NURS 6630NURS 6630 Midterm Exam Final latest update 2021/2022 100% correct questions & ans, Exams of Nursing

Download NURS 6630NURS 6630 Midterm Exam Final latest update 2021/2022 100% correct questions & ans and more Exams Nursing in PDF only on Docsity! 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). G . A “You have to take your medication to become stable.” * _B Medications work by increasing the types of neurotransmitters produced by the human brain.” c D “Why do you believe that your medication is poison?” points QUESTION 2 1. Ms. Hill is currently being treated for schizophrenia but has stopped taking her medications due to some side effects she claims she was experiencing. She presents to the clinic today with worsening symptoms. She is experiencing anhedonia, agitation, attentional impairment, and affective blunting. Which one of the symptoms mentioned is considered a positive symptom of schizophrenia? © A Anhedonia © B Agitation © C Attentional Impairment © D Affective Blunting 1 points QUESTION 3 tbo Which statement about neurotransmitters and medications is true? ‘A Endorphins were discovered before morphine which lead to the use of the opioids for pain . control. _B Several psychiatric medications have been developed after discoveries of endogenous . Neurotransmitters and defining their function in the brain. €: _C Medications work by sending messages to neurotransmitters enabling them to work more . effectively. C;D Animbalance of serotonin has been directly linked to depression. Following the discovery of this . neurotransmitter, pharmacologists were able to develop a well-known drug- Prozac as the first medication used to restore the balance of serotonin. 1 points QUESTION 4 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 "More often than you would think, multiple medications should always be tried together to see . What happens.” €. B “Due to this being your first hospitalization after starting medication treatment for the first time . in your life, the only way to effectively manage your symptoms is by adding additional medications in hopes that it will work for you." : D “l understand your concerns. Often times, it is necessary to switch medications after short . periods of time to better manage your symptoms. We will discontinue your current regimen and QUESTION 8 1. Why is the cytochrome P450 enzyme system of significance to the PMHNP? c 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. ras C C The medication’s chemical composition changes when it comes in contact with the acid in the stomach. c D The cyP enzyme system is a steady and predictable process that prescribers must understand to treat conditions effectively. 1 points QUESTION 9 = 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? c cB The term polymorphic refers to the body’s ability to break a medication down several . Ways, and this patient may require higher doses of certain antidepressants and antipsychotics. c C About 1 out of 30 Caucasians requires lower doses of some antidepressants and antipsychotics. Cc D Most enzyme pathways do not have interactions between the newer medications. 1 points QUESTION 10 1. As it relates to G-protein linked receptors, what does the PMHNP understand about medications that are used in practice? _———E>EEE=EEEEEEEEEEEEs c B The majority of medications used in practice are full agonists and are used to stimulate the body’s natural neurotransmitters. c c C Most medications act as partial agonists because they allow the body to use only what is needed. c D Medications used in practice may act as inverse agonists if the dosage is too high. 1 points QUESTION 11 1. The PMHNP is considering prescribing a 49-year-old male clozapine (Clozaril) to treat his schizophrenia and suicidal ideations. The PMHNP is aware that which factor may impact the dose needed to effectively treat his condition: ‘A The patient smokes cigarettes. C B The patient has hypertension. C The patient has chronic kidney disease, stage 2. “ nay D The patient drinks a cup of coffee a dopamine 1 points QUESTION 15 1. The PMHNP is caring for four patients. Which patient statement indicates that benzodiazepines would be beneficial? c A “| have trouble staying asleep in the middle of the night.” c B “My spouse told me that | seem to have trouble remembering things sometimes.” Cc Cu really want to stop smoking, but the cravings are too strong.” c D “| feel nervous to go outside and be in large crowds.” 