CU NR546/ NR 546 FINAL EXAM
/ ADVANCED PHARMACOLOGY
PSYCHOPHARMACOLOGY FOR THE
PSYCHIATRIC MENTAL HEALTH NURSE
PRACTITIONER
WITH QUESTIONS AND CORRECT
ANSWERS
D
O
Which medication can help with a patient's brain fog? - ✔✔✔ Correct Answer
N
>
SNRI's: The inhibition of DA reuptake helps improve cognition
O
T
Use this mnemonic to remember snris: Vexed and Depressed
C
Vexed- Venlafaxine
O
Depressed- Duloxetine & Desvenlafaxine
PY
The lesson also mentioned Mirtazapine
• A new patient arrives at the office for treatment for depression. The
patient reports taking simvastatin (Zocor) and lisinopril (Zestril).
When selecting an antidepressant, the psychiatric-mental health nurse
practitioner eliminates fluoxetine hydrochloride (Prozac), based on the
knowledge that the combination can lead to increased plasma levels of
the statin, resulting in an increased risk of muscle damage and
rhabdomyolysis. What is the PMHNP's rationale? - ✔✔✔ Correct Answer >
, One medication is a CYP450 3A4 substrate and one is a CYP450 3A4
inhibitor
Statins are substrates and ace inhibitors are inhibitors of CYP
• A patient who is to start medication therapy for depression also takes a
daily aspirin, atorvastatin, and digoxin. Which of the following
medications is the safest option for this patient and is least likely to
cause adverse effects? - ✔✔✔ Correct Answer > Escitalopram
D
O
• A patient with depression states they also experience anxiety in social
N
settings, and he feels excessively sleepy throughout the day. Which of
O
the following medications can be prescribed to help alleviate these
T
additional symptoms? - ✔✔✔ Correct Answer > sertraline; treats social
anxiety and hypersomnolence, paroxetine could be an option as well as
C
it also does this!
O
PY
• A 75-year-old patient with a history of urinary retention and chronic
pain related to fibromyalgia wishes to start a medication for her newly
diagnosed MDD. Which medication would be effective for this
patient? -
✔✔✔ Correct Answer > Duloxetine; effective for atypical pain such as
fibromyalgia and diabetic neuropathy
,• Which of the following is true about SNRI's? - ✔✔✔ Correct Answer > snris
can increase anxiety in some patients; this can occur because of the NE
effects
A client diagnosed with Alzheimer's disease has decided to stop
treatment. The nurse practitioner (NP) has educated the client that
medication discontinuation will result in the return of cognitive
symptoms and the medication may not work as well if restarted. The
client would still like to stop the medication due to the gastrointestinal
side effects. Which of the following medications requires tapering? -
✔✔✔ Correct Answer > Donepezil requires tapering. Rivastigmine and
D
galantamine do not require tapering.
O
N
O
Which medication can assist a patient with weight gain? - ✔✔✔ Correct
T
Answer > Mirtazapine= MEAL-tazapine= appetite stimulant
C
O
• The PMHNP plans to prescribe valproic acid in conjunction with
PY
Lamotrigine for a patient with bipolar type II disorder. Which of the
following does the PMHNP need to keep in mind? - ✔✔✔ Correct Answer >
When using these medications together, the valproic acid dosage needs
to be cut in half
• A patient with alcohol abuse disorder is actively drinking and using
opiates but wishes to participate in MAT to change their lifestyle.
Which of the following medications is appropriate to prescribe this
patient? -
, ✔✔✔ Correct Answer > Naltrexone; initial treatment for alcohol use disorder,
started while still drinking, can treat concurrent opioid use disorder,
contraindicated in liver disease, may be given in monthly long-acting
injections (Vivitrol)
• Which of the following laboratory values need to be monitored for a
patient on lithium? Select all that apply. - ✔✔✔ Correct Answer > serum
lithium
Renal function
Thyroid function
D
O
N
• Which medication should be considered for a patent who has concerns
O
about the sexual side effects of antidepressants? - ✔✔✔ Correct Answer >
T
Bupropion - fewest sexual side effects
C
O
• Linda is a 45-year-old female who is suffering from anorexia related to
PY
her MDD. Which medication should be prescribed for her? - ✔✔✔
Correct Answer > Mirtazapine - This medication helps increase appetite
and promotes weight gain
Which medication inhibits both dopamine and norepinephrine? - ✔✔✔
Correct Answer > Bupropion inhibits the presynaptic reuptake of both
dopamine (DA) and noradrenaline (NA), leading to increased levels of
both neurotransmitters in the synaptic cleft
/ ADVANCED PHARMACOLOGY
PSYCHOPHARMACOLOGY FOR THE
PSYCHIATRIC MENTAL HEALTH NURSE
PRACTITIONER
WITH QUESTIONS AND CORRECT
ANSWERS
D
O
Which medication can help with a patient's brain fog? - ✔✔✔ Correct Answer
N
>
SNRI's: The inhibition of DA reuptake helps improve cognition
O
T
Use this mnemonic to remember snris: Vexed and Depressed
C
Vexed- Venlafaxine
O
Depressed- Duloxetine & Desvenlafaxine
PY
The lesson also mentioned Mirtazapine
• A new patient arrives at the office for treatment for depression. The
patient reports taking simvastatin (Zocor) and lisinopril (Zestril).
