NURS6630 Final Exam: Walden University

NURS6630 Final Exam: Walden University

NURS6630 Final Exam: Walden University

NURS6630 Final Exam: Walden
University

QUESTION 1

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?

A. Stimulants

B. Antidepressants

C. Antipsychotics

D. SSRIs

QUESTION 2

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?

A. First-generation,
conventional antipsychotics

B. First-generation,
atypical antipsychotics

C. Second-generation,
conventional antipsychotics

D. Second-generation,
atypical antipsychotics

QUESTION 3

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
atypical antipsychotics?

A. The doses are based on
achieving 100% D2 receptor occupancy.

B. The doses are based on
achieving a minimum of 80% D2 receptor occupancy.

C. The doses are based on
achieving 60% D2 receptor occupancy.

D. None of the above.

 

 

QUESTION 4

Why does the PMHNP avoid
prescribing clozapine (Clozaril) as a first-line treatment to the patient with
psychosis and aggression?

A. There is too high a risk
of serious adverse side effects.

B. It can exaggerate the
psychotic symptoms.

C. Clozapine (Clozaril)
should not be used as high-dose monotherapy.

D. There is no
documentation that clozapine (Clozaril) is effective for patients who are
violent.

QUESTION 5

The PMHNP is caring for a
patient on risperidone (Risperdal). Which action made by the PMHNP exhibits
proper care for this patient?

A. Explaining to the
patient that there are no risks of EPS

B. Prescribing the patient
12 mg/dail

C. Titrating the dose by
increasing it every 5–7 days

D. Writing a prescription for a higher dose of
oral risperidone (Risperdal) to achieve high D2 receptor occupancy

QUESTION 6

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?

A. Lithium (Lithane)

B. Phenytoin (Dilantin)

C. Valproate (Depakote)

D. Topiramate (Topamax)

 

 

QUESTION 7

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?

A. Strattera

B. Concerta

C. Daytrana

D. Adderall

QUESTION 8

8 The PMHNP understands
that slow-dose extended release stimulants are most appropriate for which
patient with ADHD?

A. 8-year-old patient

B. 24-year-old patient

C. 55-year-old patient

D. 82-year-old patient

QUESTION 9

A patient is prescribed
D-methylphenidate, 10-mg extended-release capsules. What should the PMHNP
include when discussing the side effects with the patient?

A. The formulation can have
delayed actions when taken with food.

B. Sedation can be a common
side effect of the drug.

C. The medication can
affect your blood pressure.

D. This drug does not cause
any dependency.

QUESTION 10

The PMHNP is teaching
parents about their child’s new prescription for Ritalin. What will the PMHNP
include in the teaching?

A. The second dose should
be taken at lunch.

B. There are no risks for
insomnia.

C. There is only one daily
dose, to be taken in the morning.

D. There will be continued
effects into the evening.

QUESTION 11

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?

A. “I take my pill at
breakfast.”

B. “I am unable to fall
asleep at night.”

C. “I feel okay all day
long.”

D. “I am not taking my pill
at lunch.”

QUESTION 12

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?

A. The patient should take
the medication at lunch.

B. The patient will have
one or two doses a day.

C. The patient will take a
pill every 17 hours.

D. The dosing should be
done in the morning and at night.

QUESTION 13

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:

A. The child will be
prescribed 2.5 mg.

B. The child will be
prescribed a 10-mg tablet.

C. The child’s dose will
increase by 2.5 mg every other week.

D. The child will take
10–40 mg, daily.

QUESTION 14

A patient is being
prescribed bupropion and is concerned about the side effects. What will the
PMHNP tell the patient regarding bupropion?

A. Weight gain is not
unusual.

B. Sedation may be common.

C. It can cause cardiac
arrhythmias.

D. It may amplify fatigue.

QUESTION 15

Which patient will receive
a lower dose of guanfacine?

A. Patient who has
congestive heart failure

B. Patient who has
cerebrovascular disease

C. Patient who is pregnant

D. Patient with kidney
disease

QUESTION 16

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?

A. Migraines

B. Bipolar disorder and
depression

C. Pregnancy-induced
depression

D. Upper back pain

QUESTION 17

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?

A. Monitor liver function
every 6 months for a year and then yearly thereafter.

B. Monitor monthly weight.

C. Split the daily dose into two doses after
the first day.

D. Monitor for occult blood
in the stool.

QUESTION 18

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?

A. Order hydroxyzine
(Vistaril), 50 mg PRN or as needed

B. Order zolpidem (Ambien),
5mg at bedtime

C. Order melatonin, 5mg at
bedtime

D. Order quetiapine
(Seroquel), 150 mg at bedtime

QUESTION 19

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?

A. Monthly blood levels
must be drawn.

B. ECG monitoring must be
done once every 3 months.

C. White blood cell count
must be monitored weekly.

D. This medication has
unwanted side effects such as sedation, lack of coordination, and drowsiness.

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

B. Order a blood urea
nitrogen (BUN) and creatinine STAT

C. Prescribe lidocaine 5%

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?

A. Increase the dose of
lamotrigine (Lamictal) to 25 mg twice daily.

B. Ask if the patient has
been taking the medication as prescribed.

C. Order gabapentin
(Neurontin), 100 mg three times a day, because lamotrigine (Lamictal) is no
longer working for this patient.

D. Order a complete blood
count (CBC) to assess for an infection.

QUESTION 22

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?

A. Order an X-ray because
it is possible that she dislocated her hip.
B. Order ibuprofen (Motrin) because she may need long-term treatment and
chronic pain is not uncommon.

C. Order naproxen
(Naprosyn) because she may have arthritis and chronic pain is not uncommon.

D. Order Morphine and
physical therapy.

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.

B. Educate the patient on
avoiding grapefruits when taking this medication.

C. Encourage this patient
to keep fluids to 1500 ml/day until the swelling subsides.

D. Order a 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
(Motrin), 800 mg every 8 hours as needed for pain

C. Prescribe desvenlafaxine
(Pristiq), 50 mg daily

D. Prescribe risperidone
(Risperdal), 2 mg TID

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?

A. “The SNRI can increase
noradrenergic neurotransmission in the descending spinal pathway to the dorsal
horn.”

B. “The SNRI can decrease
noradrenergic neurotransmission in the descending spinal pathway to the dorsal
horn.”

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.”

NURS6630 Final Exam: Walden University.NURS6630 Final Exam: Walden University.NURS6630 Final Exam: Walden University.NURS6630 Final Exam: Walden University

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