NURS 6630 FINAL EXAM 5 LATEST VERSIONS (VERSION V1,V2,V3,V4,&V5) 2024-2025 ACTUAL EXAM E, Exercises of Nursing

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NURS 6630 FINAL EXAM 5 LATEST

VERSIONS (VERSION V1,V2,V3,V4,&V5)

2024 - 2025 ACTUAL EXAM EACH EXAM

CONTAINS 150 QUESTIONS AND

CORRECT ANSWERS

What is the strongest established risk factor for bipolar disorder? - ANSWER.... Family history which of the following medications are known as selective serotonin re-uptake inibitors (SSRIs)? - ANSWER.... Nortriptyline Citalopram Duloxetine fluoxetine venlafaxine Which disease state o a non-adherent patient is at greater risk for substance use violence, and victimization as well as worse overall quality of life? - ANSWER.... Schizophrenia Patient is a 72 year old male with a past medical history significant for the atrial fibrillation and COPD with a new diagnosis of major depression disorder. Based on his comorbid conditions, what antidepressant would you recommend as first-line?

• ANSWER.... not TCA due to fib and age, not ADHD med

which of the following is an appropriate strategy for managing treatment resistant depression - ANSWER.... SSRI and SNRI which of the following medications is best to AVOID in maintenance treatment of bipolar disorder and why - ANSWER.... antidepressants might contribute to an increase in mood episode freq1uency 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 deficit hyperactivity disorder (ADHD) is suspected. What medication is the PMNHP most likely to prescribe? - ANSWER.... ANS: b. Methylphenidate (Ritalin, Concerta) 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? - ANSWER.... ANS: d. "Naltrexone may be an appropriate option to discuss." Which of the following substances has the highest probability of becoming dependent after a single use? - ANSWER.... ANS: c. Nicotine The nursing staff asks the PMHNP for additional education regarding the treatment of agitation in dementia patients. Which of the following is correct? - ANSWER.... ANS: c.

The nurse should attempt to determine how the patient's environment may be impacting the patient's mood. 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)? - ANSWER.... ANS: c. The patient is somnolent and has 7 respirations per minute. A patient with chronic insomnia asks the PMHNP if they can first try an over the- counter (OTC) medication before one that needs to be prescribed to help the patient sleep. Which is the best response by the PMHNP? - ANSWER.... ANS: a. "You can get melatonin over the counter, which will help with sleep onset." 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? - ANSWER.... ANS: b. Avoiding prescribing the patient a drug that blocks H1 receptors Which of these statements is correct? - ANSWER.... ANS: d. Sedation is unusual with aripiprazole (ABILIFY)

The PMHNP is caring for a patient who openly admitted to drinking a quart of vodka daily. Prior to prescribing this patient disulfiram (Antabuse), it is important for the PMHNP to: - ANSWER.... ANS: d. Evaluate the patient's willingness to abstain from alcohol 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? - ANSWER.... ANS: d. There is decreased activation of the prefrontal cortex. An 18-year-old female with a history of frequent headaches and a mood disorder is prescribed topiramate (Topamax), 25 mg by mouth daily. The PMHNP understands that this medication is effective in treating which condition(s) in this patient?` - ANSWER.... ANS: c. Migraines 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? - ANSWER.... ANS: d. Carbamazepine

Antipsychotics are doses at a level that blocks % of D2 receptors. - ANSWER.... ANS: a. 50 - 70 The PMHNP is teaching a patient with a sleep 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?

• ANSWER.... ANS: b "It can cause blurred vision A 9-year-old female patient presents with symptoms of both attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder. In evaluating her symptoms, the PMHNP determines that which of the following medications may be beneficial in augmenting stimulant medication? - ANSWER.... ANS: b. Guanfacine ER (Intuniv) 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? - ANSWER.... ANS: b. Cardiovascular disease The PMHNP wishes to prescribe a medication that reduces glutamate transmission in an Alzheimer's patient. Which medication should the PMHNP prescribe? - ANSWER.... ANS: b.

Memantine (NAMENDA) 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? - ANSWER.... ANS: d. Duloxetine (Cymbalta) A patient is prescribed D-methylphenidate, 10-mg extended-release capsules. What should the PMHNP include when discussing the side effects with the patient? - ANSWER.... ANS: c. The medication can affect your blood pressure. Which medication is an irreversible inhibitor of aldehyde dehydrogenase that creates a negative and aversive response following ingestion of alcohol? - ANSWER.... ANS: c. Disulfiram (ANTABUSE) 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? - ANSWER.... ANS: a. Donepezil (Aricept) 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? - ANSWER.... ANS: b. All of these are correct