1 points QUESTION 16 1. Ms. Harlow is a 42-year-old patient who is prescribed a drug that acts on ionotropic receptors. She is curious about the effects of the drug and how it will act on her symptoms. Which statement made by the PMHNP demonstrates proper understanding of Ms. Harlow’s prescription? c A “The drug will have an almost immediate . effect.” c B “The drug can take a while to build up in your system.” c C “The drug is slow to release but lasts for a long . time.” c D “The drug will make a subtle difference in your symptoms.” 1 points QUESTION 17 1. A patient is seeking pharmacological treatment for smoking cessation. Which drug class does the PMHNP prescribe to the patient? nay my nay A Benzodiazepine B Mirtazapine (Remeron) C Ketamine D varenicline (Chantix) 1 points QUESTION 18 1. The PMHNP is caring for a new patient who has been transferred from another office. When meeting with the new patient, the patient reports, “I feel like | am improving with the stabilizers.” The PMHNP immediately recognizes that the patient is describing which kind of drug? c A Full agonists c B Antagonists c C Partial agonists c D Inverse agonists 1 points QUESTION 19 1. A patient presents with frequent episodes of mania. Which statement describes an appropriate treatment approach for this patient? C A “The patient needs to have an inverse agonist.” Cc B “The patient could benefit from an anticonvulsant.” c C “The patient’s calcium, sodium, chloride, and potassium levels must be regulated.” Cc D “The patient should have a drug that acts on ligand-gated ion channels.” 1 points QUESTION 20 1. What characteristics do the nicotinic, cholinergic, serotonin 3, and glycine receptors all have in common? c A Ligand-gated ion channels with a pentameric structure bea good choice for you.” c Cc “Amphetamines can cause hallucinations, so | would advise against this type of prescription.” c D “Amphetamines can lead to a dopamine deficiency, so | will not prescribe this for you. points QUESTION 24 The PMHNP is caring for a patient with schizophrenia and is considering a variety of treatment approaches. The PHMNP selects a viable treatment that is consistent with the “dopamine hypothesis of schizophrenia.” What action does the PMHNP anticipate this treatment having on the patient? c A Blocking the release of dopamine facilitates the onset of positive schizophrenia symptoms. c B Hyperactivity in the mesolimbic dopamine pathway mediates the positive symptoms of schizophrenia. ac Antipsychotic drugs that open D2 receptor pathways can treat schizophrenia. « DThe neuroanatomy of dopamine neuronal pathways can explain symptoms of schizophrenia. 1 points QUESTION 25 1. A patient is diagnosed with schizophrenia. What increases the patient’s potential to mediate the cognitive symptoms of the disease? c A Achieving underactivity of the mesocorticol projections to the prefrontal cortex c B Achieving overactivity of the mesocorticol projections to the ventromedial prefrontal cortex c Cc Achieving underactivity of the mesocortical projections to the ventromedial prefrontal cortex C D Achieving overactivity of the mesocorticol projections to the prefrontal cortex 1 points QUESTION 26 1 What is accurate about the clinical description of psychosis? © A It is simply a separate way to clinically describe the diagnosis of schizophrenia in . a client. _B Psychosis is listed in the DSM as a distinct disorder with unique screening criteria. fC It is a syndrome that can be associated with a number of psychiatric disorders. © _D Psychosis is always demonstrated by a paranoia in the client. 1 points QUESTION 27 1 The PMNHP is assessing a 29-year-old client who takes antipsychotics that block D2 receptors. This client has begun to develop a common side effect of this medication. What is this side effect? “ my aa B The recent change of a 2nd generation antipsychotic to a conventional one C The recent change of a 1st generation antipsychotic to a 2nd generation antipsychotic D all of the above 1 points QUESTION 31 1. Mrs. Schwartzman is a 52-year-old client with schizophrenia and no established history of depression. When meeting with the PMHNP, she presents with apathy and withdrawn social behavior, and she reports a loss of joy from enjoyable activities since starting her new medication. What does the PMHNP infer from this encounter with the client? c c nay A The client