MSN 611 NKU FINAL EXAM WITH
CORRECT ANSWERS
2025
A 65-year-old man presents with chronic insomnia. He reports that his
sleep has after beginning a new medication, but he is experiencing
improved
concerning
effects. His adverse
wife noticed him sleepwalking, eating during the night, and
attempting
drive his cartoat night. The patient has no recollection of these events and
is concerned.
Vitals signs are blood pressure 130/80 mmHg, heart rate 82 bpm,
respiratory rate
breaths/min, and18temperature 98.0 F (36.7 C). Physical examination is
normal.
the mechanism
What is of action of the medication responsible for the
patient's(adverse
effects? Correct answers ) GABA-A receptor
agonist
A 26-year-old woman is brought to the emergency department with an
acute severe
headache. Her partner reports that it started 6 hours ago and that she
vomited
times at several
home. The patient is holding her hands over her eyes and
reports severe
unilateral retroorbital throbbing pain. She has no significant past medical
historyno
takes and
regular medications. Her vital signs are within normal limits.
There neurological
gross is no deficit on examination of the cranial nerves and limbs.
Givenlikely
most the diagnosis, what is the mechanism of action of the best drug
for the acute
treatment of this patient's condition? ( Correct answers ) Cerebral
vasoconstriction
A 42-year-old man presents with a 6-month history of severe, throbbing
headaches
that are generally unilateral, worsened by light and sound, and occur
biweekly andinterrupt his workday. He has no significant improvement with
occasionally
naproxen, or acetaminophen. Vital signs are blood pressure 139/80
ibuprofen,
mmHg,
82 bpm,heart
respiratory
rate rate 14 breaths/min, and temperature 98.0 F (36.7
C). Physical is normal. Which of the following effects is caused
examination
by the most treatment option? ( Correct answers ) Constriction of
appropriate
cerebral blood
vessels
.
A 20-year-old woman presents with a severe headache. She is G2P1
at 32 weeks
gestation. Her blood pressure is 201/98 mm Hg. A urine dipstick shows
3+ protein. are made for an emergency cesarean section. She is
Preparations
started on aintravenous infusion of magnesium sulfate for the prevention
continuous
of seizures.
What is a severe, yet preventable, complication of continuous intravenous
sulfate therapy? ( Correct answers ) Respiratory
magnesium
depression
A 55-year-old man presents with difficulty passing urine and suprapubic
for the past 2 days. His symptoms are progressively worsening. The
discomfort
patient'shistory
medical past is significant for depression, and he was recently
started on a new
,medication due to refractory symptoms. The physical examination reveals
a dry mouth, and suprapubic fullness. What is the class of
tachycardia,
medication that
responsible for this
is patient's presenting symptoms? ( Correct answers )
antidepressants
Tricyclic
A 55-year-old man presents with a 1-month history of insomnia and
fatigue.
that He states
he has been unable to complete work tasks and no longer enjoys his
hobbies
going outorwith friends. He also reports a decreased appetite and bouts of
crying. The
patient has a past medical history of seizures, hypothyroidism, diabetes
mellitus, His
asthma. andblood pressure is 110/75 mm Hg, and his heart rate is 75 bpm.
The clinician
prescribes venlafaxine. Which of the following conditions requires caution
when using in this patient? ( Correct answers ) Seizures
venlafaxine
A 34-year-old woman has been troubled by migraine headaches that
typically
to 6 timesoccur
monthly.
5 Treatment of the headaches when they occur is
successful. She asks whether there is anything she can do to reduce the
moderately
frequency
with which these headaches occur. She also has been troubled by long-
standing
issues, mood
with episodes that are weeks long where she feels sad. What
therapy might be
recommended that can both reduce the frequency of her migraine
attacks
also be and may
useful in improving her mood? ( Correct answers )
Venlafaxine
A patient is diagnosed with metabolic acidosis. His medication record
shows that diclofenac,
prescribed he is atenolol, albuterol, and topiramate. Which of these
medications
is most likely responsible for the patient's condition? ( Correct answers )
Topiramate
A 60-year-old
syncope. man is brought
The patient to the television
was watching emergency department
when after an
he felt light-
episode and
headed of lostHe regained consciousness after a minute spontaneously.
consciousness.