A 26-year-old female patient with nicotine dependence and a history of anxiety presents with symptoms of attention deficit hyperactivity disorder (ADHD). Based on the assessment, what does the PMHNP consider? - ANSWER.... ANS: a. ADHD is often not the focus of treatment in adults with comorbid conditions. Parents of a 12-year-old boy want to consider attention deficit hyperactivity disorder (ADHD) medication for their son. Which medication would the PMHNP start? - ANSWER.... ANS: d. All of these could potentially treat their son's symptoms. 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 given these other factors? - ANSWER.... ANS: b. ApoE4 genotype and avoid antihistamines if possible and Type 2 diabetes and avoid olanzapine 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? - ANSWER.... ANS: c. Modafanil (PROVIGIL)

You have been consulted to evaluate a patient who presents with symptoms of dementia. The patient is experiencing memory deficit, aphasia, apraxia, and agnosia. Which treatment option is best for this patient? - ANSWER.... ANS: a. Donepezil (ARICEPT) Why does the PMHNP avoid prescribing clozapine (Clozaril) as a first-line treatment to the patient with psychosis and aggression? - ANSWER.... ANS: c. There is too high a risk of serious adverse side effects. 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? - ANSWER.... ANS: d. Triazolam (Halcion) The PMHNP prescribes gabapentin (Neurontin) for a patient's chronic pain. How does the PMHNP anticipate the drug to work? - ANSWER.... ANS: c. It will bind to the alpha- 2 - delta ligand subunit of voltage sensitive calcium channels. 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? - ANSWER.... ANS: d. "The SNRI can increase noradrenergic neurotransmission in the descending spinal pathway to the dorsal horn."

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? - ANSWER.... ANS: c. Pregabalin (Lyrica) 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? - ANSWER.... ANS: a. Order hydroxyzine (Vistaril), 50 mg PRN or as needed The PMHNP is caring for a patient on risperidone (Risperdal). Which action made by the PMHNP exhibits proper care for this patient? - ANSWER.... ANS: d. Titrating the dose by increasing it every 5-7 days 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? - ANSWER.... ANS: c. Increase the dose of lamotrigine (Lamictal) to 25 mg twice daily. 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? - ANSWER.... ANS: b. Bupropion (ZYBAN) The PMHNP is treating a patient with depression and fibromyalgia. The PMHNP chooses to prescribe a treatment that may help treat the patient's fibromyalgia and depressive symptoms. Which medication is the PMHNP likely to choose? - ANSWER.... ANS: a. Amitriptyline (ELAVIL) The PMHNP is teaching parents about their child's new prescription for Ritalin. What will the PMHNP include in the teaching? - ANSWER.... ANS: c. The second dose should be taken at lunch. You decide to start a patient on lurasidone (LATUDA). Which of these counseling points is correct? - ANSWER.... ANS: b This medication must be taken with food. Which of these characteristics does NOT meet the criteria for probably Alzheimer's dementia? - ANSWER.... ANS: b. Sudden onset A 43-year-old male patient is seeking clarification about treating attention deficit hyperactivity disorder (ADHD) in adults and how it differs from treating children,

since his son is on medication to treat ADHD. The PMHNP conveys a major difference is which of the following? - ANSWER.... ANS: b. Comorbidities are more common in adults, impacting the prescription of additional agents. 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? - ANSWER.... ANS: c. Duloxetine (Cymbalta) A patient calls the clinic to ask about an over-the-counter sleep aid. What is the best response? - ANSWER.... ANS: b. "You can purchase a second-generation antihistamine to help you sleep." The PMHNP is treating a patient for fibromyalgia and is considering prescribing milnacipran (Savella). When prescribing this medication, which action is the PMHNP likely to choose? - ANSWER.... ANS: c. Split the daily dose into two doses after the first day. A nursing students asks the PMHNP the difference between impulsivity and compulsivity. Which of the following responses is correct? - ANSWER.... ANS: b. Impulsivity is defined as acting with excessive forethought and compulsivity is defined as actions that are considered appropriate but persistent.

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? - ANSWER.... ANS: a. "SSRIs only increase serotonin levels." An adult patient presents with a history of alcohol addiction and attention deficit hyperactivity disorder (ADHD). Given these comorbidities, the PMHNP determines which of the following medications may be the best treatment option? - ANSWER.... ANS: b. Atomoxetine (Strattera) Heather is admitted for opioid withdrawals and detoxification. The PMHNP decides to prescribe an alpha-2 adrenergic agonist to reduce the symptoms of autonomic hyperactivity during withdrawal and aid in the detoxification process. Which medication did the PMHNP prescribe? - ANSWER.... ANS: c. Clonidine 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? - ANSWER.... ANS: a. Non-benzodiazepine hypnotics

