MSN 611 NKU Final EXAM QUESTIONS WITH CORRECT ANSWERS.pdf

MSN 611 NKU Final EXAM
QUESTIONS WITH CORRECT
ANSWERS
AQ65-year-
oldQmanQpresentsQwithQchronicQinsomnia.QHeQreportsQthatQhisQsleepQhasQimprovedQafterQbeginni
ngQaQnewQmedication,QbutQheQisQexperiencingQconcerningQadverseQeffects.QHisQwifeQnoticedQhimQ
sleepwalking,QeatingQduringQtheQnight,QandQattemptingQtoQdriveQhisQcarQatQnight.QTheQpatientQhas
QnoQrecollectionQofQtheseQeventsQandQisQconcerned.QVitalsQsignsQareQbloodQpressureQ130/80QmmH


g,QheartQrateQ82Qbpm,QrespiratoryQrateQ18Qbreaths/min,QandQtemperatureQ98.0QFQ(36.7QC).QPhysic
alQexaminationQisQnormal.QWhatQisQtheQmechanismQofQactionQofQtheQmedicationQresponsibleQforQt
heQpatient'sQadverseQeffects?Q-QCORRECTQANSWERSGABA-AQreceptorQagonist



AQ26-year-
oldQwomanQisQbroughtQtoQtheQemergencyQdepartmentQwithQanQacuteQsevereQheadache.QHerQpart
nerQreportsQthatQitQstartedQ6QhoursQagoQandQthatQsheQvomitedQseveralQtimesQatQhome.QTheQpatie
ntQisQholdingQherQhandsQoverQherQeyesQandQreportsQsevereQunilateralQretroorbitalQthrobbingQpain.
QSheQhasQnoQsignificantQpastQmedicalQhistoryQandQtakesQnoQregularQmedications.QHerQvitalQsignsQa


reQwithinQnormalQlimits.QThereQisQnoQgrossQneurologicalQdeficitQonQexaminationQofQtheQcranialQner
vesQandQlimbs.QGivenQtheQmostQlikelyQdiagnosis,QwhatQisQtheQmechanismQofQactionQofQtheQbestQdr
ugQforQtheQacuteQtreatmentQofQthisQpatient'sQcondition?Q-
QCORRECTQANSWERSCerebralQvasoconstriction




AQ42-year-oldQmanQpresentsQwithQaQ6-
monthQhistoryQofQsevere,QthrobbingQheadachesQthatQareQgenerallyQunilateral,QworsenedQbyQlightQ
andQsound,QandQoccurQbiweeklyQandQoccasionallyQinterruptQhisQworkday.QHeQhasQnoQsignificantQi
mprovementQwithQibuprofen,Qnaproxen,QorQacetaminophen.QVitalQsignsQareQbloodQpressureQ139/
80QmmHg,QheartQrateQ82Qbpm,QrespiratoryQrateQ14Qbreaths/min,QandQtemperatureQ98.0QFQ(36.7QC
).QPhysicalQexaminationQisQnormal.QWhichQofQtheQfollowingQeffectsQisQcausedQbyQtheQmostQapprop
riateQtreatmentQoption?Q-QCORRECTQANSWERSConstrictionQofQcerebralQbloodQvessels.



AQ20-year-
oldQwomanQpresentsQwithQaQsevereQheadache.QSheQisQG2P1QatQ32QweeksQgestation.QHerQbloodQpr
essureQisQ201/98QmmQHg.QAQurineQdipstickQshowsQ3+Qprotein.QPreparationsQareQmadeQforQanQeme

,rgencyQcesareanQsection.QSheQisQstartedQonQaQcontinuousQintravenousQinfusionQofQmagnesiumQsul
fateQforQtheQpreventionQofQseizures.QWhatQisQaQsevere,QyetQpreventable,QcomplicationQofQcontinu
ousQintravenousQmagnesiumQsulfateQtherapy?Q-QCORRECTQANSWERSRespiratoryQdepression



AQ55-year-
oldQmanQpresentsQwithQdifficultyQpassingQurineQandQsuprapubicQdiscomfortQforQtheQpastQ2Qdays.Q
HisQsymptomsQareQprogressivelyQworsening.QTheQpatient'sQpastQmedicalQhistoryQisQsignificantQforQ
depression,QandQheQwasQrecentlyQstartedQonQaQnewQmedicationQdueQtoQrefractoryQsymptoms.QTh
eQphysicalQexaminationQrevealsQtachycardia,QaQdryQmouth,QandQsuprapubicQfullness.QWhatQisQtheQ
classQofQmedicationQthatQisQresponsibleQforQthisQpatient'sQpresentingQsymptoms?Q-
QCORRECTQANSWERSTricyclicQantidepressants




