NRNP 6675 FINAL EXAM LAST EXAM
CORRECT 100%
The 1/2 life of lithium is about? - ANSWERS24 hours
Fluoxetine is the SSRI with the ______ WD risk? - ANSWERSlowest due to long half
life
What antipsychotics are good for pts who miss doses of their meds? -
ANSWERSAntipsychotics with long half-lives:
1. Cariprazine(Vrylar): (2-4 days-active metabolites up to 3 weeks)
2. Abilify (3 days)
3. Brexipiprazole (4 days)
4. Pimozide (4-5 days)
5. Pimavanserin (2 days, active metabolites 8 days)
Disulfiram's alcohol interactions persist for up to how long after the medication is
stopped? - ANSWERSLONG Half life--2-3 days
persist up to 2 weeks following stopping
What is the only TCA with a long half life? - ANSWERSProtriptyline (Vivactil)
Most psychotropics have a medium range 1/2 life of approx? - ANSWERS24 hours
what does "steady state" mean in relation to 1/2 life? - ANSWERSsteady state means
that you are eliminating the drug at the same overall rate that you are ingesting it
Lithium reaches its 'steady state' when? - ANSWERS5 half lives
example:
Day 1: Start pt on Lithium 600 mg daily
Day 2: (24 hours later) the amount left in his body is 300 mg (day 2 min) because 24
hours has passed--one 1/2 life--therefore the pt has excreted 1/2 of the initial amount.
THEN the pt takes his 2nd dose of 600 mg on DAY 2-resulting in a max dose of 900
(300 mg left in body + 600 mg of 2nd dose).
DAY 3: starts off with 450 mg (1/2 of the 900 mg in pt's system) and after taking the day
3 600 mg dose, the pt now has a total of 1050 mg.
Due to the steady state of Lithium, when do we draw a blood level? - ANSWERS5 half
lives
if you check any earlier, the trough level will underestimate the actual level the pt is on
after achieving steady state
,Fluoxetine has a half life of about? - ANSWERS2 weeks 1/2 life
take 2.5 months to achieve steady state
Most psychotropic medications operate in this fashion: - ANSWERS"when you double
the dose, the serum dose doubles."
*minus three SRIs and three anticonvulsants (Fluoxetine, fluvoxamine, paxil,
gabapentin, valproate and carbamazepine)
_________induces it's own metabolism, hastening excretion and shortening it's half life
- ANSWERSA. Carbamazepine (Tegretol)
*this effect begins to "rev up" after 2-4 weeks--which is why a carbamazepine level is so
important on obtaining 1-2 months after starting Tegretol.
Carbamazepine (Tegretol) level should be checked how soon after starting to take this
med? - ANSWERS1-2 months due to Tegretol inducing it's own metabolism, hastening
excretion and shortening it's half life.
_____ has trouble getting a "serum" level because it binds to proteins that render it
therapeutically inactive? - ANSWERSA. Valproate Acid (Depakote)
-this is particularly true at the lower levels (eg. <50 mcg/mL), so you can expect dose
changes to make a more dramatic difference when the pt's depakote level is in the
higher range
in MODERATE RELEASE/DELAYED RELEASE dissolvable solutions or "dissolvable
control", the medicine does what? - ANSWERSslowly diffuses out of a semi-permeable
membrane
ex. Effexor ER capsules, Wellbutrin XL and Focalin XR
in MODERATE RELEASE/DELAYED RELEASE
is osmotic release pills, the medicine does what? - ANSWERSis pushed out by a tiny
pump that is powered by a osmotic flow of water across a semipermeable membrane
ex. Concerta, Invega, and Effexor ER tablets
Pros of Modified Release/Delayed Release meds? - ANSWERSD. All of the above
Cons of Modified Release/Delayed Release meds? - ANSWERSD. All of the above
Medicines that are preferred in IR? - ANSWERSBenzos and stimulants
, Most ______ medications cannot be split or crushed without disrupting the integrity of
the time-release mechanism? - ANSWERSMR/delayed release
Concerns when treating geriatric patients with psychotherapeutic drugs include all of the
following EXCEPT? - ANSWERSC. Elderly persons may metabolize psychotherapeutic
drugs more rapidly
The treatment of others equitably and distribution of benefits/burdens fairly is known as
which of the following? - ANSWERSB. Justice
a fair an equitable distribution of health resources
Persons who subordinate their own needs to those of others, get others to assume
responsibility for major areas of their lives, lack self-confidence, and may experience
intense discomfort when alone for more than a brief period of time are demonstrating
characteristics of which of the following PD? - ANSWERSC. Dependent PD
According to Sullivan, which of the following are consistent with a mentor/mentee
relationship? - ANSWERSC. Goals for the mentoring are set mutually
The need for NPs to practice to the full extent of their education and training is
necessary for which of the following reasons? - ANSWERSB, C & D
The ARNP assessing lifestyle as a social determinant of health would ask about which
of the following? - ANSWERSA. Diet
Trifluphenazine is also known as? - ANSWERSStelazine
first generation antipsychotic
Lillipucin hallucinations are what? - ANSWERS"little people or kids" hallucinations
What is a red flag that indicates Lewy Body? - ANSWERSLillipucin hallucinations
hallucinations of little people or kids
What is a key question to ask someone with dementia when performing an evaluation of
mental status to show confabulation? - ANSWERS"You look familiar, didn't we meet
before?"
will show confabulation
How to test for lewy body dementia? (question to ask?) - ANSWERSQ: how do you
think they are getting in the house?
