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1. What is tolerance?: Decreased response/effects of the same dose of a drug over time
2. A psychiatric mental health nurse practitioner working in an outpatient clinic
is evaluating Tom, a 45-year-old man, who has been prescribed oxycodone
(Oxycontin 10mg q 12h) for chronic lower back pain. Tom reports that he used
to feel relief with on pill, but now he requires three pills to achieve the same
level of relief. This is possibly an example of which process?
A. Kindling
B. Addiction
C. Tolerance
D. Potency: C. Tolerance
3. The tendency of some regions of the brain to react to repeated low-level bio-
electrical stimulation by progressively boosting synaptic discharges, thereby
lowering seizure thresholds.: Kindling
4. Compulsive substance use despite harmful consequence: Addiction
5. The amount of drug required to produce an effect of given intensity: Potency
6. What is an example of a high potency drug?: Haldol
7. What is an example of a low potency drug?: Chlorpromazine
8. If you are giving a drug that is high potency, you would note the dose to be: Low
9. If you are giving a drug that is low potency, you would note the dose to be: High
10. What can withdrawal from ETOH or benzodiazepines trigger?: Kindling
11. A persistent pattern of inattention or hyperactivity, impulsivity, or both,
that interferes with functioning and development is called: Attention-deficit hyperactivity
disorder
12. Abnormalities in which parts of the brain are associated with ADHD?: Fron-
to-subcortical pathways
- Frontal cortex
- Basal ganglia
Reticular activating system
Neurotransmitter dysfunction
- Dopamine dysfunction
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- Norepinephrine dysfunction
- Serotonin dysfunction
13. Which particular part of the frontal cortex plays a critical role in executive
functioning?: The dorsolateral prefrontal cortex
14. The dorsolateral prefrontal cortex is responsible for these executive func-
tions:: Attention
Impulse control
Working memory
15. What abnormalities of the prefrontal cortex may be the cause of ADHD?: Re-
duced volume
Reduced connectivity
16. What are some functions of the basal ganglia?: Motor control
Motor learning
Executive function and behaviors
Emotions
17. What are some functions of the reticular activating system?: Ability to focus
Fight or flight response
Regulating arousal and sleep-wake transitions
18. The abnormalities of the neurotransmitters implicated in ADHD are caused
by: Structural abnormalities which cause abnormal neurotransmitters to be produced
19. Which symptoms of ADHD may be associated with dopamine dysfunction?-
: Attention
Focus
Self-control
20. Which symptoms of ADHD may be associated with norepinephrine dysfunc-
tion?: Attention
Focus
Impulse control
21. Which symptoms of ADHD may be associated with serotonin dysfunction?: -
Impulsivity
Emotional dysregulation
Sustained attention
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22. What mnemonic may be helpful to remember the neurotransmitters associ-
ated with ADHD?: DNS
23. Why are stimulants prescribed for ADHD?: Stimulants increase dopamine, which affects
attention, focus, and self-control
24. What classes of drugs are used to treat ADHD?: Stimulants
Alpha agonists or alpha 2 receptor agonists
NRI
25. Why do you assess cardiac history before prescribing stimulants?: Stimulants can
cause:
- Elevated HR
- Elevated BP
- Increased risk for heart attack or stroke
26. Amphetamines are approved for use in those ages __________ years and
older: 3
27. Methylphenidate medications are approved for use in those ages
____________ years and older: 6
28. Guanfacine and clonidine are FDA approved in ages _________________________
years with ADHD: 6 - 17
29. Strattera is approved for children aged _____________ and older for ADHD: 6
30. What is the mechanism of action of the alpha agonists?: They increase norepinephrine,
which may increase attention, focus, and impulse control
31. What other drug is often used off-label for the treatment of ADHD?: Wellbutrin
32. What are the signs and symptoms of stimulant abuse?: Insomnia
Tremor
Increased BP and HR
Palpitations
Agitation
Anxiety
Irritability
Mood swings
Elevated mood