The patient's
past medical history is significant for hypertension, diabetes, and
neuropathy. His medications include metformin, hydrochlorothiazide, and
peripheral
ECG in the emergency department shows a QT interval of 480 ms.
amitriptyline.
What is the of action of the drug responsible for this patient's
mechanism
symptoms( and
findings? Correct
ECGanswers ) Blocking the reuptake of both
serotonin and neurotransmitters
norepinephrine
A 23-year-old man recently started taking a new medication for a
history of hallucinations, poor eye contact, flat affect, and poor work
long-standing
After six days of using this medication, this patient presents to the
performance.
department with acute neck stiffness. On exam, his head is rotated to
emergency
the leftinand
flexed a fixed position. The medication used by this patient mainly
works of
which by the
blocking
following receptor? ( Correct answers ) Dopamine receptor
A 40-year-old man is brought to the emergency department due to a
severe headache for the past hour. His symptoms started 2 hours after
having dinner with his family. On
, further questioning, his wife reveals that they had pizza and red wine for
dinner. On physical exam, he appears anxious and tremulous. Medical
history includes atypical depression being treated with phenelzine. He
does not smoke or use illicit drugs.
Which of the following Is the most likely finding? ( Correct answers )
Hypertension
A 25-year-old woman presents with depression resistant to multiple
classes of
antidepressants. A nonselective monoamine oxidase inhibitor (MAOI) is
Which of the following should be included in patient counseling
prescribed.
regarding the
prevention of one of the most serious adverse effects of this drug?
( Correct
Avoid tyramine-containing
answers )
foods
A 48-year-old man with a 20-pack-year smoking history presents with 3
weeks of anhedonia, and decreased concentration after losing his
insomnia,
father toHe
cancer. lungworries that he will die of cancer and be unable to provide for
his family.
often feels He down and spends most of his day in bed. He has lost 5 lbs (2.2
kg) over
past 2 weeks
the due to poor appetite. He denies suicidal ideation and
would likeWhat
smoking. to quit
is the best pharmacotherapy for this patient? ( Correct
answers )
Bupropio
n
A 65-year-old woman presents to the clinic with signs and symptoms of
She states she has been feeling hopeless and depressed for the past six
depression.
months
her since death and the loss of her job. She has a past medical
mother's
history offor
sinusitis, chronic
which she has been taking antihistamines for the past two
months.vital
current Her signs are as follows; blood pressure 126/80 mmHg, heart
rate 70/min,rate 18/min, and temperature 98.6 F. What is the next best
respiratory
step for this
patient? ( Correct answers ) Start on
sertraline
A 17-year-old female presents for a follow-up on major depressive
disorder
with venlafaxine.
therapy The mother and patient state that the patient's
symptoms She
improved. havehas been performing better at school, enjoying
activitiesand
friends, with her to the gym every day. However, the patient has
going
trouble falling
asleep. The mother states that she gives her daughter a cough
dextromethorphan, to make her drowsy and help her fall asleep. The
medication,
mother ask
patient and if they should be concerned about the use of
dextromethorphan.
the best response toWhat theirisquestion? ( Correct answers ) There is an
increased syndrome
serotonin risk of if dextromethorphan is used with
venlafaxine.
A 25-year-old woman presents with severe acute asthma
exacerbation. responds
inadequately She to a combination of nebulized albuterol, inhaled
ipratropium,
prednisone, and oxygen. The clinical team decides to administer
intravenous
magnesium. While placing the order, the clinician receives an alert
for potential
overdose with this medication. Which of the following symptoms is most
likely
if to is
there occur
an overdose? ( Correct answers ) Muscle
weakness
CORRECT ANSWERS
2025
A 65-year-old man presents with chronic insomnia. He reports that his
sleep has after beginning a new medication, but he is experiencing
improved
concerning
effects. His adverse
wife noticed him sleepwalking, eating during the night, and
attempting
drive his cartoat night. The patient has no recollection of these events and
is concerned.