The PMHNP is selecting a medication treatment option for a patient who is exhibiting psychotic behaviors with poor impulse control and aggression. Of the available treatments, which can help temper some of the adverse effects or symptoms that are normally caused by D2 antagonism? - ANSWER.... ANS: b. Second-generation, atypical antipsychotics Insomnia is caused by excessive nighttime arousal. The PMHNP is likely to prescribe which of the following to treat insomnia? - ANSWER.... ANS: d. A positive allosteric modulator of GABA-A receptors Which neurotransmitter is secreted by the pineal gland that acts on the suprachiasmatic nucleus to regulate circadian rhythms? - ANSWER.... ANS: a. Melatonin 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? - ANSWER.... ANS: b. Prescribe lidocaine 5% 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? - ANSWER.... ANS: a. This medication has unwanted side effects such as sedation, lack of coordination, and drowsiness. A patient is being prescribed bupropion and is concerned about the side effects. What will the PMHNP tell the patient regarding bupropion? - ANSWER.... ANS: b. It can cause cardiac arrhythmias. The PMHNP wants to use a symptom-based approach to treating a patient with fibromyalgia. How does the PMHNP go about treating this patient? - ANSWER.... ANS: d. Matching the patient's symptoms with the malfunctioning brain circuits and neurotransmitters that might mediate those symptoms. 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? - ANSWER.... ANS: b. Decrease his SSRI and add buspirone (Buspar).

The PMHNP understands that bupropion (Wellbutrin) is an effective way to assist patients with smoking cessation. Why is this medication effective for these patients? - ANSWER.... ANS:b. Bupropion (Wellbutrin) blocks dopamine reuptake, enabling more availability of dopamine. 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? - ANSWER.... ANS: c. Order liver function tests. The PMHNP prescribes an obese patient phentermine (Adipex-p)/topiramate ER (Topamax) (Qsymia), Why is topiramate (Topamax) often prescribed with phentermine (Adipex-P)? - ANSWER.... ANS: d. Phentermine (Adipex-P) works by suppressing appetite while topiramate (Topamax) acts by inhibiting appetite. 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 basis. What does the PMHNP find problematic about this documentation? - ANSWER.... ANS: b. Hypnotics have prolonged half-lives that can cause drug accumulation in the elderly. A 63-year-old patient presents with the following symptoms. The PMHNP determines which set of symptoms warrant prescribing a medication? Select the ANSWER that is matched with an appropriate treatment. - ANSWER.... ANS: a. Impairment in the ability to learn and retain new information is most problematic, and an appropriate treatment option would be donepezil. An opioid-naive patient is taking MS Contin (morphine sulfate) to treat his pain that is secondary to cancer. Under what circumstances would the PMHNP order naloxone (Narcan) IM/SQ? - ANSWER.... ANS:b. The patient's vital signs are 98.4F temp, 88 pulse, 104/62 blood pressure, and 8 respirations An adult patient presents with a history of substance-use disorder and attention deficit hyperactivity disorder (ADHD). Which of the following treatment options is best for this patient? - ANSWER.... ANS: d. Atomoxetine Which statement best describes a pharmacological approach to treating patients for impulsive aggression? - ANSWER.... ANS: a. Opioid antagonists can be used to reduce drive.

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? - ANSWER.... ANS: c. Duloxetine (CYMBALTA) The PMHNP understands that slow-dose extended release stimulants are most appropriate for which patient with ADHD? - ANSWER.... ANS: d. 8 - year-old patient Alcohol enhances inhibition at synapses and reduces excitation at synapses. - ANSWER.... ANS: b. GABA / Glutamate A patient addicted to heroin is receiving treatment for detoxification. He begins to experience autonomic hyperactivity during the drug withdrawal period. What medication will the PMHNP prescribe for this patient? - ANSWER.... ANS: a. Clonidine (CATAPRES) 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 following would be an appropriate choice? - ANSWER.... ANS: a. All of these are correct

Jerry presents to the clinic for his four-week follow-up after starting trazodone for insomnia. How does trazodone help with insomnia? - ANSWER.... ANS: a. Trazodone blocks alpha-1 and histamine-1 receptors at low doses. 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? - ANSWER.... ANS: b. a 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: - ANSWER.... ANS: b. Amnesia, apraxia, agnosia Sharon is a 56-year-old female that presents to the clinic with pain after suffering 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? - ANSWER.... ANS: c. Neuropathic pain Even though both of these medications are useful in the treatment of ADHD, their actions are different. Atomoxetine is a selective reuptake inhibitor, while bupropion is a selective reuptake inhibitor. - ANSWER.... ANS: a. Norepinephrine / norepinephrine-dopamine

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? - ANSWER.... ANSWER: D. All of the above 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? - ANSWER.... ANSWER: A. Order an X- ray because it is possible that she dislocated her hip. 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? - ANSWER.... ANSWER: B. Benzodiazepines 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? - ANSWER.... ANSWER: D. Clonidine (Catapres) The PMHNP prescribes gabapentin (Neurontin) for a patient's chronic pain. How does the PMHNP anticipate the drug to work? - ANSWER.... ANSWER: A. It will bind to the alpha- 2 - delta ligand subunit of voltage-sensitive calcium channels.

