NURS 6630 FINAL

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Question 1 When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Question 2 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? Question 3 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? Question 4 Which of the following substances has the highest probability of becoming dependent after a single use? Question 5 The nursing staff asks the PMHNP for additional education regarding the treatment of agitation in dementia patients. Which of the following is correct? Question 6 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)? Question 7 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? Question 8 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? Question 9 Which of these statements is correct? Question 10 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: Question 11 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? Question 12 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? Question 13 Antipsychotics are doses at a level that blocks ________% of D2 receptors. Question 14 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? Question 15 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? Question 16 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? Question 17 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? Question 18 The PMHNP wishes to prescribe a medication that reduces glutamate transmission in an Alzheimer's patient. Which medication should the PMHNP prescribe? Question 19 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? Question 20 A patient is prescribed D-methylphenidate, 10-mg extended-release capsules. What should the PMHNP include when discussing the side effects with the patient? Question 21 Which medication is an irreversible inhibitor of aldehyde dehydrogenase that creates a negative and aversive response following ingestion of alcohol? Question 22 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? Question 23 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? Question 24 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? Question 25 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? Question 26 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? Question 27 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? Question 28 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? Question 29 Why does the PMHNP avoid prescribing clozapine (Clozaril) as a first-line treatment to the patient with psychosis and aggression? Question 30 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? Question 31 The PMHNP is caring for a patient on risperidone (Risperdal). Which action made by the PMHNP exhibits proper care for this patient? Question 32 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? Question 33 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? Question 34 The PMHNP prescribes gabapentin (Neurontin) for a patient’s chronic pain. How does the PMHNP anticipate the drug to work? Question 35 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? Question 36 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? Question 37 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? Question 38 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? Question 39 The PMHNP is teaching parents about their child’s new prescription for Ritalin. What will the PMHNP include in the teaching? Question 40 You decide to start a patient on lurasidone (LATUDA). Which of these counseling points is correct? Question 41 Which of these characteristics does NOT meet the criteria for probably Alzheimer's dementia? Question 42 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? Question 43 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? Question 44 A patient calls the clinic to ask about an over-the-counter sleep aid. What is the best response? Question 45 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? Question 46 A nursing students asks the PMHNP the difference between impulsivity and compulsivity. Which of the following responses is correct? Question 47 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? Question 48 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? Question 49 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? Question 50 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? Question 51 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? Question 52 Insomnia is caused by excessive nighttime arousal. The PMHNP is likely to prescribe which of the following to treat insomnia? Question 53 Which neurotransmitter is secreted by the pineal gland that acts on the suprachiasmatic nucleus to regulate circadian rhythms? Question 54 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? Question 55 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? Question 56 A patient is being prescribed bupropion and is concerned about the side effects. What will the PMHNP tell the patient regarding bupropion? Question 57 The PMHNP wants to use a symptom-based approach to treating a patient with fibromyalgia. How does the PMHNP go about treating this patient? Question 58 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? Question 59 The PMHNP understands that bupropion (Wellbutrin) is an effective way to assist patients with smoking cessation. Why is this medication effective for these patients? Question 60 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? Question 61 The PMHNP prescribes an obese patient phentermine (Adipex-p)/topiramate ER (Topamax) (Qsymia), Why is topiramate (Topamax) often prescribed with phentermine (Adipex-P)? Question 62 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? Question 63 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. Question 64 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? Question 65 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? Question 66 Which statement best describes a pharmacological approach to treating patients for impulsive aggression? Question 67 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? Question 68 The PMHNP understands that slow-dose extended release stimulants are most appropriate for which patient with ADHD? Question 69 Alcohol enhances inhibition at ____________ synapses and reduces excitation at ______________ synapses. Question 70 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? Question 71 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? Question 72 Jerry presents to the clinic for his four-week follow-up after starting trazodone for insomnia. How does trazodone help with insomnia? Question 73 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? Question 74 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: Question 75 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? Question 76 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. [Show More]

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