has been misdiagnosed with schizophrenia B The client is not compliant with this new medication C The new medication is blocking D2 receptors in the mesolimbic . system D The dose of this new antipsychotic medication is too low 1 points QUESTION 32 a The student inquires about antipsychotic medications. Which response by the PMHNP describes the factors that contribute to reduced risk of extrapyramidal symptoms (EPS) for patients who take antipsychotics? my a my my A Those that are potent D2 antagonists B Those that are potent D2 antagonists with 5HT2A antagonism properties C p2 receptors that are blocked in the nigrostriatal pathway D Potent D2 antagonists that block the muscarinic anti-M1 cholinergic receptors 1 points QUESTION 33 1. Mr. Gordon is a middle-aged patient who is taking antipsychotics. When meeting with the PMHNP, he reports positive responses to the medication, stating, “I really feel as though the effects of my depression are going away.” Which receptor action in antipsychotic medications is believed to be the most beneficial in producing the effects described by Mr. Gordon? eA 5HT2 antagonism c B p2 antagonism c C Alpha-2 antagonism C D p2 partial agonist 1 points QUESTION 34 1 Mr. Gordon is a middle-aged client who was started on antidepressant monotherapy for depression. After beginning this medication, the PMHNP noticed that this client seemed to swing into a hypomanic episode. What can the PMHNP infer from this behavior change? (A This client may have Bipolar Ill disorder © B The antidepressant monotherapy should be . continued “. C Asecond antidepressant agent should be added as dual therapy D Aandc my 1 points QUESTION 35 1. Ms. Ryerson is a 28-year-old patient with a mood disorder. She recently requested to transfer to a new PMHNP, after not getting along well with her previous provider. The new PHMNP is reviewing Ms. Ryerson’s medical chart prior to their first appointment. Upon review, the PMHNP sees that the former provider last documented “patient had rapid poop out.” What does the PMHNP infer about the patient’s prescription based on this documentation? c A The patient has an unsustained response to antidepressants. Cc B The patient has antidepressant-induced hypomania. c C The patient has a depletion of monoamine neurotransmitters. 1 points QUESTION 39 1. Ms. Boeckh is a 42-year-old patient with major depression. The PMHNP understands that which action of norepinephrine will affect Ms. Boeckh’s serotonin levels? c A Norepinephrine potentiates 5HT release through a2 postsynaptic receptors. c B Norepinephrine inhibits 5HT release through a2 receptors. c Cc Norepinephrine inhibits a2 receptors on axon terminals. c D Norepinephrine potentiates 5HT release through al and a2 receptors. 1 points QUESTION 40 1. Ms. Boeckh is a 42-year-old client who is taking an antidepressant therapy. The PMHNP understands that this medication can have substantial food interactions that can cause Ms. Boeckh to develop a hypertensive crisis. Which antidepressant class is Ms. Boeckh’s medication in? € A Selective serotonin reuptake inhibitors B MAO inhibitors © C Tricyclic antidepressants © D Selective norepinephrine reuptake inhibitors 1 points QUESTION 41 1. The PMHNP is assessing a patient in the psychiatric emergency room. The patient tells the PMHNP that he does not understand why his depression has not lifted after being on four different antidepressants over the course of a year. Which of the following symptoms can be residual symptoms for patients who do not achieve remission with major depressive disorder? cA Insomnia © B Suicidal ideation c C Problems concentrating D Aandc C points QUESTION 42 a Fluoxetine (Prozac) has been prescribed for a patient. Which of the following statements is true regarding the action of this medication? c c A Neuronal firing rates are not dysregulated in depression. B Blocking the presynaptic SERT will immediately lead to a great deal of serotonin in many synapses. Cc Upon the acute administration of a SSRI, 5HT decreases. 1. 