issue usually last a few days up
to several weeks and appear 1-10 times per year. Once the
episode subsides, normal sleep/wake cycles occur; until next
episode. Idiopathic hypersomnia or Kliene Levin syndrome?
Sleeping issues - ANSWER ✔ Idiopathic hypersomnia and Kliene
Levin syndrome are both types of
Frontotemporal dementia - ANSWER ✔ Which disease often
responds adversely to cholinesterase inhibitors with increased
agitation and insomnia.
Frontotemporal - ANSWER ✔ This dementia: One form of this
condition is Pick's disease
Aphasia, Apraxia, Agnosia - ANSWER ✔ 3 A's of Alzheimer's
disease
downs, AA, depression - ANSWER ✔ Alzheimer's disease may
be genetic. Common in ____________ Syndrome, more common
in ________, females and those with DM type 2, HTN, high
cholesterol, and ______________.
, 1, 4 - ANSWER ✔ Vascular dementia prevalence in aged 65+ is
__% to ___%.
Ramelteon - ANSWER ✔ BEST SLEEP MED FOR ELDERLY-
more natural, least interactions
Ramelteon - ANSWER ✔ Targets melatonin receptors in the
brain
Ramelteon - ANSWER ✔ FDA approved for insomnia (difficulty
with sleep onset)
½ life is 1.5 hours
empty, M1, M2, agonist - ANSWER ✔ Ramelteon is a non benzo
hypnotic, helps sleep onset and increases sleep periods. Works
best on ________ stomach.
binds selectively on _____ & ______ receptors as a full
__________ (it opens the gates, lets melatonin in).
Ramelteon - ANSWER ✔ Sedation is common side effect,
dizziness, fatigue, headache
angioedema - ANSWER ✔ Ramelteon has Rare ____________
or anaphylaxis- do not rechallenge
8mg - ANSWER ✔ Dose of Ramelteon HS
abnormal thinking, behavioral changes, complex behaviors,
hallucinations, worsening depression, and SI - ANSWER ✔ BBW
of Ramelteon mneumonic: ABC-HWS
Modafinil - ANSWER ✔ FDA: Reducing excessive sleepiness r/t
narcolepsy and shift work sleep disorder
,FDA: Reducing excessive sleepiness in OSAHA- adjunct tx for
underlying airway obstruction
Modafinil - ANSWER ✔ Dopamine Reuptake Inhibitor with most
common SE:
Headache- dose dependant
200mg - ANSWER ✔ Modafinil dose in morning
rash, SJS - ANSWER ✔ BBW for Modafinil
benzo - ANSWER ✔ What class is Temazepam (Restoril)
15mg-30mg - ANSWER ✔ What dose for Temazepam (Restoril)
narrow-angle glaucoma, OSA - ANSWER ✔ Temazepam
(Restoril): Contraindicated if __________________, untreated
_______, hx substance abuse
SI - ANSWER ✔ Temazepam (Restoril) BBW: may potentiate or
increase ____ and suicidal behavior, especially in children,
adolescents, and young adults.
7.5 - ANSWER ✔ Elder patients w/ renal/hepatic impairment
should be dosed ____mg of Temazepam (Restoril)
Temazepam - ANSWER ✔ Educate not stop this drug abruptly
since it could result in a seizure, especially for those with a history
of seizures.
liver, kidney - ANSWER ✔ Temazepam warnings: rare ________
dysfunction, ________ dysfunction, and blood abnormalities
, Temazepam - ANSWER ✔ FDA approved: Short term treatment
of insomnia
8-25 hour ½ life
H1, 5HT2C - ANSWER ✔ Mirtazapine blocks _______ &
_________= weight gain and sedation
15mg - ANSWER ✔ Mirtazapine (remeron) dose:
remeron - ANSWER ✔ Rare: SZ, induction of mania, induction of
SI and suicidal behavior (not shown beyond age 24)
Rivastigmine - ANSWER ✔ My increase selectivity for
hippocampus and neocortex.
1.5, BID - ANSWER ✔ Rivastigmine: Starting dose is _____mg
_____ with breakfast and dinner.
Rumination Disorder - ANSWER ✔ - Repeated regurgitation of
food for AT LEAST 1 MONTH
- Regurgitation of food is not due to a general medical condition
- Does not occur during the course of avoidant/restrictive food
intake disorder, anorexia nervosa, binge eating disorder, or
bulimia nervosa
- If occurs in the context of another mental disorder or general
medication condition, the severity warrant additional clinical
attention
Rumination Disorder
Diagnostic features - ANSWER ✔ - "at least several times per
week, typically daily"
- NO involuntary retching, NO nausea, NO disgust
- Afterward: rechew, reswallow, or spit out