NURS 6630 MIDTERM EXAM , Exams of Nursing

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NURS 6630 MIDTERM EXAM WITH ACTUAL

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Question1 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

Selected C. Answer: (^) “Many psychiatric illnesses involve several dys-functioning neurotransmitter systems in the brain. Often, a single medication may only effect one or two of the dys- functioning systems. The addition of another medication can work with the current medication in stabilizing multiple neurotransmitter systems and help to alleviate your symptoms.”

• Question 2

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 d Answer :

C. Lithium (Lithobid )

• Question 3

Mr. Gordon is a middle-

aged client who was started on (^1) out of

1 points

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?

Selecte : d Answer

A. (^) This client may have Bipolar III disorder

• • Question

1 out of 1 points

A patient presents with frequent episodes of mania. Which statement describes an appropriate treatment approach for this patient?

Selected Answer: B. “The patient could benefit from an

anticonvulsant.”

• Question 5 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 d Answer :

B. Those that are potent D2 antagonists with 5HT2A antagonism properties

• Question

1 out of 1 points

After ordering flumazenil (Rumazicon) the PMHNP cautions the staff to monitor for which possible effect? Selecte d Answer :

D. All of

t h abov e e

• Question

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 Answer :

A. dopamine and serotonin

• Question 8

1 out of 1 points While genes have potential to modify behavior, behavior can also modify genes. How do genes impact this process?Selected Answer:B. Changes made to proteins lead to changes in behavior.

• Question 9 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 d Answer :

C. The new medication is blocking D2 receptors in the mesolimbic system

• Question 10

A nursing student is seeking clarification on the use of

1 out of 1 points

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 d Answer :

B. Gabapenti n (Neuronti

n ) 1 out of 1

11 points

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

Selecte d A. Answer Most^ medications^ that^ act^ on^ G-protein^ linked^ receptors^ have : antagonistic^ traits.

- Question

• Question 12

1 out of 1 points A patient is seeking pharmacological treatment for smoking cessation. Which drug class does the PMHNP prescribe to the patient?

Selected Answer: D. Varenicline (Chantix)

• Question 13

1 out of 1 pointsThe 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?

Selected

B. Answer:

Hyperactivity in the mesolimbic dopamine pathway mediates the positive symptoms of schizophrenia.

• Question 14 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: Selecte d Answer :

C. Neurotransmitters can spread by diffusion.

1 out of 1

15 points

- Question

A patient is 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?

Selected Answer: D. trazadone (Oleptro)

• Question 16

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)?

Selected Answer: B. Patient with partial seizures

• Question 17

1 out of 1 points Which statement about neurotransmitters and medications is true?

Selected Answer: B. Several psychiatric medications have been developed after discoveries of endogenous neurotransmitters and defining their function in the brain.

• Question 18

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 d Answer :

C. The patient has severe renal impairment. 1 out of

Question

1 points

A patient with schizophrenia is given an inverse agonist that acts on the receptor 5HT and neurotransmitter serotonin. What is the rationale for prescribing a medication such as this?

Selecte d Answer :

A. To promote the availability of serotonin

• Question

2 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 d Answer :

A. “You must avoid soy products, such as tofu.”

• Question

1 out of 1 points

The PMHNP evaluates the patient for “fear conditioning” when he asks:

Selected Answer: A. Have you ever experienced any type of trauma?

• Question 22

0 out of 1 points The PMHNP recognizes that which patient would be contraindicated for antidepressant monotherapy?

Selected Answer:

A. Pa t i e n t w ith a b i p o l a r d e s i g n a t i o n

• Question

0 out of 0 points

When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?

Yes Answer

• Question 24 1 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.”

Selected

Which receptor action in antipsychotic medications is believed to be the most beneficial in producing the effects described by Mr. Gordon?

Selecte d Answer :

D. D2 partial agonist

• Question 25

2 out of 1 points The PMHNP understands that which mechanism contributes to a worse tolerability profile for patients taking tricyclic antidepressants (TCAs)?Selected Answer:B. Muscarinic M1 receptor blockade causes blurred vision.

• Question 26

1 out of 1 points 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 the PMHNP order? Selected Answer: A. Thyroid Stimulating Hormone

• Question 27

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).

Selected

C. Answer:

“Most medications that work in the brain will result in restoring an imbalance of one or more neurotransmitters that your body already produces helping to alleviate your symptoms .”

• Question 28

1 out of 1 points Mrs. Trevor is a 44-year-old patient who does not have a diagnosis of schizophrenia but occasionally reports symptoms of psychosis, followed by severe fatigue. Mrs. Trevor inquires about the use of amphetamines to help with her energy levels. Which response made by the PMHNP is most appropriate?

Selected Answer:

C. “Amphetamines can cause hallucinations, so I would advise against this type of prescription.”

• Question 29

1 out of 1 points A patient is diagnosed with bipolar disorder and is currently taking carbamazepine (Tegretol), aripiprazole (Abilify), and melatonin. The PMHNP has just written an order to discontinue the carbamazepine (Tegretol) for drug-induced thrombocytopenia. The PMHNP is aware that his next best action is to:

Selected Answer: C. Decrease the amount prescribed for aripiprazole (Abilify)

• Question 30 1 out of 1 points 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?

Selected Answer: D. Weight gain is unusual.

• Question 31