PMHNP Final Exam 1 With Complete Solutions
_______ is produced in the locus ceruleus of the pons Ans:- Norepinephrine
The hallmark symptom in _______ is a disturbance of consciousness accompanied by
changes in cognitive function Ans:- delirium
Disturbance of consciousness develops over a short time, usually hours to days is
seen in _______ Ans:- delirium
How are Sleep-rest cycle different in patients with delirium? Ans:- clients are
awake at night andsleep during the day.
Impaired _______ and ______ memory is seen in patients with delirium Ans:- recent
and intermediate
Symptoms of delirium resolve within ? Ans:- 3 to 6 months
Delirium Mnemonic Ans:- D-Drugs
E-electrolyte abnormality
L-low oxygen saturation
I-infection
R-reduced sensory input
I-intracranial
U-urinary or renal retention
M-myocardial
What is the most common type of dementia? Ans:- Alzheimer's
__________ has a Gradual onset and progressive decline without focal neurological
deficits Ans:- Dementia of Alzheimer's type (DAT)
What are the hallmark signs of Dementia of Alzheimer's type (DAT) Ans:- amyloid
deposits and neurofibrillary tangles senile plaques
What changes in the brain are seen in DAT? Ans:- Diffuse cerebral atrophy and
enlarged ventricles
Which neurotransmitters are decreased in DAT? Ans:- acetylcholine (ACh) and
norepinephrine
___________is Often induced by traumatic experiences such as physical/sexual
abuse, or betrayal by a trusted individual Ans:- Dissociative amnesia
Clinical features of _____________ includes An inability to recall important personal
information, usually of a traumatic/stressful nature, that is inconsistent with
ordinary forgetting Ans:- Dissociative amnesia
localized amnesia is the disruption of Ans:- an event or period of time
,selective amnesia is the disruption of Ans:- Specific aspect of an event
generalized amnesia is the disruption of Ans:- Identity or life history
purposeful travel or bewildered wandering that is associated with amnesia for
identity or for other important autobiographical information Ans:- dissociative
fugue
inability to learn new info Ans:- Anterograde amnesia
inability to recall previously remembered info Ans:- Retrograde amnesia
Which TCA is used in the treatment of OCD? Ans:- Clomipramine
Which substances may cause dementia? Ans:- Alcohol
· Heavy metals
· Carbon monoxide
·Pseudodementia r/t meds ( anticholinergics)
inhalants
Which SSRIs have a sedative effect? Ans:- Citalopram (Celexa)
Escitalopram (Lexapro)
Fluvoxamine (Luvox)
Paroxetine (Paxil)
Sertraline (Zoloft)
Which TCAs have a sedative effect? Ans:- Amitriptyline (Elavil)
Doxepin (Sineqan)
Which other antidepressants may cause sedation? Ans:- Mirtazapine (Remeron)
Nefazodone (Serzone)
Trazodone
What are side effects of trazadone? Ans:- Sedation, nausea, headache,
hypotension, priapism
Wellbutrin (NDRI) can be used to treat which disorders? Ans:- -Antidepressant
(mood disorders, unipolar affective disorders and depressive disorders)
-attention deficit hyperactive disorder
-smoking cessation.
Wellbutrin is contraindicated in clients with Ans:- SZ disorder
eating disorder
What is Considered first-line agents for chronic anxiety disorders? Ans:- Selective
serotonin reuptake inhibitors (SSRIs)
black box warning for SSRIs in children, adolescents, and young adults Ans:-
increased risk for suicide
, Which benzo have a short half life? Ans:- Alprazolam (Xanax)
Lorazepam (Ativan)
Which benzo have a long half life? Ans:- Clonazepam (Klonopin)
Diazepam (Valium)
Medications used to treat anxiety works on which system? Ans:- directly or
indirectly on GABA
Benzodiazepines with short/long half life have More severe withdrawal and more
rebound anxiety Ans:- short
Which non- benzo anxiolytics can be used to treat anxiety Ans:- Buspirone
(Buspar)
Tiagabine (Gabitril)
Gabapentin(Neurontin)
Propranolol (Inderal)
Males greater than ______ yrs old are have a risk factor associated with suicide
Ans:- 45 yr. old
females greater than ______ yrs old are have a risk factor associated with suicide
Ans:- 55 yr.s old
Which Benzodiazepines or hypnotics used for insomnia is long acting and should be
avoided in older adults Ans:- Flurazepam (Dalmane)
Pharmacological Management for insomnia include: Ans:- §Melatonin
§Benzodiazepines or hypnotics
Nonbenzodiazepine hypnotics
§Antidepressants
Classification?
Zaleplon (Sonata)
•Zolpidem (Ambien)
•Eszopiclone (Lunesta) Ans:- Nonbenzodiazepine hypnotics used for insomnia
•Classification?
Flurazepam (Dalmane)
•Temazepam (Restoril)
•Triazolam (Halcion) Ans:- Benzodiazepines or hypnotics used for insomnia
Which antidepressant use to treat insomnia should be avoided in older adults?
Ans:- Doxepin (Sinequan)
Classification?