Q: where in the home are they hiding?
CORRECT 100%
The 1/2 life of lithium is about? - ANSWERS24 hours
Fluoxetine is the SSRI with the ______ WD risk? - ANSWERSlowest due to long half
life
What antipsychotics are good for pts who miss doses of their meds? -
ANSWERSAntipsychotics with long half-lives:
1. Cariprazine(Vrylar): (2-4 days-active metabolites up to 3 weeks)
2. Abilify (3 days)
3. Brexipiprazole (4 days)
4. Pimozide (4-5 days)
5. Pimavanserin (2 days, active metabolites 8 days)
Disulfiram's alcohol interactions persist for up to how long after the medication is
stopped? - ANSWERSLONG Half life--2-3 days
persist up to 2 weeks following stopping
What is the only TCA with a long half life? - ANSWERSProtriptyline (Vivactil)
Most psychotropics have a medium range 1/2 life of approx? - ANSWERS24 hours
what does "steady state" mean in relation to 1/2 life? - ANSWERSsteady state means
that you are eliminating the drug at the same overall rate that you are ingesting it
Lithium reaches its 'steady state' when? - ANSWERS5 half lives
example:
Day 1: Start pt on Lithium 600 mg daily
Day 2: (24 hours later) the amount left in his body is 300 mg (day 2 min) because 24
hours has passed--one 1/2 life--therefore the pt has excreted 1/2 of the initial amount.
THEN the pt takes his 2nd dose of 600 mg on DAY 2-resulting in a max dose of 900
(300 mg left in body + 600 mg of 2nd dose).
DAY 3: starts off with 450 mg (1/2 of the 900 mg in pt's system) and after taking the day
3 600 mg dose, the pt now has a total of 1050 mg.
Due to the steady state of Lithium, when do we draw a blood level? - ANSWERS5 half
lives
if you check any earlier, the trough level will underestimate the actual level the pt is on
after achieving steady state
,Fluoxetine has a half life of about? - ANSWERS2 weeks 1/2 life
take 2.5 months to achieve steady state
Most psychotropic medications operate in this fashion: - ANSWERS"when you double
the dose, the serum dose doubles."
*minus three SRIs and three anticonvulsants (Fluoxetine, fluvoxamine, paxil,
gabapentin, valproate and carbamazepine)
_________induces it's own metabolism, hastening excretion and shortening it's half life
- ANSWERSA. Carbamazepine (Tegretol)
*this effect begins to "rev up" after 2-4 weeks--which is why a carbamazepine level is so
important on obtaining 1-2 months after starting Tegretol.
Carbamazepine (Tegretol) level should be checked how soon after starting to take this
med? - ANSWERS1-2 months due to Tegretol inducing it's own metabolism, hastening
excretion and shortening it's half life.
_____ has trouble getting a "serum" level because it binds to proteins that render it
therapeutically inactive? - ANSWERSA. Valproate Acid (Depakote)
-this is particularly true at the lower levels (eg. <50 mcg/mL), so you can expect dose
changes to make a more dramatic difference when the pt's depakote level is in the
higher range
in MODERATE RELEASE/DELAYED RELEASE dissolvable solutions or "dissolvable
control", the medicine does what? - ANSWERSslowly diffuses out of a semi-permeable
membrane
ex. Effexor ER capsules, Wellbutrin XL and Focalin XR
in MODERATE RELEASE/DELAYED RELEASE
is osmotic release pills, the medicine does what? - ANSWERSis pushed out by a tiny
pump that is powered by a osmotic flow of water across a semipermeable membrane
ex. Concerta, Invega, and Effexor ER tablets
Pros of Modified Release/Delayed Release meds? - ANSWERSD. All of the above
Cons of Modified Release/Delayed Release meds? - ANSWERSD. All of the above
Medicines that are preferred in IR? - ANSWERSBenzos and stimulants
, Most ______ medications cannot be split or crushed without disrupting the integrity of
the time-release mechanism? - ANSWERSMR/delayed release
Concerns when treating geriatric patients with psychotherapeutic drugs include all of the
following EXCEPT? - ANSWERSC. Elderly persons may metabolize psychotherapeutic
drugs more rapidly
The treatment of others equitably and distribution of benefits/burdens fairly is known as
which of the following? - ANSWERSB. Justice
a fair an equitable distribution of health resources
Persons who subordinate their own needs to those of others, get others to assume
responsibility for major areas of their lives, lack self-confidence, and may experience
intense discomfort when alone for more than a brief period of time are demonstrating
characteristics of which of the following PD? - ANSWERSC. Dependent PD
According to Sullivan, which of the following are consistent with a mentor/mentee
relationship? - ANSWERSC. Goals for the mentoring are set mutually
The need for NPs to practice to the full extent of their education and training is
necessary for which of the following reasons? - ANSWERSB, C & D
The ARNP assessing lifestyle as a social determinant of health would ask about which
of the following? - ANSWERSA. Diet
Trifluphenazine is also known as? - ANSWERSStelazine
first generation antipsychotic
Lillipucin hallucinations are what? - ANSWERS"little people or kids" hallucinations
What is a red flag that indicates Lewy Body? - ANSWERSLillipucin hallucinations
hallucinations of little people or kids
What is a key question to ask someone with dementia when performing an evaluation of
mental status to show confabulation? - ANSWERS"You look familiar, didn't we meet
before?"
will show confabulation
How to test for lewy body dementia? (question to ask?) - ANSWERSQ: how do you
think they are getting in the house?
Q: where in the home are they hiding?