When selecting an antidepressant, the psychiatric-mental health nurse
practitioner eliminates fluoxetine hydrochloride (Prozac), based on the
knowledge that the combination can lead to increased plasma levels of
the statin, resulting in an increased risk of muscle damage and
rhabdomyolysis. What is the PMHNP's rationale? - ✔✔✔ Correct Answer >
, One medication is a CYP450 3A4 substrate and one is a CYP450 3A4
inhibitor
Statins are substrates and ace inhibitors are inhibitors of CYP
• A patient who is to start medication therapy for depression also takes a
daily aspirin, atorvastatin, and digoxin. Which of the following
medications is the safest option for this patient and is least likely to
cause adverse effects? - ✔✔✔ Correct Answer > Escitalopram
D
O
• A patient with depression states they also experience anxiety in social
N
settings, and he feels excessively sleepy throughout the day. Which of
O
the following medications can be prescribed to help alleviate these
T
additional symptoms? - ✔✔✔ Correct Answer > sertraline; treats social
anxiety and hypersomnolence, paroxetine could be an option as well as
C
it also does this!
O
PY
• A 75-year-old patient with a history of urinary retention and chronic
pain related to fibromyalgia wishes to start a medication for her newly
diagnosed MDD. Which medication would be effective for this
patient? -
✔✔✔ Correct Answer > Duloxetine; effective for atypical pain such as
fibromyalgia and diabetic neuropathy
,• Which of the following is true about SNRI's? - ✔✔✔ Correct Answer > snris
can increase anxiety in some patients; this can occur because of the NE
effects
A client diagnosed with Alzheimer's disease has decided to stop
treatment. The nurse practitioner (NP) has educated the client that
medication discontinuation will result in the return of cognitive
symptoms and the medication may not work as well if restarted. The
client would still like to stop the medication due to the gastrointestinal
side effects. Which of the following medications requires tapering? -
✔✔✔ Correct Answer > Donepezil requires tapering. Rivastigmine and
D
galantamine do not require tapering.
O
N
O
Which medication can assist a patient with weight gain? - ✔✔✔ Correct
T
Answer > Mirtazapine= MEAL-tazapine= appetite stimulant
C
O
• The PMHNP plans to prescribe valproic acid in conjunction with
PY
Lamotrigine for a patient with bipolar type II disorder. Which of the
following does the PMHNP need to keep in mind? - ✔✔✔ Correct Answer >
When using these medications together, the valproic acid dosage needs
to be cut in half
• A patient with alcohol abuse disorder is actively drinking and using
opiates but wishes to participate in MAT to change their lifestyle.
Which of the following medications is appropriate to prescribe this
patient? -
, ✔✔✔ Correct Answer > Naltrexone; initial treatment for alcohol use disorder,
started while still drinking, can treat concurrent opioid use disorder,
contraindicated in liver disease, may be given in monthly long-acting
injections (Vivitrol)
• Which of the following laboratory values need to be monitored for a
patient on lithium? Select all that apply. - ✔✔✔ Correct Answer > serum
lithium
Renal function
Thyroid function
D
O
N
• Which medication should be considered for a patent who has concerns
O
about the sexual side effects of antidepressants? - ✔✔✔ Correct Answer >
T
Bupropion - fewest sexual side effects
C
O
• Linda is a 45-year-old female who is suffering from anorexia related to
PY
her MDD. Which medication should be prescribed for her? - ✔✔✔
Correct Answer > Mirtazapine - This medication helps increase appetite
and promotes weight gain
Which medication inhibits both dopamine and norepinephrine? - ✔✔✔
Correct Answer > Bupropion inhibits the presynaptic reuptake of both
dopamine (DA) and noradrenaline (NA), leading to increased levels of
both neurotransmitters in the synaptic cleft