1. QUESTION 46 1. A 51-year-old female patient presents with symptoms of depression, including lack of motivation and difficulty sleeping. What risk factors would increase her vulnerability for a diagnosis of depression? c A First onset in puberty or early adulthood c B Late onset of menses c C Premenstrual syndrome c D wandc 1 points QUESTION 47 A nurse overhears that a patient has failed single therapy with an SSRI and SNRI. She also learns that the patient has been on dual SSRI/SNRI therapy without adequate symptom control. She approaches the PMHNP and asks what the next treatment option could be in this seemingly treatment-resistant patient. The PMHNP tells the nurse she will treat the patient with the following regimen: cA MAO! plus SNRI cB SsRISNRI plus NDRI ¢ C NDRI/SNRI plus mirtazapine c D nprRI plus modafinil 1 points QUESTION 48 A nurse overhears that a client has failed monotherapy with an SSRI and an SNRI. She also learns that the client has failed dual SSRI + SNRI therapy. The nurse approaches the PMHNP and asks what treatment options should be considered in this treatment resistant client. The PMHNP tells the nurse that she will treat the client with the following regimen. C A SSRI + SNRI B SSRI + NDRI my C SSRI + MAOI q D SSRI + Mood stabilizer 1 points QUESTION 49 1. A patient is prescribed fluoxetine but is concerned about the side effects. Which statement demonstrates accurate patient teaching when discussing the side effects associated with fluoxetine? C A Weight gain can be problematic. c B Sedation is very common. c C Induction of mania is . rare. C D Seizures are not unusual. 1 points QUESTION 50 1 A client is prescribed fluoxetine but is concerned about side effects. Which statement demonstrates accurate client teaching when discussing the side effects associated with fluoxetine? ‘A Weight gain is common « B Sedation is common - C Sedation is unusual = D Seizures occur frequently 1 points QUESTION 51 1. A 25-year-old female patient is being prescribed milnacipran to treat fibromyalgia, and expresses concern regarding “how she will feel and look” from taking the medicine. Which statement correctly describes the side effects as a result of taking this medication? c C The patient has severe renal impairment. c D The patient has cardiac impairment. 1 points QUESTION 55 a The PMHNP understands that which mechanism contributes to a worse tolerability profile for patients taking tricyclic antidepressants (TCAs)? c A Histamine H1 receptor blockade can cause insomnia. C B Muscarinic M1 receptor blockade causes blurred vision. c c Alpha 1 adrenergic receptor blockade causes weight gain. c D Muscarinic M3 receptor blockade causes sedation. 1 points QUESTION 56 1. A patient who was prescribed an MAO inhibitor is learning about dietary modifications. Which statement made by the PMHNP demonstrates proper teaching of the food-drug interactions for MAO inhibitors? c A “You must avoid soy products, such as . tofu.” c B “You should not consume processed meats.” c C “You may consume fermented foods, like sauerkraut.” c D “You may continue to drink beers on tap.” 1 points QUESTION 57 1. A patient who is prescribed MAO inhibitors asks about whether he can continue taking pseudoephedrine to relieve his congestion. Which response by the PMHNP indicates proper understanding of drug-drug interactions? c A “Decongestants are fine to continue taking with MAO inhibitors.” c B “Decongestants are okay to take with MAO inhibitors in moderation.” c Cc “Decongestants should be avoided due to risk of serotonin syndrome.” “ D “Decongestants should be avoided due to risk of hypertensive crisis.” points QUESTION 58 A patien' being prescribed a sedating antidepressant, but is concerned about weight gain. Which medication is most likely to be prescribed to addresses the patient’s concerns? c A mirtazapine (Remeron) C B doxepin (Silenor) c Cc alprazolam (Xanax) c D trazadone (Oleptro) 1 points QUESTION 62 1. A patient who was diagnosed with bipolar disorder without mania, asks the PMHNP why he is being prescribed a mood stabilizer. What is the appropriate response? c A Mood stabilizers are only prescribed to treat manic phases of bipolar depression B Mood stabilizers can consistently treat both mania and bipolar depression nay « C Mood stabilizers can target mania and mania relapse and also reduce symptoms of bipolar depression and relapse of bipolar depression symptoms but no drug has been proven to target all four therapeutic actions © D Certain mood stabilizers, such as lithium, are able to consistently target mania and bipolar depression 1 points QUESTION 63 1. A client who was diagnosed with bipolar disorder without mania, asks the PMHNP why he is being prescribed a mood stabilizer. What is the appropriate response? A Mood stabilizers only treat manic phases of bipolar disorder. ‘. B Mood stabilizers only treat the depressive phases of bipolar disorder. € C Mood stabilizers can treat either manic phases or depressive phases of bipolar disorder. D Mood stabilizer monotherapy is effective in treating bipolar disorder without mania. 