NURS 6630 - Psychopharmacologic Approaches to Treatment of Psychopathology

1. Question: Antihistamines may cause side eOects such as blurred vision, constipation, memory problems, and dry mouth. This is due to the _______________ eGects of antihistamines.
2. Question: 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?
3. Question: 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?
4. Question: 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?
5. Question: Which of the following is considered as a disruptive/impulse control behavior?
6. Question: 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?
7. Question: 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?
8. Question: 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?
9. Question: 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?
10. Question: 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?
11. Question: 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 ?
12. Question: 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:
13. Question: The PMHNP prescribes gabapentin (Neurontin) for a patient’s chronic pain. How does the PMHNP anticipate the drug to work?
14. Question: 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?
15. Question: 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?
16. Question: The PMHNP wants to use a symptom-based approach to treating a patient with Fbromyalgia. How does the PMHNP go about treating this patient?
17. Question: The PMHNP prescribes pregabalin (LYRICA) for a patient with chronic pain. How does pregabalin work to reduce pain?
18. Question: 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?
19. Question: The PMHNP understands that slow-dose extended release stimulants are most appropriate for which patient with ADHD?
20. Question: 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?
21. Question: Antipsychotics are doses at a level that blocks ________% of D2 receptors.
22. Question: Neal is complaining of restless leg syndrome and insomnia. Which Nrst-line medication should the PMHNP prescribe to treat both?
23. Question: 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?
24. Question: Which of the following anticonvulsants increases serotonergic neurotransmission and GABAergic transmission, while decreasing glutamatergic neurotransmission?
25. Question: The nursing staU asks the PMHNP for additional education regarding the treatment of agitation in dementia patients. Which of the following is correct?
26. Question: 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?
27. Question: 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?
28. Question: 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?
29. Question: 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?
30. Question: 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:
31. Question: 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:
32. Question: A PMHNP supervisor is discussing with a nursing student how stimulants and noradrenergic agents assist with ADHD symptoms. What is the appropriate response?
33. Question: 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?
34. Question: 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?
35. Question: 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?
36. Question: 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)?
37. Question: 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?
38. Question: 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?
39. Question: 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?
40. Question: 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?
41. Question: 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?
42. Question: A patient is being prescribed bupropion and is concerned about the side eKects. What will the PMHNP tell the patient regarding bupropion?
43. Question: 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?
44. Question: 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?
45. Question: Why does the PMHNP avoid prescribing clozapine (Clozaril) as a Krst-line treatment to the patient with psychosis and aggression?
46. Question: 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?
47. Question: Sandra complains of constipation after being on quetiapine (SEROQUEL) for several weeks.
    1. Constipation is likely caused by the binding of quetiapine (SEROQUEL) to which receptor?
48. Question: 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?
49. Question: 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?
50. Question: Individuals who su  er from an addiction often increase the dose of medication to achieve the
    1. desired eTect. The need to increase the dose to reach the safe e  ect is due to __________________.
51. Question: 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?
52. Question: 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?
53. Question: 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?
54. Question: 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 ____________.
55. Question: 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?
56. Question: 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 a typical anti psychotics?
57. Question: Which of the following substances has the highest probability of becoming dependent after a single use?
58. Question: 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?
59. Question: 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?
60. Question: All drugs that lead to addiction increase __________________in the ventral striatum, which is also called the _______________.
61. Question: 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?
62. Question: Naltrexone (Revia), an opioid antagonist, is a medication that is used for which of the following conditions?
63. Question: The PMHNP is treating a patient for bromyalgia and is considering prescribing milnacipran (Savella). When prescribing this medication, which action is the
64. Question: 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?
65. Question: 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?
66. Question: 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?
67. Question: 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?
68. Question: 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?
69. Question: Which of these statements is correct?
70. Question: 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?
71. Question: 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?
72. Question: 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?
73. Question: 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?
74. Question: 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?
75. Question: The PMHNP wishes to prescribe a medication that reduces glutamate transmission in an Alzheimer's patient. Which medication should the PMHNP prescribe?
76. Question: When comple
    ng this exam, did you comply with Walden University’s Code of Conduct including the expecta
    ons for academic integrity?