A patient with hypersexual disorder is being assessed for possible pharmacologic treatment. Why does the PMHNP prescribe an antiandrogen for this patient? - ANSWER.... ANSWER: C. It will block testosterone. Which statement best describes a pharmacological approach to treating patients for impulsive aggression? - ANSWER.... ANSWER: D. Opioid antagonists can be used to reduce drive. A 26-year-old female patient with nicotine dependence and a history of anxiety presents with symptoms of attention deficit hyperactivity disorder (ADHD). Based on the assessment, what does the PMHNP consider? - ANSWER.... ANSWER: A. ADHD is often not the focus of treatment in adults with comorbid conditions. 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? - ANSWER.... ANSWER: C. Duloxetine (Cymbalta) Parents of a 12-year-old boy want to consider attention deficit hyperactivity disorder (ADHD) medication for their son. Which medication would the PMHNP start? - ANSWER.... ANSWER: All of the above could potentially treat their son's symptoms.

Which of the following is a true statement regarding the use of stimulants to treat attention deficit hyperactivity disorder (ADHD)? - ANSWER.... ANSWER: B. Signal strength output is increased by dialing up the release of dopamine (DA) and norepinephrine (NE). 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? - ANSWER.... A. There is decreased activation of the prefrontal cortex 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 following would be an appropriate choice? - ANSWER.... ANSWER: D. All of the above A patient is prescribed D-methylphenidate, 10-mg extended-release capsules. What should the PMHNP include when discussing the side effects with the patient? - ANSWER.... ANSWER: C. The medication can affect your blood pressure. 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-stimulant. Which medication will the PMHNP will most likely prescribe? - ANSWER.... ANSWER: A. Strattera

The PMHNP is assessing a patient who has expressed suicidal intent and is now stating that he is hearing voices and sees people chasing him. The PMHNP identifies these symptoms to be associated with which of the following? - ANSWER.... ANSWER: C. "Bath salt" intoxication 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? - ANSWER.... ANSWER: A. Donepezil (Aricept) A 63-year-old patient presents with the following symptoms. The PMHNP determines which set of symptoms warrant prescribing a medication? Select the ANSWER that is matched with an appropriate treatment. - ANSWER.... ANSWER: B. Impairment in the ability to learn and retain new information is most problematic, and an appropriate treatment option would be donepezil. 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? - ANSWER.... ANSWER: D. Non-benzodiazepine hypnotics 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 basis. What does the PMHNP find problematic about this documentation? - ANSWER.... ANSWER: B. Hypnotics have prolonged half-lives that can cause drug accumulation in the elderly. 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? - ANSWER.... ANSWER: C. Prescribe desvenlafaxine (Pristiq), 50 mg daily 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? - ANSWER.... ANSWER: C. Imipramine (Tofranil) 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? - ANSWER.... ANSWER: A. Order hydroxyzine (Vistaril), 50 mg PRN or as needed 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? - ANSWER.... ANSWER: A. Triazolam (Halcion)

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? - ANSWER.... ANSWER: D. Naltrexone 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 staff? - ANSWER.... ANSWER: D. Both "A" & "C." A 14-year-old patient is prescribed Strattera and asks when the medicine should be taken. What does the PMHNP understand regarding the drug's dosing profile?

• ANSWER.... ANSWER: B. The patient will have one or two doses a day. Naltrexone (Revia), an opioid antagonist, is a medication that is used for which of the following conditions? - ANSWER.... ANSWER: A. Alcoholism 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? - ANSWER.... ANSWER: A. "Naltrexone may be an appropriate option to discuss." 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? - ANSWER.... ANSWER: C. Triazolam (Halcion)

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? - ANSWER.... ANSWER: C. Prescribe lidocaine 5% The PMHNP wants to use a symptom-based approach to treating a patient with fibromyalgia. How does the PMHNP go about treating this patient? - ANSWER.... ANSWER: C. Matching the patient's symptoms with the malfunctioning brain circuits and neurotransmitters that might mediate those symptoms 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? - ANSWER.... ANS: b. Decrease his SSRI and add buspirone (Buspar). The PMHNP understands that bupropion (Wellbutrin) is an effective way to assist patients with smoking cessation. Why is this medication effective for these patients? ANS: Quiz 60 1 out of 1 points