Test Submission: Week 6

Question 1 Selected Answer: A.  A patient recently transferred following a suicide attempt has a history of schizophrenia, depression, and fibromyalgia. He is currently taking Amitriptyline (Elavil), Lisinopril, aspirin, and fluoxetine (Prozac). When assessing the psychiatric medications and the reason for admission, what would be the best course of action for the PMHNP with this client? Review Amitriptyline (Elavil) level Question 2 Selected Answer: B. A patient is diagnosed with schizophrenia. What increases the patient’s potential to mediate the cognitive symptoms of the disease? Achieving overactivity of the mesocorticol projections to the ventromedial prefrontal cortex Question 3 Selected Answer: B.  A patient with schizophrenia is given an inverse agonist that acts on the receptor 5HT and neurotransmitter serotonin. What is the rationale for prescribing a medication such as this? To decrease serotonin Question 4 1 out of 1 points 0 out of 1 points 1 out of 1 points 1 out of 1 points 7/7/2020 Review Test Submission: Week 6 Midterm Exam – NURS-6630N... Selected Answer: C. Ms. Skidmore presents for a follow-up appointment after being prescribed phenelzine (Nardil), and reports “I take my 45 mg pill, three times a day, just like I’m supposed to.” What does the PMHNP understand about this patient? Ms. Skidmore is taking too much of the phenelzine (Nardil); she should be taking the 45 mg in three doses.  Question 5 Selected Answer: D. The student inquires about antipsychotic medications. Which response by the PMHNP describes the factors that contribute to reduced risk of extrapyramidal symptoms (EPS) for patients who take antipsychotics? Potent D2 antagonists that block the muscarinic anti-M1 cholinergic receptors Question 6 Selected Answer: A.  A client is prescribed fluoxetine but is concerned about side effects. Which statement demonstrates accurate client teaching when discussing the side effects associated with fluoxetine? Weight gain is common Question 7 Selected Answer: A. Though medications have the ability to target neurotransmitter release into the synapse by the presynaptic neuron it is not always necessary. The PMHNP understands that this is because: Neurotransmission occurring along the axon is normally at a level to prevent symptoms of mental illness and rarely require augmentation from medication therapy. Question 8 Selected Answer: A.  The PMHNP is caring for four patients. Which patient statement indicates that benzodiazepines would be beneficial? “I have trouble staying asleep in the middle of the night.” Question 9 Selected Answer: A.  Ms. Ryerson is a 28-year-old patient with a mood disorder. She recently requested to transfer to a new PMHNP, after not getting along well with her previous provider. The new PHMNP is reviewing Ms. Ryerson’s medical chart prior to their first appointment. Upon review, the PMHNP sees that the former provider last documented “patient had rapid poop out.” What does the PMHNP infer about the patient’s prescription based on this documentation? The patient has an unsustained response to antidepressants. 0 out of 1 points 1 out of 1 points 0 out of 1 points 0 out of 1 points 1 out of 1 points 7/7/2020 Review Test Submission: Week 6 Midterm Exam – NURS-6630N... Question 10 Selected Answer: C.  A patient is prescribed fluoxetine but is concerned about the side effects. Which statement demonstrates accurate patient teaching when discussing the side effects associated with fluoxetine? Induction of mania is rare. Question 11 Selected Answer: B.  The PMHNP is caring for a new patient who has been transferred from another office. When meeting with the new patient, the patient reports, “I feel like I am improving with the stabilizers.” The PMHNP immediately recognizes that the patient is describing which kind of drug? Antagonists Question 12 Selected Answer: B.  Ms. Hill is currently being treated for schizophrenia but has stopped taking her medications due to some side effects she claims she was experiencing. She presents to the clinic today with worsening symptoms. She is experiencing anhedonia, agitation, attentional impairment, and affective blunting. Which one of the symptoms mentioned is considered a positive symptom of schizophrenia? Agitation Question 13 Selected Answer: D.  There are a number of endocrine reactions that accompany fear. A quick boost of cortisol may enhance survival when encountering a real but short-term threat. However, chronic elevations in cortisol can lead to increased medical comorbidities. Which of the following medical conditions may be related to these persistent cortisol elevations? All of the above Question 14 Selected Answer: A.  The PMHNP is considering prescribing a 49-year-old male clozapine (Clozaril) to treat his schizophrenia and suicidal ideations. The PMHNP is aware that which factor may impact the dose needed to effectively treat his condition: The patient smokes cigarettes. Question 15 The PMHNP is meeting with a new mother who would like to begin taking medication again to treat her bipolar depression; she is breastfeeding her 2-month old daughter. The PMHNP recognizes that which 1 out of 1 points 0 out of 1 points 1 out of 1 points 1 out of 1 points 1 out of 1 points 1 out of 1 points 7/7/2020 Review Test Submission: Week 6 Midterm Exam – NURS-6630N... Selected Answer: C.  of the following medications is contraindicated for this client? Lithium (Lithobid) Question 16 Selected Answer: B.  A patient presents with frequent episodes of mania. Which statement describes an appropriate treatment approach for this patient? “The patient could benefit from an anticonvulsant.”   Question 17 Selected Answer: B.  Ms. Boeckh is a 42-year-old client who is taking an antidepressant therapy. The PMHNP understands that this medication can have substantial food interactions that can cause Ms. Boeckh to develop a hypertensive crisis. Which antidepressant class is Ms. Boeckh’s medication in? MAO inhibitors