NURS 6630 Midterm and Final Exam Questions and Answers

NURS 6630 Midterm and Final Exam Questions and Answers

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).

A.

"You have to take your medication to become stable."

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1 points  

QUESTION 2

  1. Which statement about neurotransmitters and medications is true?

NURS 6630 Midterm and Final Exam Questions and Answers

The neurotransmitter serotonin is directly linked to depression. Following this discovery, the antidepressant Prozac was developed.

1 points  

QUESTION 3

  1. When an unstable patient asks why it is necessary to add medications to his current regimen, the PMHNP's best response would be:

NURS 6630 Midterm and Final Exam Questions and Answers

1 points  

QUESTION 4

  1. During gene expression, what must occur prior to a gene being expressed?

A.

Transcription factor must bind to the regulatory region within the cell's nucleus.

NURS 6630 Midterm and Final Exam Questions and Answers

1 points  

QUESTION 5

  1. While genes have potential to modify behavior, behavior can also modify genes. How do genes impact this process?

A.

Genes impact neuron functioning directly.

 

1 points  

QUESTION 6

  1. Though medications have the ability to target neurotransmitters in the synapse, it is not always necessary. The PMHNP understands that this is because:

NURS 6630 Midterm and Final Exam Questions and Answers

1 points  

QUESTION 7

  1. Why is the cytochrome P450 enzyme system of significance to the PMHNP?

NURS 6630 Midterm and Final Exam Questions and Answers

1 points  

QUESTION 8

  1. 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?

 

1 points  

QUESTION 9

  1. As it relates to G-protein linked receptors, what does the PMHNP understand about medications that are used in practice?

NURS 6630 Midterm and Final Exam Questions and Answers

D.

Medications used in practice may act as inverse agonists if the dosage is too high.

1 points  

QUESTION 10

  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:

The patient has chronic kidney disease, stage 2.

D.

Question 20

A patient recovering from shingles presents with tenderness and sensitivity to the upper back. He states it is bothersome to put a shirt on most days. This patient has end stage renal disease (ESRD) and is scheduled to have hemodialysis tomorrow but states 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?

a) order herpes simplex virus (HSV) antibody testing

 

d) Prescribe hydromorphone (dilaudid) 2mg

Question 21

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 most likely take?

NURS 6630 Midterm and Final Exam Questions and Answers

c) Order gabapentin, 100mg TID because lamotrigine is no longer working for this patient

d) Order a CBC to assess for an infection

Question 22

An elderly woman with a hx 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?

a) order an X-ray because it is possible that she dislocated her hip

b) order ibuprofen because she mayneed long term treatment and chronic pain is not uncommon

NURS 6630 Midterm and Final Exam Questions and Answers

Question 23

The PMHNP is assessing a 49-year-old male with a history of depression, post-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 lower extremities and a chief complaint of pain with numbness and tingling to each leg 5/10. The PMHNP starts this patient on a low dose of doxepin (Sinequan). What is the next action that must be taken by the PMHNP?

a) Orders liver function tests

NURS 6630 Midterm and Final Exam Questions and Answers

d) Order BUN/Creatinine test

Question 24

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?

a) Prescribe estrin FE 24 birth control

b) Prescribe Ibuprofen 800mg every 8 hours as needed for pain

NURS 6630 Midterm and Final Exam Questions and Answers

Question 25

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?

NURS 6630 Midterm and Final Exam Questions and Answers

c) “the SNRI can reduce brain atrophy by slowing the gray matter loss in the dorsolateral prefrontal cortex”

d) “the SNRI can increase neurotransmission to descending neurons”

Question 26

A patient with fibromyalgia and major depression needs to be treated for symptoms of pain. Which is the PMHNP most likely to prescribe for this patient?

a) Venlafaxine (Effexor)

b) Duloxetine (Cymbalta)

c) Clozapine (Clozaril)

d) Phenytoin (Dilantin)

Question 27

The PMHNP prescribes gabapentin (Neurontin) for a patient’s chronic pain. How does the PMHNP anticipate the drug to work?

