NURS-6630N-4/NURS-6630F-4/NURS-6630C-4 Week 11 Final Exam (100% CORRECT SOLUTIONS)

NURS-6630N-4/NURS-6630F-4/NURS-6630C-4-Approaches to Treatment2020 Summer Qtr 06/01-08/23-PT27 Review Test Submission: Week 11 Final Exam Question 1 1 out of 1 points Anti histamines may cause side eOects such as blurred vision, constipation, memory problems, and dry mouth. This is due to the eGects of antihistamines. Selected Answer: a. Anticholinergic Question 2 1 out of 1 points A 26-year-old female patient with nicotine dependence and a history of anxiety presents with symptoms of attention de cit hyperactivity disorder (ADHD). Based on the assessment, what does the PMHNP consider? Selected d. Answer: ADHD is often not the focus of treatment in adults with comorbid conditions. Question 3 0 out of 1 points Molly is a 52-year-old female that has a diagnosis of bromyalgia. She complains of fatigue and cognitive di culties. Which medication is the PMHNP most likely to prescribe? Selected Answer: c. Topiramate (TOPAMAX) Question 4 1 out of 1 points A patient with gambling disorder and no other psychiatric comorbidities is being treated with pharmacological agents. Which drug is the PMHNP most likely to prescribe? Selected Answer: d. Naltrexone Question 5 1 out of 1 points Which of the following is considered as a disruptive/impulse control behavior? Selected Answer: a. Pyromania Question 6 1 out of 1 points 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? Selected Answer: c. “Naltrexone may be an appropriate option to discuss.” Question 7 1 out of 1 points 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? Selected Answer: b. “I am unable to fall asleep at night.” Question 8 1 out of 1 points The novel neurotransmitter adenosine is responsible for the sleep-wake cycle by increasing throughout the day and diminishing during night. Which of the follow is an antagonist of adenosine? Selected Answer: a. Ca eine Question 9 1 out of 1 points 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? Selected Answer: a. Antipsychotics Question 10 1 out of 1 points 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? Selected Answer: c. Bupropion (ZYBAN) Question 11 1 out of 1 points 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 sta ? Selected c. Answer: The use of an psycho cs may cause increased cardiovascular events and mortality and an psycho cs are o en used as “chemical straightjackets” to over- tranquilize pa ents. Question 12 1 out of 1 points The PMHNP is caring for a patient who openly admitted to drinking a quart of vodka daily. Prior to prescribing this patient disulJram (Antabuse), it is important for the PMHNP to: Selected Answer: b. Evaluate the patient’s willingness to abstain from alcohol 3/15 Question 13 1 out of 1 points The PMHNP prescribes gabapentin (Neurontin) for a patient’s chronic pain. How does the PMHNP anticipate the drug to work? Selected d. Answer: It will bind to the alpha-2-delta ligand subunit of voltage-sensitive calcium channels. Question 14 1 out of 1 points The parents of a 7-year-old patient with ADHD are concerned about the eects 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? Selected Answer: d. Strattera Question 15 1 out of 1 points 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? Selected Answer: a. Decrease his SSRI and add buspirone (Buspar). Question 16 1 out of 1 points The PMHNP wants to use a symptom-based approach to treating a patient with Fbromyalgia. How does the PMHNP go about treating this patient? Selected b. Answer: Matching the patient’s symptoms with the malfunctioning brain circuits and neurotransmitters that might mediate those symptoms. Question 17 1 out of 1 points The PMHNP prescribes pregabalin (LYRICA) for a patient with chronic pain. How does pregabalin work to reduce pain? Selected a. Answer: It will block excitatory neurotransmission by blocking voltage-sensitive calcium channels. Question 18 1 out of 1 points 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? Selected Answer: a. Modafanil (PROVIGIL) Question 19 1 out of 1 points The PMHNP understands that slow-dose extended release stimulants are most appropriate for which patient with ADHD? Selected Answer: c. 8-year-old patient Question 20 1 out of 1 points Sharon is a 56-year-old female that presents to the clinic with pain after suGering a back injury several years ago. The patient states she feels a tingling sensation in her legs. What type of pain is Sharon likely experiencing? Selected Answer: c. Neuropathic pain Question 21 1 out