Vitals signs are blood pressure 130/80 mmHg, heart rate 82 bpm,
respiratory rate
breaths/min, and18temperature 98.0 F (36.7 C). Physical examination is
normal.
the mechanism
What is of action of the medication responsible for the
patient's(adverse
effects? Correct answers ) GABA-A receptor
agonist
A 26-year-old woman is brought to the emergency department with an
acute severe
headache. Her partner reports that it started 6 hours ago and that she
vomited
times at several
home. The patient is holding her hands over her eyes and
reports severe
unilateral retroorbital throbbing pain. She has no significant past medical
historyno
takes and
regular medications. Her vital signs are within normal limits.
There neurological
gross is no deficit on examination of the cranial nerves and limbs.
Givenlikely
most the diagnosis, what is the mechanism of action of the best drug
for the acute
treatment of this patient's condition? ( Correct answers ) Cerebral
vasoconstriction
A 42-year-old man presents with a 6-month history of severe, throbbing
headaches
that are generally unilateral, worsened by light and sound, and occur
biweekly andinterrupt his workday. He has no significant improvement with
occasionally
naproxen, or acetaminophen. Vital signs are blood pressure 139/80
ibuprofen,
mmHg,
82 bpm,heart
respiratory
rate rate 14 breaths/min, and temperature 98.0 F (36.7
C). Physical is normal. Which of the following effects is caused
examination
by the most treatment option? ( Correct answers ) Constriction of
appropriate
cerebral blood
vessels
.
A 20-year-old woman presents with a severe headache. She is G2P1
at 32 weeks
gestation. Her blood pressure is 201/98 mm Hg. A urine dipstick shows
3+ protein. are made for an emergency cesarean section. She is
Preparations
started on aintravenous infusion of magnesium sulfate for the prevention
continuous
of seizures.
What is a severe, yet preventable, complication of continuous intravenous
sulfate therapy? ( Correct answers ) Respiratory
magnesium
depression
A 55-year-old man presents with difficulty passing urine and suprapubic
for the past 2 days. His symptoms are progressively worsening. The
discomfort
patient'shistory
medical past is significant for depression, and he was recently
started on a new
,medication due to refractory symptoms. The physical examination reveals
a dry mouth, and suprapubic fullness. What is the class of
tachycardia,
medication that
responsible for this
is patient's presenting symptoms? ( Correct answers )
antidepressants
Tricyclic
A 55-year-old man presents with a 1-month history of insomnia and
fatigue.
that He states
he has been unable to complete work tasks and no longer enjoys his
hobbies
going outorwith friends. He also reports a decreased appetite and bouts of
crying. The
patient has a past medical history of seizures, hypothyroidism, diabetes
mellitus, His
asthma. andblood pressure is 110/75 mm Hg, and his heart rate is 75 bpm.
The clinician
prescribes venlafaxine. Which of the following conditions requires caution
when using in this patient? ( Correct answers ) Seizures
venlafaxine
A 34-year-old woman has been troubled by migraine headaches that
typically
to 6 timesoccur
monthly.
5 Treatment of the headaches when they occur is
successful. She asks whether there is anything she can do to reduce the
moderately
frequency
with which these headaches occur. She also has been troubled by long-
standing
issues, mood
with episodes that are weeks long where she feels sad. What
therapy might be
recommended that can both reduce the frequency of her migraine
attacks
also be and may
useful in improving her mood? ( Correct answers )
Venlafaxine
A patient is diagnosed with metabolic acidosis. His medication record
shows that diclofenac,
prescribed he is atenolol, albuterol, and topiramate. Which of these
medications
is most likely responsible for the patient's condition? ( Correct answers )
Topiramate
A 60-year-old
syncope. man is brought
The patient to the television
was watching emergency department
when after an
he felt light-
episode and
headed of lostHe regained consciousness after a minute spontaneously.
consciousness.
