NURS 6630 Midterm Exam NURS6630 Midterm Exam (Ps, Quizzes of Chemistry

Download NURS 6630 Midterm Exam NURS6630 Midterm Exam (Ps and more Quizzes Chemistry in PDF only on Docsity! NURS 6521Approaches to health final exam.docx Attempt Score 72 out of 75 points Time Elapsed 1 hour, 15 minutes out of 2 hours Results Displayed Submitted Answers • Question 1 1 out of 1 points What will the PMHNP mos t 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: C. Antipsychot ics • Question 2 1 out of 1 points The PMHNP is selecting a medication treatment option for a patient who is exhibiting psychotic behav iors with poor impulse control and aggression. Of the available treatments, which can help temper some of the adverse effects or s ymptoms that are normally caused by D2 antagonism? Selected Answer: D. Second-generation, atypical antipsychotics • Question 3 1 out of 1 points The PMH NP is discuss ing do pamine D2 receptor o ccupa ncy and its as sociation with aggressive behav iors in patients with the s tudent. Why do es the PMH NP prescribe a standard dose of atypical antipsychotics ? Selected Answer: C. The doses are based on achieving 60% D2 receptor o ccupancy. • Question 4 1 out of 1 points Why does the PMHNP avoid prescribing clozapine (Clozari l) as a firs t-line treatment to the patient with psychosis and aggression? Selected Answer: A. There is too high a ris k of serious adverse NURS 6521Approaches to health final exam.docx side effects. • Question 5 1 out of 1 points The PMHNP is caring for a patient on risperidone (Risperdal). Which action made by the PMHNP exhibits proper care for this patient? </p? Selected Answer: C. Titrating the dose by increasing it every 5–7 days • Question 6 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 neurotransmiss ion. Which mood stabilizer will the PMHNP select? Selected Answer: A. Lithium (Lithane) • Question 7 1 out of 1 points 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-s timulant. Which medication will the PMHNP will most likely prescribe? Selected Answer: A. Stratt era • Question 8 1 out of 1 points The PMHNP unders tands that s lo w-dose extended release s timulants are mos t appropriate for which patient with ADHD? Selected Answer: A. 8-year-old patient NURS 6521Approaches to health final exam.docx • Question 18 1 out of 1 points The PMH NP is assess ing a patient she has been treating with the diagnosis of chronic pain. During the assessment, the patient s tates that he has recent ly been hav ing troub le getting to s leep and s taying as leep. Based on this information, what action is the PMHNP most likely t o take? Selected Answer: A. Order hydroxyzine (Vis tari l), 50 mg PRN or as needed • Question 19 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 Answer: D. This medication has unwanted side effects such as sedation, lack of coordination, and dro ws iness . • Question 20 1 out of 1 points A patient recovering from shingles presents with tenderness and sensitivity to the upper back. He s tates it is bothersome to put a shirt on mos t days . This patient has end s tage renal disease (ESRD) and is s cheduled to have hemodialysis tomorrow but s tates that he does not know how he can lie in a recliner for 3 hours feeling this uncomfortable. What will be the PMHNP’s priority? Selected Answer: C. Prescribe lidocaine 5% • Question 21 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 office with the complaint that the medication is no longer working and complains of increased pain. What action will the PMHNP mos t likely take? NURS 6521Approaches to health final exam.docx Selected Answer: A. Increase the dose of lamotrigine (Lamictal) to 25 mg twice daily. • Question 22 0 out of 1 points 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? Selected Answer: B. Order ibuprofen (Motrin) because she may need long-term treatment and chronic pain is not uncommon. • Question 23 1 out of 1 points The PMHNP is assessing a 49-year-old male with a his tory of depression, pos t-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 lo wer extremities and a chief complaint of pain with numbness and tingling to each leg 5/10. The PMHNP s tarts this patient on a low dose of doxepin (Sinequan). What is the next action that must be taken by the PMHNP? Selected Answer: A. Orders liver function tes ts. • Question 24 1 out of 1 points The PMHNP is evaluating a 30-year-old female patient who s tates that she notices pain and a dras tic change in mood before the s tart of her mens trual cycle. The patient states that she has tried diet and lifes tyle changes but nothing has worked. What will the PMHNP mos t likely do? Selected Answer: C. Prescribe desvenlafaxine (Pristiq), 50 mg daily NURS 6521Approaches to health final exam.docx • Question 25 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 Answer: A. “The SNRI can increase noradrenergic neurotra nsmission in the descending spinal pathwa y to the dorsal horn.” • Question 26 1 out of 1 points A patient with fibromyalgia and major depression needs to be treated for s ymptoms of pain. Which is the PMHNP most likely to prescribe for this patient? Selected Answer: Duloxetine (Cymbalta) • Question 27 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 Answer: A. It will bind to the alpha-2-delta ligand subunit of voltage-sensitive calcium channels . • Question 28 1 out of 1 points Mrs. Rosen is a 49-year-old patient who is experiencing fibro-fog. What does the PMHNP prescribe for Mrs. Rosen to improve this condition? Selected Answer: D. All of the above • Question 29 1 out of 1 points NURS 6521Approaches to health final exam.docx Selected Answer: C. It will block testosterone. • Question 38 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 Answer: D. “There are no evidence-based treatments for Internet addiction, but there are behavioral therapies your daughter can try.” • Question 39 1 out of 1 points Mr. Peterson is meeting with the PMHNP to discuss healthier dietary habits . With a BMI of 33, Mr. Peterson is obese and needs to modify his food intake. “Sometimes I think I’m addicted to food the way some people are addicted to drugs,” he says . Which s tatement bes t describes the neurobiological parallels between food and drug addiction? Selected Answer: A. There is decreased activation of the prefrontal cortex. • Question 40 1 out of 1 points 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 s leep s tate? Selected Answer: B. Benzodiazepi nes • Question 41 1 out of 1 points The PMHNP is caring for a patient who experiences too much overs timulation and anxiety during daytime hours . The patient agrees to a pharmacological treatment but states, “I NURS 6521Approaches to health final exam.docx don’t want to feel sedated or drowsy from the medicine.” Which decision made by the PMHNP demonstrates proper knowledge of this patient’s s ymptoms and appropriate treatment options? Selected Answer: A. Avoiding prescribing the patient a drug that blocks H1 receptors • Question 42 1 out of 1 points The PMHNP is performing a quality assurance peer review of the chart of another PMHNP. Upon review, the PMHNP reviews the chart of an older adult patient in long -term care facility who has chronic insomnia. The chart indicates that the patient has been receiving hypnotics on a nightly bas is. What does the PMH NP find pro blemati c abo ut this docum entation? Selected Answer: B. Hypnotics have prolonged half-lives that can cause drug accumulation in the elderly. • Question 43 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: D. Non-benzodiazepine hypnotics • Question 44 1 out of 1 points 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? Selected Answer: C. Triazolam (Halcion) NURS 6521Approaches to health final exam.docx • Question 45 1 out of 1 points The PMHNP is attempting to treat a patient’s chronic insomnia and wishes to s tart 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: A. Triazolam (Halcion) • Question 46 1 out of 1 points A patient with chronic insomnia asks the PMHNP if they can firs t try an over-the-counter (OTC) medication before one that needs to be prescribed to help the patient s leep. Which is the bes t response by the PMHNP? Selected Answer: D. “You can get melatonin over the counter, which will help with s leep onset.” • Question 47 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 effects? Selected Answer: C. Give the medicine at night and lower the dose • Question 48 1 out of 1 points The PMHNP is teaching a patient with a s leep 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? Selected Answer: B. “It can cause blurred vision.” • Question 49 NURS 6521Approaches to health final exam.docx Selected Answer: D. Both “A” & “C” • Question 58 1 out of 1 points A 71-year-old male patient comes to an appointment with his 65-year-old wife. They are both hav ing concerns related to her memory and ability to recognize faces. The PMNHP is considering prescribing memantine (Namenda) based on the follo wing symptoms: Selected Answer: C. Amnesia, apraxia, agnosia • Question 59 0 out of 1 points The PMH NP evaluates a patient presenting with sym pto ms of dementia. Befor e the PMHNP co nsiders treatm ent options , the patient must be asses sed for other poss ible causes of dementia. Which of the follo wing ans wers addresses both pos sible other ca uses of dem entia and a rational tr eatment option for D ementia? Selected Answer: C. Possible other causes: hypothyroidism, adrenal insufficiency, niacin deficiency Possible treatment option: risperidone • Question 60 1 out of 1 points A group of nursing students seeks further clarification from the PMHNP on how cholinesterase inhibitors are beneficial for Alzheimer’s disease patients. What is the appropriate response? Selected Answer: D. Both “A” & “C.” • Question 61 NURS 6521Approaches to health final exam.docx 1 out of 1 points 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 g iven these other factors? Selected Answer: D. Both “A” & “B” • Question 62 1 out of 1 points 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 follo wing would be an appropriate choice? Selected Answer: D. All of the above • Question 63 1 out of 1 points A 63-year-old patient presents with the following symptoms. The PMHNP determines which set of s ymptoms warrant prescribing a medication? Select the answer that is matched with an appropriate treatment. Selected Answer: B. Impairment in the ability to learn and retain new information is mos t problematic, and an appropriate treatment option would be donepezil. • Question 64 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 follo wing to be the bes t treatment option? Selected Answer: D. Citalopram (Celexa) or Escitalopram (Lexapro) • Question 65 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 s taff? Selected D. NURS 6521Approaches to health final exam.docx Answer: Both “A” & “C.” • Question 66 1 out of 1 points An 80-year-old female patient diagnosed with S tage II Alzheimer’s has a his tory of irritable bowe l syndrome. Which cholinergic drug may be the bes t choice for treatment given the patient’s gas trointes tinal problems? Selected Answer: A. Donepezil (Aricept) • Question 67 1 out of 1 points The PMHNP understands that bupropion (Wellbutrin) is an effective way to assist patients with smoking cessation. Why is this medication effective for these patients ? Selected Answer: C. Bupropion (Wellbutrin) blocks dopamine reuptake, enabling more availability of dopamine. • Question 68 1 out of 1 points Naltrexone (Revia), an opioid antagonis t, is a medication that is used for which of the follo wing conditions? Selected Answer: A. Alcoholis m • Question 69 1 out of 1 points A patient addicted to heroin is receiving treatment for detoxification. He begins to experience tachycardia, tremors, and diaphoresis. What medication will the PMHNP prescribe for this patient? Selected Answer: D. Clonidine (Catapres ) • Question 70 1 out of 1 points