of 1 points Antipsychotics are doses at a level that blocks % of D2 receptors. Selected Answer: d. 60-80 Question 22 0 out of 1 points Neal is complaining of restless leg syndrome and insomnia. Which Nrst-line medication should the PMHNP prescribe to treat both? Selected Answer: d. Gabapentin (NEURONTIN) Question 23 1 out of 1 points 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 deRcit hyperactivity disorder (ADHD) is suspected. What medication is the PMNHP most likely to prescribe? Selected Answer: a. Methylphenidate (Ritalin, Concerta) Question 24 0 out of 1 points Which of the following anticonvulsants increases serotonergic neurotransmission and GABAergic transmission, while decreasing glutamatergic neurotransmission? Selected Answer: c. Lamotrigine (LAMICTAL) Question 25 1 out of 1 points The nursing staU asks the PMHNP for additional education regarding the treatment of agitation in dementia patients. Which of the following is correct? Selected c. Answer: The nurse should attempt to determine how the patient's environment may be impacting the patient's mood. Question 26 1 out of 1 points 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? Selected Answer: a. Order hydroxyzine (Vistaril), 50 mg PRN or as needed Question 27 1 out of 1 points 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? Selected Answer: a. Lithium (Lithane) Question 28 1 out of 1 points 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? Selected Answer: c. Citalopram (Celexa) or Escitalopram (Lexapro) Question 29 0 out of 1 points Harold complains of pain associated with his irritable bowel syndrome with constipation. The PMHNP decides to prescribe a medication that prevents pain signals from reaching the brain. Which agent does the PMHNP prescribe? Selected Answer: b. Venlafaxine (EFFEXOR) Question 30 0 out of 1 points 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: Selected Answer: d. The child’s dose will increase by 2.5 mg every other week. Question 31 1 out of 1 points A 71-year-old male patient comes to an appointment with his 65-year-old wife. They are both having concerns related to her memory and ability to recognize faces. The PMNHP is considering prescribing memantine (Namenda) based on the following symptoms: Selected Answer: a. Amnesia, apraxia, agnosia Question 32 1 out of 1 points A PMHNP supervisor is discussing with a nursing student how stimulants and noradrenergic agents assist with ADHD symptoms. What is the appropriate response? Selected Answer: a. All of these are correct Question 33 1 out of 1 points The PMHNP is assessing a female patient who has been taking lamotrigine (Lamictal) for migraine prophylaxis. After discovering that the patient has reached the maximum dose of this medication, the PMHNP decides to change the patient’s medication to zonisamide (Zonegran). In addition to evaluating this patient’s day-to-day activities, what should the PMHNP ensure that this patient understands? Selected c. Answer: This medication has unwanted side eCects such as sedation, lack of coordination, and drowsiness. Question 34 1 out of 1 points Mrs. Rosen is a 49-year-old patient who is experiencing bro-fog. What does the PMHNP prescribe for Mrs. Rosen to improve this condition? Selected Answer: d. All of these are correct Question 35 1 out of 1 points The PMHNP is treating a patient with depression and bromyalgia. The PMHNP chooses to prescribe a treatment that may help treat the patient's bromyalgia and depressive symptoms. Which medication is the PMHNP likely to choose? Selected Answer: a. Amitriptyline (ELAVIL) Question 36 1 out of 1 points 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)? Selected Answer: a. The patient is somnolent and has 7 respirations per minute. Question 37 1 out of 1 points Jacob is a 7-year-old pediatric patient who has signiCcant oppositional symptoms associated with his ADHD diagnosis. What is the best treatment for this patient? Selected Answer: b. Prescribe methylphenidate and augment with guanfacine. Question 38 1 out of 1 points The PMHNP understands that bupropion (Wellbutrin) is an eWective way to assist patients with smoking cessation. Why is this medication e[ective for these patients? Selected b. Answer: Bupropion (Wellbutrin) blocks dopamine reuptake, enabling more availability of dopamine. Question 39 1 out of 1 points The PMHNP is assessing a patient who will be receiving phentermine (Adipex-P)/topiramate (Topamax) (Qsymia). Which of the following conditions/diseases will require further evaluation before