1 points QUESTION 64 The PMHNP is assessing a client in the emergency room. The client shares that he has been on lithium for many years. What blood test does fA Thyroid Stimulating Hormone - B Erythrocyte Sedimentation Rate fC Platelet Count €) D Phosphate 1 points QUESTION 65 1. A nursing student is seeking clarification on the use of anticonvulsants to treat depression and is unclear about most effective outcomes. Which of the following agents does the PMHNP convey as having uncertain outcomes? c A Carbamazepine (Tegretol) c B Gabapentin (Neurontin) C Cc Valporoic Acid (Depakene) c D All of the above 1 points QUESTION 66 1 A nursing student is seeking clarification on the use of anticonvulsants to treat bipolar depression and is unclear about which anticonvulsants have the most effective outcomes in treating bipolar depression. Which of the following anticonvulsants is NOT used for treating bipolar depression? ‘A Carbamazepine (Tegretol) C B Gabapentin (Neurontin) C C Lamotrigine (Lamictal) possible sedation ac Clonazepam (klonopin) was used as an aid to treat your condition while you were adjusting to citalopram (celexa) a D Clonazepam (klonopin) and citalopram (celexa) target the same area in the brain and . after long-term use they will begin to compete making one more or less effective than the other 1 points QUESTION 70 1. During assessment a patient states “Why are you asking me about my heart, | am here for my head”, the PMHNP’s best response c A “Some medications can cause heart issues so it is necessary to rule those out before you begin medication.” c B “this isa part of our routine admission and it is important that you give me truthful answers.” c C “Chronic conditions such as Lupus can cause an area in your brain to malfunction, specifically your hippocampus.” aa D “Anxiety can cause cortisol levels to increase and when this happens frequently it puts you at risk for comorbidities such as type 2 diabetes.” 1 points QUESTION 71 1. There are a number of endocrine reactions that accompany fear. A quick boost of cortisol may enhance survival when encountering a real but short-term threat. However, chronic elevations in cortisol can lead to increased medical comorbidities. Which of the following medical conditions may be related to these persistent cortisol elevations? €) A Increased rates of coronary artery disease ‘ B Increased rates of type 2 diabetes fC Increased rates of stroke D all of the above nay 1 points QUESTION 72 1. The PMHNP understands that the potential of alcohol abuse in the anxious client is higher for the following reasons: c + @ Alcohol exerts an effect on GABAs receptors. 7 - b Alcohol increases serotonin levels c Alcohol exerts an effect on the cannabinoid receptors my © d Alcohol has an immediate action by altering G Protein Coupled Receptors 1 points QUESTION 73 1 After ordering flumazenil (Rumazicon) the PMHNP cautions the staff to monitor for which possible effect? © A Agitation 1 out of 1 points 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). Selecte ¢ d “Most medications that work in the brain will result in restoring an imbalance of Answer one or more neurotransmitters that your body already produces helping to alleviate your symptoms .” Question 2 1 out of 1 points Ms. Hill is currently being treated for schizophrenia but has stopped taking her medications due to some side effects she claims she was experiencing. She presents to the clinic today with worsening symptoms. She is experiencing anhedonia, agitation, attentional impairment, and affective blunting. Which one of the symptoms mentioned is considered a positive symptom of schizophrenia? Selecte B. d Agitation Answer: . Question 3 1 out of 1 points Which statement about neurotransmitters and medications is true? Selecte d Several psychiatric medications have been developed after discoveries of Answer endogenous neurotransmitters and defining their function in the brain. ° Question 4 1 out of 1 points When an unstable patient asks why it is necessary to add medications to his current regimen, the PMHNP’s best response would be: Select ed Answer: Cc. cillnesses involve several