NURS 6630 FINAL EXAM EXAM SCRIPT 2026
COMPLETE SOLUTION BUNDLED
◉ Which neurotransmitter is secreted by the pineal gland that acts
on the suprachiasmatic nucleus to regulate circadian rhythms?
Answer: ANS: a.
Melatonin
◉ 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? Answer: ANS: b.
Prescribe lidocaine 5%
◉ 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? Answer: ANS: a.
This medication has unwanted side effects such as sedation, lack of
coordination, and drowsiness.
,◉ A patient is being prescribed bupropion and is concerned about
the side effects. What will the PMHNP tell the patient regarding
bupropion? Answer: ANS: b.
It can cause cardiac arrhythmias.
◉ The PMHNP wants to use a symptom-based approach to treating a
patient with fibromyalgia. How does the PMHNP go about treating
this patient? Answer: ANS: d.
Matching the patient's symptoms with the malfunctioning brain
circuits and neurotransmitters that might mediate those symptoms.
◉ 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? Answer: ANS: b.
Decrease his SSRI and add buspirone (Buspar).
◉ The PMHNP understands that bupropion (Wellbutrin) is an
effective way to assist patients with smoking cessation. Why is this
medication effective for these patients? Answer: ANS:b.
Bupropion (Wellbutrin) blocks dopamine reuptake, enabling more
availability of dopamine.
,◉ 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? Answer:
ANS: c.
Order liver function tests.
◉ The PMHNP prescribes an obese patient phentermine (Adipex-
p)/topiramate ER (Topamax) (Qsymia), Why is topiramate
(Topamax) often prescribed with phentermine (Adipex-P)? Answer:
ANS: d.
Phentermine (Adipex-P) works by suppressing appetite while
topiramate (Topamax) acts by inhibiting appetite.
◉ 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? Answer: ANS: b.
Hypnotics have prolonged half-lives that can cause drug
accumulation in the elderly.
, ◉ 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. Answer: ANS: a.
Impairment in the ability to learn and retain new information is
most problematic, and an appropriate treatment option would be
donepezil.
◉ 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? Answer: ANS:b.
The patient's vital signs are 98.4F temp, 88 pulse, 104/62 blood
pressure, and 8 respirations
◉ 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? Answer: ANS: d.
Atomoxetine
◉ Which statement best describes a pharmacological approach to
treating patients for impulsive aggression? Answer: ANS: a.
Opioid antagonists can be used to reduce drive.
◉ Harold complains of pain associated with his irritable bowel
syndrome with constipation. The PMHNP decides to prescribe a
COMPLETE SOLUTION BUNDLED
◉ Which neurotransmitter is secreted by the pineal gland that acts
on the suprachiasmatic nucleus to regulate circadian rhythms?
Answer: ANS: a.
Melatonin
◉ 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? Answer: ANS: b.
Prescribe lidocaine 5%
◉ 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? Answer: ANS: a.
This medication has unwanted side effects such as sedation, lack of
coordination, and drowsiness.
,◉ A patient is being prescribed bupropion and is concerned about
the side effects. What will the PMHNP tell the patient regarding
bupropion? Answer: ANS: b.
It can cause cardiac arrhythmias.
◉ The PMHNP wants to use a symptom-based approach to treating a
patient with fibromyalgia. How does the PMHNP go about treating
this patient? Answer: ANS: d.
Matching the patient's symptoms with the malfunctioning brain
circuits and neurotransmitters that might mediate those symptoms.
◉ 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? Answer: ANS: b.
Decrease his SSRI and add buspirone (Buspar).
◉ The PMHNP understands that bupropion (Wellbutrin) is an
effective way to assist patients with smoking cessation. Why is this
medication effective for these patients? Answer: ANS:b.
Bupropion (Wellbutrin) blocks dopamine reuptake, enabling more
availability of dopamine.
,◉ 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? Answer:
ANS: c.
Order liver function tests.
◉ The PMHNP prescribes an obese patient phentermine (Adipex-
p)/topiramate ER (Topamax) (Qsymia), Why is topiramate
(Topamax) often prescribed with phentermine (Adipex-P)? Answer:
ANS: d.
Phentermine (Adipex-P) works by suppressing appetite while
topiramate (Topamax) acts by inhibiting appetite.
◉ 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? Answer: ANS: b.
Hypnotics have prolonged half-lives that can cause drug
accumulation in the elderly.
, ◉ 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. Answer: ANS: a.
Impairment in the ability to learn and retain new information is
most problematic, and an appropriate treatment option would be
donepezil.
◉ 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? Answer: ANS:b.
The patient's vital signs are 98.4F temp, 88 pulse, 104/62 blood
pressure, and 8 respirations
◉ 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? Answer: ANS: d.
Atomoxetine
◉ Which statement best describes a pharmacological approach to
treating patients for impulsive aggression? Answer: ANS: a.
Opioid antagonists can be used to reduce drive.
◉ Harold complains of pain associated with his irritable bowel
syndrome with constipation. The PMHNP decides to prescribe a