this medication can be prescribed? Selected Answer: a. Cardiovascular disease Question 40 1 out of 1 points 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? Selected Answer: d. “SSRIs only increase serotonin levels.” Question 41 1 out of 1 points A patient you have been evaluating was admitted to the hospital with some abnormal lab work. Hematology/oncology was consulted and diagnoses the patient with aplastic anemia and agranulocytosis. Which medication was likely the culprit? Selected Answer: c. Carbamazepine Question 42 1 out of 1 points A patient is being prescribed bupropion and is concerned about the side eKects. What will the PMHNP tell the patient regarding bupropion? Selected Answer: a. It can cause cardiac arrhythmias. Question 43 1 out of 1 points An adult patient presents with a history of alcohol addiction and attention de cit hyperactivity disorder (ADHD). Given these comorbidities, the PMHNP determines which of the following medications may be the best treatment option? Selected Answer: b. Atomoxetine (Strattera) Question 44 1 out of 1 points A patient with chronic back pain has been prescribed a serotonin-norepinephrine reuptake inhibitor (SNRI). How does the PMHNP describe the action of SNRIs on the inhibition of pain to the patient? Selected c. Answer: “The SNRI can increase noradrenergic neurotransmission in the descending spinal pathway to the dorsal horn.” Question 45 1 out of 1 points Why does the PMHNP avoid prescribing clozapine (Clozaril) as a Krst-line treatment to the patient with psychosis and aggression? Selected Answer: d. There is too high a risk of serious adverse side e ects. 9/15 Question 46 0 out of 1 points 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? Selected Answer: a. Antipsychotics Question 47 0 out of 1 points 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? Selected Answer: c. 5HT2A Question 48 0 out of 1 points 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? Selected a. Answer: Possible other causes: hypothyroidism, Cushing’s syndrome, multiple sclerosis Possible treatment option: memantine Question 49 0 out of 1 points Brandon is a non-compliant patient that presents to the clinic asking for help with his alcohol dependence. The PMHNP evaluates the patient and determines a long-acting injection that blocks the mu-receptors would be the best treatment option for Brandon. Which medication should the PMHNP prescribe? Selected Answer: b. Acamprosate (CAMPRAL) Question 50 1 out of 1 points Individuals who su er from an addiction often increase the dose of medication to achieve the desired eTect. The need to increase the dose to reach the safe e ect is due to . Selected Answer: a. tolerance Question 51 1 out of 1 points A patient with a new diagnosis of diabetic peripheral neuropathy is switched from sertraline (ZOLOFT) to duloxetine (CYMBALTA). The patient asks why they are switching treatment. What is the best response? Selected a. Answer: Sertraline only increases serotonin levels. You need a medication that increases both serotonin and norepinephrine. Question 52 1 out of 1 points A patient with chronic insomnia and depression is taking trazodone (Oleptro) but complains of feeling drowsy during the day. What can the PMHNP do to reduce the drug’s daytime sedating eGects? Selected Answer: d. Give the medicine at night and lower the dose Question 53 1 out of 1 points Mrs. Kenner is concerned that her teenage daughter spends too much time on the Internet. She inquires about possible treatments for her daughter’s addiction. Which response by the PMHNP demonstrates understanding of pharmacologic approaches for compulsive disorders? Selected b. Answer: “There are no evidence-based treatments for Internet addiction, but there are behavioral therapies your daughter can try.” Question 54 1 out of 1 points An interneuron is a neuron that has its cell body, dendrites, and axon within the spinal cord. The neuron can be considered excitatory if it contains or inhibitory if it contains . Selected Answer: a. Glutamate / GABA Question 55 1 out of 1 points A patient is prescribed D-methylphenidate, 10-mg extended-release capsules. What should the PMHNP include when discussing the side e ects with the patient? Selected Answer: c. The medication can a ect your blood pressure. Question 56 1 out of 1 points 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? Selected Answer: c. The doses are based on achieving 60% D2 receptor occupancy. Question 57 1 out of 1 points Which of the following substances has the highest