AQ55-year-oldQmanQpresentsQwithQaQ1-
monthQhistoryQofQinsomniaQandQfatigue.QHeQstatesQthatQheQhasQbeenQunableQtoQcompleteQworkQt
asksQandQnoQlongerQenjoysQhisQhobbiesQorQgoingQoutQwithQfriends.QHeQalsoQreportsQaQdecreasedQa
ppetiteQandQboutsQofQcrying.QTheQpatientQhasQaQpastQmedicalQhistoryQofQseizures,Qhypothyroidism
,QdiabetesQmellitus,QandQasthma.QHisQbloodQpressureQisQ110/75QmmQHg,QandQhisQheartQrateQisQ75Q
bpm.QTheQclinicianQprescribesQvenlafaxine.QWhichQofQtheQfollowingQconditionsQrequiresQcautionQ
whenQusingQvenlafaxineQinQthisQpatient?Q-QCORRECTQANSWERSSeizures



AQ34-year-
oldQwomanQhasQbeenQtroubledQbyQmigraineQheadachesQthatQtypicallyQoccurQ5QtoQ6QtimesQmonthl
y.QTreatmentQofQtheQheadachesQwhenQtheyQoccurQisQmoderatelyQsuccessful.QSheQasksQwhetherQth
ereQisQanythingQsheQcanQdoQtoQreduceQtheQfrequencyQwithQwhichQtheseQheadachesQoccur.QSheQals
oQhasQbeenQtroubledQbyQlong-
standingQmoodQissues,QwithQepisodesQthatQareQweeksQlongQwhereQsheQfeelsQsad.QWhatQtherapyQ
mightQbeQrecommendedQthatQcanQbothQreduceQtheQfrequencyQofQherQmigraineQattacksQandQmayQ
alsoQbeQusefulQinQimprovingQherQmood?Q-QCORRECTQANSWERSVenlafaxine



AQpatientQisQdiagnosedQwithQmetabolicQacidosis.QHisQmedicationQrecordQshowsQthatQheQisQprescri
bedQdiclofenac,Qatenolol,Qalbuterol,QandQtopiramate.QWhichQofQtheseQmedicationsQisQmostQlikelyQ
responsibleQforQtheQpatient'sQcondition?Q-QCORRECTQANSWERSTopiramate

,AQ60-year-
oldQmanQisQbroughtQtoQtheQemergencyQdepartmentQafterQanQepisodeQofQsyncope.QTheQpatientQwa
sQwatchingQtelevisionQwhenQheQfeltQlight-
headedQandQlostQconsciousness.QHeQregainedQconsciousnessQafterQaQminuteQspontaneously.QTheQ
patient'sQpastQmedicalQhistoryQisQsignificantQforQhypertension,Qdiabetes,QandQperipheralQneuropat
hy.QHisQmedicationsQincludeQmetformin,Qhydrochlorothiazide,QandQamitriptyline.QECGQinQtheQeme
rgencyQdepartmentQshowsQaQQTQintervalQofQ480Qms.QWhatQisQtheQmechanismQofQactionQofQtheQdr
ugQresponsibleQforQthisQpatient'sQsymptomsQandQECGQfindings?Q-
QCORRECTQANSWERSBlockingQtheQreuptakeQofQbothQserotoninQandQnorepinephrineQneurotransmi


tters



AQ23-year-oldQmanQrecentlyQstartedQtakingQaQnewQmedicationQforQaQlong-
standingQhistoryQofQhallucinations,QpoorQeyeQcontact,QflatQaffect,QandQpoorQworkQperformance.QA
fterQsixQdaysQofQusingQthisQmedication,QthisQpatientQpresentsQtoQtheQemergencyQdepartmentQwith
QacuteQneckQstiffness.QOnQexam,QhisQheadQisQrotatedQtoQtheQleftQandQflexedQinQaQfixedQposition.QTh


eQmedicationQusedQbyQthisQpatientQmainlyQworksQbyQblockingQwhichQofQtheQfollowingQreceptor?Q-
QCORRECTQANSWERSDopamineQreceptor




AQ40-year-
oldQmanQisQbroughtQtoQtheQemergencyQdepartmentQdueQtoQaQsevereQheadacheQforQtheQpastQhour.
QHisQsymptomsQstartedQ2QhoursQafterQhavingQdinnerQwithQhisQfamily.QOnQfurtherQquestioning,QhisQ


wifeQrevealsQthatQtheyQhadQpizzaQandQredQwineQforQdinner.QOnQphysicalQexam,QheQappearsQanxiou
sQandQtremulous.QMedicalQhistoryQincludesQatypicalQdepressionQbeingQtreatedQwithQphenelzine.Q
HeQdoesQnotQsmokeQorQuseQillicitQdrugs.QWhichQofQtheQfollowingQIsQtheQmostQlikelyQfinding?Q-
QCORRECTQANSWERSHypertension