dys-functioning neurotransmitter systems in the brain. Often, a “Many single medication may only effect one or two of the dys-functioning systems. The psychiatri addition of another medication can work with the current medication in stabilizing multiple neurotransmitter systems and help to alleviate your symptoms.” . Question 5 1 out of 1 points During gene expression, what must occur prior to a gene being expressed? Selecte A. d Transcription factor must bind to the regulatory region Answers within the cell’s nucleus. Question 6 1 out of 1 points While genes have potential to modify behavior, behavior can also modify genes. How do genes impact this process? Selecte B. d Changes made to proteins lead to Answer: changes in behavior. Question 7 1 out of 1 points Though medications have the ability to target neurotransmitter release into the synapse by the presynaptic neuron it is not always necessary. The PMHNP understands that this is because: aolecte Cc. Neurotransmitters can spread Answer: by diffusion. . Question 8 1 out of 1 points Why is the cytochrome P450 enzyme system of significance to the PMHNP? Selecte B d The bioavailability of the medication after it passes through the Answer: stomach and liver can be altered. . Question 9 1 out of 1 points 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? Selecte iN d About 1 out of 5 Asians requires lower-than-normal doses of some Answer antidepressants and antipsychotics. . Question 15 1 out of 1 points The PMHNP is caring for four patients. Which patient statement indicates that benzodiazepines would be beneficial? Selecte D d “| feel nervous to go outside and Answer: be in large crowds.” . Question 16 1 out of 1 points Ms. Harlow is a 42-year-old patient who is prescribed a drug that acts on ionotropic receptors. She is curious about the effects of the drug and how it will act on her symptoms. Which statement made by the PMHNP demonstrates proper understanding of Ms. Harlow’s prescription? Selecte A. d “The drug will have an Answer: almost immediate effect.” . Question 17 1 out of 1 points A patient is seeking pharmacological treatment for smoking cessation. Which drug class does the PMHNP prescribe to the patient? Selecte D. d Vareniclin Answer: e (Chantix) . Question 18 1 out of 1 points The PMHNP is caring for a new patient who has been transferred from another office. When meeting with the new patient, the patient reports, “I feel like |am improving with the stabilizers.” The PMHNP immediately recognizes that the patient is describing which kind of drug? Selecte C. d Partial Answer: agonist s . Question 19 1 out of 1 points A patient presents with frequent episodes of mania. Which statement describes an appropriate treatment approach for this patient? Selecte B d “The patient could benefit Answer: from an anticonvulsant.” . Question 20 1 out of 1 points What characteristics do the nicotinic, cholinergic, serotonin 3, and glycine receptors all have in common? Selecte A d Ligand-gated ion channels Answer: with a pentameric structure . Question 21 0 out of 1 points What is accurate about the clinical description of psychosis? Selecte Cc answer It is a syndrome that can be associated with a . number of psychiatric disorders. Question 27 1 out of 1 points The PMNHP is assessing a 29-year-old client who takes antipsychotics that block D2 receptors. This client has begun to develop a common side effect of this medication. What is this side effect? Selecte D qd : Tardive dyskinesia Answer: Question 28 1 out of 1 points The PMHNP is caring for a patient who is taking antipsychotics heard the psychiatrist tell the patient that the patient would be placed on a different antipsychotic agent called an atypical antipsychotic. What neurotransmitters will this new medication work on? Selecte d A. dopamine and serotonin Answer: Question 29 1 out of 1 points Which statement made by the PMHNP exemplifies correct teaching of physiological effects in the body? Selecte D d D2 partial agonists are associated with increased efficacy in Answer treating positive symptoms of schizophrenia. Question 30 1 out of 1 points Mrs. Schwartzman is a 52-year-old patient with schizophrenia and no established history of depression. When meeting with the PMHNP, she presents with apathy and withdrawn social behavior, and she reports a loss of joy from enjoyable activities. What does the PMHNP infer from this encounter with the