probability of becoming dependent after a single use? Selected Answer: d. Nicotine Question 58 1 out of 1 points The PMHNP prescribed a patient lamotrigine (Lamictal), 25 mg by mouth daily, for nerve pain 6 months ago. The patient suddenly presents to the o ce with the complaint that the medication is no longer working and complains of increased pain. What action will the PMHNP most likely take? Selected Answer: a. Increase the dose of lamotrigine (Lamictal) to 25 mg twice daily. Question 59 1 out of 1 points 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? Selected Answer: b. Non-benzodiazepine hypnotics Question 60 1 out of 1 points All drugs that lead to addiction increase in the ventral striatum, which is also called the . Selected Answer: b. Dopamine / nucleus accumbens Question 61 1 out of 1 points A group of nursing students seeks further clariGcation from the PMHNP on how cholinesterase inhibitors are beneUcial for Alzheimer’s disease patients. What is the appropriate response? Selected c. Answer: Acetylcholine (ACh) destruction is inhibited by blocking the enzyme acetylcholinesterase and by increasing acetylcholine, the decline in some patients may be less rapid. Question 62 1 out of 1 points Naltrexone (Revia), an opioid antagonist, is a medication that is used for which of the following conditions? Selected Answer: b. Alcoholism Question 63 1 out of 1 points The PMHNP is treating a patient for bromyalgia and is considering prescribing milnacipran (Savella). When prescribing this medication, which action is the PMHNP likely to choose? Selected Answer: b. Split the daily dose into two doses after the rst day. Question 64 1 out of 1 points 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? Selected Answer: a. Prescribe desvenlafaxine (Pristiq), 50 mg daily Question 65 1 out of 1 points 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? Selected Answer: c. Donepezil (Aricept) Question 66 1 out of 1 points The PMHNP is caring for a patient with chronic insomnia who would bene t 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? Selected Answer: a. Triazolam (Halcion) Question 67 1 out of 1 points The PMHNP is teaching a patient with a sleep disorder about taking diphenhydramine (Benadryl). The patient is concerned about the side eects of the drug. What can the PMHNP teach the patient about this treatment approach? Selected Answer: a. “It can cause blurred vision.” Question 68 0 out of 1 points A nursing student asks the PMHNP about the dierence between the use of stimulants in the treatment of ADHD and the abuse of stimulants in substance-use disorders. Which is the correct response? Selected c. Answer: Stimulants used for abuse crate a pulsating release of dopamine, which increases the reinforcing pleasurable eQects of the drugs. Question 69 0 out of 1 points Which of these statements is correct? Selected Answer: c. Sedation is common with aripiprazole (ABILIFY) Question 70 1 out of 1 points 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? Selected Answer: c. Doxepin (SILENOR) Question 71 0 out of 1 points 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? Selected Answer: a. "All available treatment options are considered stimulants." Question 72 1 out of 1 points The PMHNP is caring for a patient with bromyalgia. Which second-line treatment does the PMHNP select that may be e ective for managing this patient’s pain? Selected Answer: d. Imipramine (Tofranil) Question 73 1 out of 1 points The PMHNP is attempting to treat a patient’s chronic insomnia and wishes to start with an initial prescription that has a half-life of approximately 1–2 hours. What is the most appropriate prescription for the PMHNP to make? Selected Answer: c. Triazolam (Halcion) Question 74 1 out of 1 points Heather is admitted for opioid withdrawals and detoxiKcation. The PMHNP decides to prescribe an alpha-2 adrenergic agonist to reduce the symptoms of autonomic hyperactivity during withdrawal and aid in the detoxi cation process. Which medication did the PMHNP prescribe? Selected Answer: c. Clonidine Question 75 0 out of 1 points The PMHNP wishes to prescribe a medication that reduces glutamate transmission in an Alzheimer's patient. Which medication should the PMHNP prescribe? Selected Answer: d. Galantamine (RAZADYNE) Question 76 0 out of 0 points When comple ng this exam, did you comply with Walden University’s Code of Conduct including the expecta ons for academic integrity? Selected Answer: Yes Thursday, August 13, 2020 4:57:25 AM EDT ← OK Show Less