NURS 6630 MIDTERM EXAM TEST BANK 225 QUESTIONS WITH ANSWERS (ALL ANSWERS CORRECT)

1. The therapeutic effect of SSRIs is primarily due to: a. Increased degradation of monoamines b. Blockade of serotonin reuptake into the presynaptic neuron c. Direct agonism of postsynaptic serotonin receptors d. Inhibition of monoamine oxidase ANSWER: b. Blockade of serotonin reuptake into the presynaptic neuron 2. A key difference between typical (first-generation) and atypical (second-generation) antipsychotics is that atypical agents: a. Are more potent dopamine D2 receptor antagonists b. Have a higher risk of causing extrapyramidal symptoms (EPS) c. Have significant serotonin 5-HT2A receptor antagonism d. Are ineffective for positive symptoms of schizophrenia ANSWER: c. Have significant serotonin 5-HT2A receptor antagonism 3. The primary reason for conducting therapeutic drug monitoring (TDM) for Lithium is: a. Its narrow therapeutic index b. Its extensive first-pass metabolism c. Its high protein binding d. Its short half-life ANSWER: a. Its narrow therapeutic index 4. Which of the following is a potentially life-threatening adverse reaction associated with antipsychotic use? a. Neuroleptic Malignant Syndrome b. Tardive Dyskinesia c. Akathisia d. Dystonia ANSWER: a. Neuroleptic Malignant Syndrome 5. The mechanism of action of Benzodiazepines involves: a. Blocking NMDA glutamate receptors b. Enhancing the inhibitory effects of GABA c. Inhibiting the reuptake of norepinephrine d. Antagonizing muscarinic cholinergic receptors ANSWER: b. Enhancing the inhibitory effects of GABA 6. Which neurotransmitter is most implicated in the positive symptoms of schizophrenia? a. Excess Serotonin in the limbic system b. Excess Dopamine in the mesolimbic pathway c. Deficiency of Dopamine in the prefrontal cortex d. Deficiency of Norepinephrine in the hippocampus ANSWER: b. Excess Dopamine in the mesolimbic pathway 7. Before starting a patient on a tricyclic antidepressant (TCA), it is essential for the PMHNP to assess for: a. History of narrow-angle glaucoma b. History of migraines c. Family history of allergies d. Dietary habits ANSWER: a. History of narrow-angle glaucoma 8. The most common side effect of SSRI antidepressants is: a. Hypertensive crisis b. Sexual dysfunction c. Weight loss d. Urinary retention ANSWER: b. Sexual dysfunction 9. Which of the following medications requires strict dietary avoidance of tyramine-rich foods? a. Sertraline (Zoloft) b. Phenelzine (Nardil) c. Bupropion (Wellbutrin) d. Trazodone (Desyrel) ANSWER: b. Phenelzine (Nardil) 10. The primary goal during the acute phase of antidepressant treatment is: a. To achieve remission of symptoms b. To prepare the patient for medication discontinuation c. To prevent relapse d. To manage long-term side effects ANSWER: a. To achieve remission of symptoms 11. Which part of the neuron is primarily responsible for receiving signals from other neurons? a. Axon b. Soma c. Dendrites d. Axon Terminal ANSWER: c. Dendrites 12. Valproic acid (Depakote) is often used as a mood stabilizer, but it carries a significant Black Box Warning for: a. Hepatotoxicity b. Renal failure c. Pulmonary fibrosis d. Cardiomyopathy ANSWER: a. Hepatotoxicity 13. The "Kindling Hypothesis" in bipolar disorder suggests that: a. Early treatment may prevent future, more severe episodes b. Seizures and mood episodes share the same pathophysiology c. All mood stabilizers are also anticonvulsants d. Depression is caused by a chemical imbalance ANSWER: a. Early treatment may prevent future, more severe episodes 14. Which antipsychotic is associated with the highest risk of QTc prolongation? a. Haloperidol (Haldol) b. Thioridazine (Mellaril) c. Risperidone (Risperdal) d. Aripiprazole (Abilify) ANSWER: b. Thioridazine (Mellaril) 15. A patient taking an SSRI presents with confusion, agitation, hyperreflexia, and fever. The PMHNP should suspect: a. Neuroleptic Malignant Syndrome b. Serotonin Syndrome c. Anticholinergic Toxicity d. Diabetic Ketoacidosis ANSWER: b. Serotonin Syndrome 16. The primary role of a PMHNP in pharmacogenetics is to: a. Order genetic testing for every patient b. Use genetic information to predict drug response and tailor treatment c. Prescribe based solely on genetic markers d. Replace clinical judgment with genetic data ANSWER: b. Use genetic information to predict drug response and tailor treatment 17. Which of the following is a common and often distressing side effect of SNRIs like Venlafaxine (Effexor)? a. Bradycardia b. Hypersalivation c. Diaphoresis d. Hypothyroidism ANSWER: c. Diaphoresis 18. Tardive Dyskinesia (TD) is characterized by: a. Acute muscle spasms of the neck and face b. A subjective feeling of inner restlessness c. Involuntary, choreoathetoid movements of the tongue, face, and trunk d. Muscle rigidity and hyperthermia ANSWER: c. Involuntary, choreoathetoid movements of the tongue, face, and trunk 19. Lamotrigine (Lamictal) is particularly effective for which aspect of bipolar disorder? a. Acute Mania b. Prevention of Manic Episodes c. Prevention of Depressive Episodes d. Treatment of Psychosis ANSWER: c. Prevention of Depressive Episodes 20. The "Black Box Warning" for antidepressants regarding increased risk of suicidality applies to which population? a. All adults over 65 b. Children, adolescents, and young adults c. Only patients with a prior suicide attempt d. Pregnant women ANSWER: b. Children, adolescents, and young adults 21. What is the mechanism of action of Bupropion (Wellbutrin)? a. Serotonin and Norepinephrine Reuptake Inhibition b. Norepinephrine and Dopamine Reuptake Inhibition c. Serotonin 5-HT2A Receptor Antagonism d. Monoamine Oxidase Inhibition ANSWER: b. Norepinephrine and Dopamine Reuptake Inhibition 22. Which of the following is a critical baseline assessment before initiating Clozapine (Clozaril)? a) Thyroid Stimulating Hormone (TSH) b) Absolute Neutrophil Count (ANC) c) Liver Function Tests (LFTs) d) Serum Creatinine ANSWER: b. Absolute Neutrophil Count (ANC)