•Amitriptyline (Elavil), Doxepin (Sinequan)
•Mirtazapine (Remeron), Desyrel (Trazadone) Ans:- Antidepressants used for
insomnia
_______ is produced in the locus ceruleus of the pons Ans:- Norepinephrine
The hallmark symptom in _______ is a disturbance of consciousness accompanied by
changes in cognitive function Ans:- delirium
Disturbance of consciousness develops over a short time, usually hours to days is
seen in _______ Ans:- delirium
How are Sleep-rest cycle different in patients with delirium? Ans:- clients are
awake at night andsleep during the day.
Impaired _______ and ______ memory is seen in patients with delirium Ans:- recent
and intermediate
Symptoms of delirium resolve within ? Ans:- 3 to 6 months
Delirium Mnemonic Ans:- D-Drugs
E-electrolyte abnormality
L-low oxygen saturation
I-infection
R-reduced sensory input
I-intracranial
U-urinary or renal retention
M-myocardial
What is the most common type of dementia? Ans:- Alzheimer's
__________ has a Gradual onset and progressive decline without focal neurological
deficits Ans:- Dementia of Alzheimer's type (DAT)
What are the hallmark signs of Dementia of Alzheimer's type (DAT) Ans:- amyloid
deposits and neurofibrillary tangles senile plaques
What changes in the brain are seen in DAT? Ans:- Diffuse cerebral atrophy and
enlarged ventricles
Which neurotransmitters are decreased in DAT? Ans:- acetylcholine (ACh) and
norepinephrine
___________is Often induced by traumatic experiences such as physical/sexual
abuse, or betrayal by a trusted individual Ans:- Dissociative amnesia
Clinical features of _____________ includes An inability to recall important personal
information, usually of a traumatic/stressful nature, that is inconsistent with
ordinary forgetting Ans:- Dissociative amnesia
localized amnesia is the disruption of Ans:- an event or period of time
,selective amnesia is the disruption of Ans:- Specific aspect of an event
generalized amnesia is the disruption of Ans:- Identity or life history
purposeful travel or bewildered wandering that is associated with amnesia for
identity or for other important autobiographical information Ans:- dissociative
fugue
inability to learn new info Ans:- Anterograde amnesia
inability to recall previously remembered info Ans:- Retrograde amnesia
Which TCA is used in the treatment of OCD? Ans:- Clomipramine
Which substances may cause dementia? Ans:- Alcohol
· Heavy metals
· Carbon monoxide
·Pseudodementia r/t meds ( anticholinergics)
inhalants
Which SSRIs have a sedative effect? Ans:- Citalopram (Celexa)
Escitalopram (Lexapro)
Fluvoxamine (Luvox)
Paroxetine (Paxil)
Sertraline (Zoloft)
Which TCAs have a sedative effect? Ans:- Amitriptyline (Elavil)
Doxepin (Sineqan)
Which other antidepressants may cause sedation? Ans:- Mirtazapine (Remeron)
Nefazodone (Serzone)
Trazodone
What are side effects of trazadone? Ans:- Sedation, nausea, headache,
hypotension, priapism
Wellbutrin (NDRI) can be used to treat which disorders? Ans:- -Antidepressant
(mood disorders, unipolar affective disorders and depressive disorders)
-attention deficit hyperactive disorder
-smoking cessation.
Wellbutrin is contraindicated in clients with Ans:- SZ disorder
eating disorder
What is Considered first-line agents for chronic anxiety disorders? Ans:- Selective
serotonin reuptake inhibitors (SSRIs)
black box warning for SSRIs in children, adolescents, and young adults Ans:-
increased risk for suicide
, Which benzo have a short half life? Ans:- Alprazolam (Xanax)
Lorazepam (Ativan)
Which benzo have a long half life? Ans:- Clonazepam (Klonopin)
Diazepam (Valium)
Medications used to treat anxiety works on which system? Ans:- directly or
indirectly on GABA
Benzodiazepines with short/long half life have More severe withdrawal and more
rebound anxiety Ans:- short
Which non- benzo anxiolytics can be used to treat anxiety Ans:- Buspirone
(Buspar)
Tiagabine (Gabitril)
Gabapentin(Neurontin)
Propranolol (Inderal)
Males greater than ______ yrs old are have a risk factor associated with suicide
Ans:- 45 yr. old
females greater than ______ yrs old are have a risk factor associated with suicide
Ans:- 55 yr.s old
Which Benzodiazepines or hypnotics used for insomnia is long acting and should be
avoided in older adults Ans:- Flurazepam (Dalmane)
Pharmacological Management for insomnia include: Ans:- §Melatonin
§Benzodiazepines or hypnotics
Nonbenzodiazepine hypnotics
§Antidepressants
Classification?
Zaleplon (Sonata)
•Zolpidem (Ambien)
•Eszopiclone (Lunesta) Ans:- Nonbenzodiazepine hypnotics used for insomnia
•Classification?
Flurazepam (Dalmane)
•Temazepam (Restoril)
•Triazolam (Halcion) Ans:- Benzodiazepines or hypnotics used for insomnia
Which antidepressant use to treat insomnia should be avoided in older adults?
Ans:- Doxepin (Sinequan)
Classification?
•Amitriptyline (Elavil), Doxepin (Sinequan)
•Mirtazapine (Remeron), Desyrel (Trazadone) Ans:- Antidepressants used for
insomnia