AQ25-year-
oldQwomanQpresentsQwithQdepressionQresistantQtoQmultipleQclassesQofQantidepressants.QAQnonsel
ectiveQmonoamineQoxidaseQinhibitorQ(MAOI)QisQprescribed.QWhichQofQtheQfollowingQshouldQbeQin
cludedQinQpatientQcounselingQregardingQtheQpreventionQofQoneQofQtheQmostQseriousQadverseQeffec
tsQofQthisQdrug?Q-QCORRECTQANSWERSAvoidQtyramine-containingQfoods



AQ48-year-oldQmanQwithQaQ20-pack-
yearQsmokingQhistoryQpresentsQwithQ3QweeksQofQinsomnia,Qanhedonia,QandQdecreasedQconcentra

, tionQafterQlosingQhisQfatherQtoQlungQcancer.QHeQworriesQthatQheQwillQdieQofQcancerQandQbeQunableQ
toQprovideQforQhisQfamily.QHeQoftenQfeelsQdownQandQspendsQmostQofQhisQdayQinQbed.QHeQhasQlostQ5
QlbsQ(2.2Qkg)QoverQtheQpastQ2QweeksQdueQtoQpoorQappetite.QHeQdeniesQsuicidalQideationQandQwoul


dQlikeQtoQquitQsmoking.QWhatQisQtheQbestQpharmacotherapyQforQthisQpatient?Q-
QCORRECTQANSWERSBupropion




AQ65-year-
oldQwomanQpresentsQtoQtheQclinicQwithQsignsQandQsymptomsQofQdepression.QSheQstatesQsheQhasQb
eenQfeelingQhopelessQandQdepressedQforQtheQpastQsixQmonthsQsinceQherQmother'sQdeathQandQtheQl
ossQofQherQjob.QSheQhasQaQpastQmedicalQhistoryQofQchronicQsinusitis,QforQwhichQsheQhasQbeenQtakin
gQantihistaminesQforQtheQpastQtwoQmonths.QHerQcurrentQvitalQsignsQareQasQfollows;QbloodQpressur
eQ126/80QmmHg,QheartQrateQ70/min,QrespiratoryQrateQ18/min,QandQtemperatureQ98.6QF.QWhatQisQ
theQnextQbestQstepQforQthisQpatient?Q-QCORRECTQANSWERSStartQonQsertraline



AQ17-year-oldQfemaleQpresentsQforQaQfollow-
upQonQmajorQdepressiveQdisorderQtherapyQwithQvenlafaxine.QTheQmotherQandQpatientQstateQthatQt
heQpatient'sQsymptomsQhaveQimproved.QSheQhasQbeenQperformingQbetterQatQschool,QenjoyingQact
ivitiesQwithQherQfriends,QandQgoingQtoQtheQgymQeveryQday.QHowever,QtheQpatientQhasQtroubleQfalli
ngQasleep.QTheQmotherQstatesQthatQsheQgivesQherQdaughterQaQcoughQmedication,Qdextromethorp
han,QtoQmakeQherQdrowsyQandQhelpQherQfallQasleep.QTheQmotherQandQpatientQaskQifQtheyQshouldQb
eQconcernedQaboutQtheQuseQofQdextromethorphan.QWhatQisQtheQbestQresponseQtoQtheirQquestion
?Q-
QCORRECTQANSWERSThereQisQanQincreasedQriskQofQserotoninQsyndromeQifQdextromethorphan QisQu


sedQwithQvenlafaxine.



AQ25-year-
oldQwomanQpresentsQwithQsevereQacuteQasthmaQexacerbation.QSheQinadequatelyQrespondsQtoQaQc
ombinationQofQnebulizedQalbuterol,QinhaledQipratropium,Qprednisone,QandQoxygen.QTheQclinicalQt
eamQdecidesQtoQadministerQintravenousQmagnesium.QWhileQplacingQtheQorder,QtheQclinicianQrecei
vesQanQalertQforQpotentialQoverdoseQwithQthisQmedication.QWhichQofQtheQfollowingQsymptomsQisQ
mostQlikelyQtoQoccurQifQthereQisQanQoverdose?Q-QCORRECTQANSWERSMuscleQweakness



AQ40-year-
oldQmaleQwithQaQhistoryQofQbipolarQ1QdisorderQisQadmittedQtoQaQpsychiatricQinpatientQfacilityQafterQ