The patient's
past medical history is significant for hypertension, diabetes, and
neuropathy. His medications include metformin, hydrochlorothiazide, and
peripheral
ECG in the emergency department shows a QT interval of 480 ms.
amitriptyline.
What is the of action of the drug responsible for this patient's
mechanism
symptoms( and
findings? Correct
ECGanswers ) Blocking the reuptake of both
serotonin and neurotransmitters
norepinephrine
A 23-year-old man recently started taking a new medication for a
history of hallucinations, poor eye contact, flat affect, and poor work
long-standing
After six days of using this medication, this patient presents to the
performance.
department with acute neck stiffness. On exam, his head is rotated to
emergency
the leftinand
flexed a fixed position. The medication used by this patient mainly
works of
which by the
blocking
following receptor? ( Correct answers ) Dopamine receptor
A 40-year-old man is brought to the emergency department due to a
severe headache for the past hour. His symptoms started 2 hours after
having dinner with his family. On
, further questioning, his wife reveals that they had pizza and red wine for
dinner. On physical exam, he appears anxious and tremulous. Medical
history includes atypical depression being treated with phenelzine. He
does not smoke or use illicit drugs.
Which of the following Is the most likely finding? ( Correct answers )
Hypertension
A 25-year-old woman presents with depression resistant to multiple
classes of
antidepressants. A nonselective monoamine oxidase inhibitor (MAOI) is
Which of the following should be included in patient counseling
prescribed.
regarding the
prevention of one of the most serious adverse effects of this drug?
( Correct
Avoid tyramine-containing
answers )
foods
A 48-year-old man with a 20-pack-year smoking history presents with 3
weeks of anhedonia, and decreased concentration after losing his
insomnia,
father toHe
cancer. lungworries that he will die of cancer and be unable to provide for
his family.
often feels He down and spends most of his day in bed. He has lost 5 lbs (2.2
kg) over
past 2 weeks
the due to poor appetite. He denies suicidal ideation and
would likeWhat
smoking. to quit
is the best pharmacotherapy for this patient? ( Correct
answers )
Bupropio
n
A 65-year-old woman presents to the clinic with signs and symptoms of
She states she has been feeling hopeless and depressed for the past six
depression.
months
her since death and the loss of her job. She has a past medical
mother's
history offor
sinusitis, chronic
which she has been taking antihistamines for the past two
months.vital
current Her signs are as follows; blood pressure 126/80 mmHg, heart
rate 70/min,rate 18/min, and temperature 98.6 F. What is the next best
respiratory
step for this
patient? ( Correct answers ) Start on
sertraline
A 17-year-old female presents for a follow-up on major depressive
disorder
with venlafaxine.
therapy The mother and patient state that the patient's
symptoms She
improved. havehas been performing better at school, enjoying
activitiesand
friends, with her to the gym every day. However, the patient has
going
trouble falling
asleep. The mother states that she gives her daughter a cough
dextromethorphan, to make her drowsy and help her fall asleep. The
medication,
mother ask
patient and if they should be concerned about the use of
dextromethorphan.
the best response toWhat theirisquestion? ( Correct answers ) There is an
increased syndrome
serotonin risk of if dextromethorphan is used with
venlafaxine.
A 25-year-old woman presents with severe acute asthma
exacerbation. responds
inadequately She to a combination of nebulized albuterol, inhaled
ipratropium,
prednisone, and oxygen. The clinical team decides to administer
intravenous
magnesium. While placing the order, the clinician receives an alert
for potential
overdose with this medication. Which of the following symptoms is most
likely
if to is
there occur
an overdose? ( Correct answers ) Muscle
weakness