patient? Selecte B d The recent change of a 2nd generation antipsychotic to a Answer: conventional one . Question 31 1 out of 1 points Mrs. Schwartzman is a 52-year-old client with schizophrenia and no established history of depression. When meeting with the PMHNP, she presents with apathy and withdrawn social behavior, and she reports a loss of joy from enjoyable activities since starting her new medication. What does the PMHNP infer from this encounter with the client? Selecte Cc d . The new medication is blocking D2 receptors in the Answer: mesolimbic system . Question 32 1 out of 1 points The student inquires about antipsychotic medications. Which response by the PMHNP describes the factors that contribute to reduced risk of extrapyramidal symptoms (EPS) for patients who take antipsychotics? Selecte B d Those that are potent D2 antagonists with Answer: 5HT2A antagonism properties . Question 33 0 out of 1 points Mr. Gordon is a middle-aged patient who is taking antipsychotics. When meeting with the PMHNP, he reports positive responses to the medication, stating, “I really feel as though the effects of my depression are going away.” Which receptor action in antipsychotic medications is believed to be the most beneficial in producing the effects described by Mr. Gordon? Selecte D. d D2 Answer: partial agonist . Question 34 1 out of 1 points Mr. Gordon is a middle-aged client who was started on antidepressant monotherapy for depression. After beginning this medication, the PMHNP noticed that this client seemed to swing into a hypomanic episode. What can the PMHNP infer from this behavior change? aolecte A. This client may have Bipolar III disorder Answer: . Question 35 1 out of 1 points Ms. Ryerson is a 28-year-old patient with a mood disorder. She recently requested to transfer to a new PMHNP, after not getting along well with her previous provider. The new PHMNP is reviewing Ms. Ryerson’s medical chart prior to their first appointment. Upon review, the PMHNP sees that the former Selecte qd B. MAO inhibitors Answer: . Question 41 1 out of 1 points The PMHNP is assessing a patient in the psychiatric emergency room. The patient tells the PMHNP that he does not understand why his depression has not lifted after being on four different antidepressants over the course of a year. Which of the following symptoms can be residual symptoms for patients who do not achieve remission with major depressive disorder? Selecte D. d A Answer: and c . Question 42 1 out of 1 points Fluoxetine (Prozac) has been prescribed for a patient. Which of the following statements is true regarding the action of this medication? Selecte D d The action at the somatodendritic end of the serotonin neuron Answer may best explain the therapeutic action of SSRIs. . Question 43 1 out of 1 points Fluoxetine (Prozac) has been prescribed for a client with depression. Which of the following statements is true regarding the action of this medication? Selecte B d Fluoxetine inhibits the serotonin transporter (SERT). Answer: . Question 44 0 out of 1 points The nurse education knows that teaching was effective when one of the students compares fluvoxamine to sertraline and notes which of the following similarities? Selecte c d Both agents are approved for the treatment of depression in the United Answer: States . Question 45 1 out of 1 points A 45 year old female client with allergic rhinitis and normal blood pressure has had no reduction in depressive symptoms after trying bupropion, paroxetine, and venlafaxine. What precautions are needed when considering phenelzine in treating her depression? Selecte d Answer: The client will need to minimize dietary intake of foods that are high in tyramine. . Question 46 0 out of 1 points A 51-year-old female patient presents with symptoms of depression, including lack of motivation and difficulty sleeping. What risk factors would increase her vulnerability for a diagnosis of depression? Selecte B. d Late onset of Answer: medication? Selecte D. d Weight gain is Answer: unusual. Question 52 1 out of 1 points Mr. Ruby is a 33-year-old single father who is requesting pharmacological intervention to treat his fibromyalgia. The PMHNP sees in the medical chart that he has a recent diagnosis of arrhythmia and a BMI of 29. During his assessment, the PMHNP learns that Mr. Ruby works 40-50 hours a week as a contractor and “manages his stress” by smoking 3-4 cigarettes a day and