a) It will bind to the alpha-2-delta ligand subunit of voltage-sensitive calcium channels

b) It will induce synaptic changes, including sprouting

c) It will act on the presynaptic neuron to trigger sodium influx

d) It will Inhibit activity of dorsal horn neurons to suppress body input from reaching the brain

Question 28

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?

a) Venlafaxine (Effexor)

b) Armodafinil (Nuvigil)

NURS 6630 Midterm and Final Exam Questions and Answers

Question 29

The PMHNP is caring for a patient with fibromyalgia. Which second-line treatment does the PMHNP select that may be effective for managing this patient’s pain?

a) Methylphenidate (Ritalin)

b) Viloxazine (Vivalan)

 

Question 30

The PMHNP is attempting to treat a patient’s chronic pain by having the agent bind the open channel conformation of VSCCs to block those channels with a “use-dependent” form of inhibition. Which agent will the PMHNP most likely select?

a) Pregabalin (Lyrica)

 

d) Atomoxetine (Strattera)

Question 31

A patient with irritable bowel syndrome reports chronic stomach pain. The PMHNP wants to prescribe the patient an agent that will cause irrelevant nociceptive inputs from the pain to be ignored and no longer perceived as painful. Which drug will the PMHNP prescribe?

a) Pregabalin (Lyrica)

b) Gabapentin (Neurontin)

NURS 6630 Midterm and Final Exam Questions and Answers

Question 32

The PMHNP wants to use a symptom-based approach to treating a patient with fibromyalgia. How does the PMHNP go about treating this patient?

a) Prescribing the patient an agent that ignores the painful symptoms by initiating a reaction known as “fibro-fog”

b) Targeting the patient’s symptoms with anticonvulsants that inhibits gray matter loss in the dorsolateral prefrontal cortex

c) Mzatching the patient’s symptoms with the malfunctioning brain circuits and neurotransimitters that might mediate those symptoms

d) None of the above

Question 33

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?

 

c) “SSRIs only increase serotonin and norepinephrine levels”

d) “SSRIs do not increase serotonin or norepinephrine levels”

Question 34

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?

a) Antipsychotics

b) Lithium

 

Question 35

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?

a) “Naltrexone may be an appropriate option to discuss”

b) “there are many medicine options that treat Kleptomania”

NURS 6630 Midterm and Final Exam Questions and Answers

Question 36

Which statement best describes a pharmacological approach to treating patients for impulsive aggression?

a) Anticonvulsant mood stabilizers can eradicate limbic irritability

b) Atypical antipsychotics can increase subcortical dopaminergic stimulation

NURS 6630 Midterm and Final Exam Questions and Answers

Question 37

A patient with hypersexual disorder is being assessed for possible pharmacologic treatment. Why does the PMHNP prescribe an antiandrogen for this patient?

a) It will prevent feelings of euphoria

b) It will amplify impulse control

c) It will block testosterone

d) It will redirect the patient to think about other things

Question 38

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?

a) “Compulsive internet use can be treated similarly to how we treat people with substance use disorders”

b) “internet addiction is treated with drugs that help block the tension/arousal state your daughter experiences”

 

Question 39

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 statement best describes the neurobiological parallels between food and drug addiction?

a) There is decreased activation of the prefrontal cortex

NURS 6630 Midterm and Final Exam Questions and Answers

d) There are amplified reward circuits that activate upon consumption

Question 40

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 sleep state?

a) Histamine 2 receptor antagonist

b) Benzodiazepines

NURS 6630 Midterm and Final Exam Questions and Answers

 

Question 41

The PMHNP is caring for a patient who experiences too much overstimulation and anxiety during daytime hours. The patient agrees to a pharmacological treatment but states, “I don’t want to feel sedated or drowsy from the medicine.” Which decision made by the PMHNP demonstrates proper knowledge of this patient’s symptoms and appropriate treatment options?

a) Avoiding prescribing the patient a drug that blocks H1 receptors

b) Prescribing the patient a drug that acts on H2 receptors

c) Stopping the patient from taking medicine that unblocks H1 receptors

d) None of the above

NURS 6630 Midterm and Final Exam Questions and Answers