having 8-10 drinks of alcohol each week. Why would duloxetine be contraindicated for Mr. Ruby? Selecte Cc. d He Answer: uses alcohol Question 53 1 out of 1 points A patient is prescribed sertraline to treat panic disorder. Knowing that sertraline can initially cause anxiety or insomnia, what should the PMHNP do? Selecte B d Prescribe short-acting benzodiazepine for 2 Answer: weeks, then discontinue. Question 54 1 out of 1 points A patient is prescribed 50 mg of desvenlafaxine to take every other day for major depressive disorder. What does the PMHNP understand about this patient? Selecte Cc d The patient has severe Answer: renal impairment. Question 55 1 out of 1 points The PMHNP understands that which mechanism contributes to a worse tolerability profile for patients taking tricyclic antidepressants (TCAs)? Selecte B. d Muscarinic M1 receptor blockade Answer: causes blurred visi Question 56 1 out of 1 points A patient who was prescribed an MAO inhibitor is learning about dietary modifications. Which statement made by the PMHNP demonstrates proper teaching of the food-drug interactions for MAO inhibitors? Selecte iN d “You must avoid soy products, Answer: such as tofu.” Question 57 1 out of 1 points A patient who is prescribed MAO inhibitors asks about whether he can continue taking pseudoephedrine to relieve his congestion. Which response by the PMHNP indicates proper understanding of drug-drug interactions? Selecte D d “Decongestants should be avoided due to Answer: risk of hypertensive crisis.” Question 58 1 out of 1 points Ms. Skidmore presents for a follow-up appointment after being prescribed phenelzine (Nardil), and reports “I take my 45 mg pill, three times a day, just like I’m supposed to.” What does the PMHNP understand about this patient? Selecte Cc. d Ms. Skidmore is taking too much of the phenelzine (Nardil); she Answer should be taking the 45 mg in three doses. Question 59 1 out of 1 points The PMHNP is caring for several patients who present with various symptoms and health issues. For which patient does the PMHNP prescribe pregabalin (Lyrica)? Selecte B d Patient with Answer: partial seizures Question 60 1 out of 1 points Mr. Gutier is 72 years old with anxiety and depressive symptoms. His PMHNP is prescribing lorazepam (Ativan). What does the PMHNP understand regarding this prescription? A nursing student is seeking clarification on the use of anticonvulsants to treat depression and is unclear about most effective outcomes. Which of the following agents does the PMHNP convey as having uncertain outcomes? Selecte B. d Gabapenti Answer: n (Neurontin ) . Question 66 1 out of 1 points A nursing student is seeking clarification on the use of anticonvulsants to treat bipolar depression and is unclear about which anticonvulsants have the most effective outcomes in treating bipolar depression. Which of the following anticonvulsants is NOT used for treating bipolar depression? Selecte d B. Gab. tin (N: ti Answer: abapentin (Neurontin) Question 67 0 out of 1 points The PMHNP is meeting with a new mother who would like to begin taking medication again to treat her bipolar depression; she is breastfeeding her 2- month old daughter. The PMHNP recognizes that which of the following medications is contraindicated for this patient? Selecte c d Lithium Answer: (Lithobid ) Question 68 1 out of 1 points The PMHNP is meeting with a new mother who would like to begin taking medication again to treat her bipolar depression; she is breastfeeding her 2-month old daughter. The PMHNP recognizes that which of the following medications is contraindicated for this client? Selecte d Cc. Lithium (Lithobid) Answer: Question 69 1 out of 1 points A patient was diagnosed with GAD 4 weeks ago and was placed on Clonazepam (klonopin) twice a day and citalopram (citalopram (celexa)) once daily. When he asks the PMHNP why it is necessary to wean him off of the Clonazepam (klonopin) the best response is: Selecte Cc d Clonazepam (klonopin) was used as an aid to treat your condition Answer while you were adjusting to citalopram (celexa) . Question 70 1 out of 1 points During assessment a patient states “Why are you asking me about my heart, | am here for my head”, the PMHNP’s best response i Selecte D d “Anxiety can cause cortisol levels to increase and when this Answer happens frequently it puts you at risk for comorbidities such as : type 2 diabetes.” . Question 71 0 out of 1 points