NR546 Midterm Exam Questions And
Answers Verified 100% Correct
Excitatory neurotransmitters: - ANSWER -increase the likelihood that the neuron
will fire an action potential
inhibitory neurotransmitters: - ANSWER -decrease the likelihood that a neuron
will fire an action
neurotransmitters that most impact mental health can be classified into four major
categories: - ANSWER -cholinergics
-acetylcholine
monoamines
-norepinephrine, dopamine, serotonin, histamine
amino acids
-gamma- amino-butyric acid and glutamate
neuropeptides
Inhibitors: VISA CKGQ - ANSWER -Valproate
Isoniazid
Sulfonamides
Amiodarone
Chloramphenicol
Ketoconazole
Grapefruit Juice
Quinidine
-decrease medication metabolism
Inducers: CRAP GPS - ANSWER -Carbamazepine
,Rifampin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas
-increase medication metabolism
neurotransmitters that may be responsible for a client's symptoms of depression -
ANSWER -Imbalanced levels of acetylcholine, norepinephrine, serotonin,
histamine, or glutamate can contribute to symptoms of depression
client who is a poor metabolizer: - ANSWER -has a lower concentration of the
necessary enzyme to metabolize a drug, which results in higher blood
concentrations of the drug.
-increase the risk of side effects and adverse reactions
Why is trazodone not used as a front-line antidepressant - ANSWER -Its
antidepressant that has a secondary effect of blocking histamine and adrenergic
receptors
-causes sedation and somnolence and as a result
*often used as an adjunct in therapy when a depressed patient has difficulty
sleeping
effect on neurotransmitters and side effects: Selective Serotonin Reuptake
Inhibitors (SSRIs) - ANSWER -Inhibits the reuptake of serotonin, which can cause
nausea, agitation, headache, and sexual dysfunction
effect on neurotransmitters and side effects: Serotonin and Norepinephrine
Reuptake Inhibitors (SNRIs) - ANSWER -Inhibits the reuptake of serotonin and
norepinephrine, which can cause nausea, sweating, insomnia, tremors, sexual
dysfunction
, effect on neurotransmitters and side effects: Tricyclic Antidepressants - ANSWER
--Inhibits the reuptake of serotonin and norepinephrine, which can cause sexual
dysfunction
-Blocks norepinephrine receptors, which can cause hypotension and tachycardia
-Blocks histamine receptors, which can cause sedation and weight gain
-Blocks acetylcholine receptors, which can cause dry mouth, constipation, blurred
vision, and urinary retention
effect on neurotransmitters and side effects: Monoamine Oxidase Inhibitors
(MAOIs) - ANSWER -Increases norepinephrine and serotonin by inhibiting the
enzyme that inactivates it, which can cause sedation, dizziness, sexual dysfunction,
and hypertensive crisis
effect on neurotransmitters and side effects: Benzodiazepines - ANSWER -
Increases the receptor affinity for GABA, which can cause dependence and
confusion
effect on neurotransmitters and side effects: Bupropion - ANSWER -Inhibits the
reuptake of norepinephrine and dopamine, which can cause insomnia, dry mouth,
tremors, and seizures
antagonist - ANSWER -causes a conformational change that stabilizes the receptor
in the baseline state and thus is "silent."
-blocks the action of a neurotransmitter
agonists - ANSWER -fully stimulate G-protein-linked receptors
partial agonists - ANSWER -stimulate receptors to a lesser degree than an agonist
or natural neurotransmitter
SSRIs, SNRIs, and tricyclic antidepressants increase ________ levels.
___________ do not impact serotonin levels. - ANSWER -increase serotonin
levels.
Benzodiazepines do not impact serotonin levels.
, Is nicotine an inducer or an inhibitor of the CYP 1A2 enzyme? - ANSWER -
inducer
Nicotine is an inducer of the CYP 1A2 enzyme. Does the PMHNP anticipate
Joshua may need a higher or lower dose of olanzapine to achieve a therapeutic
response? - ANSWER -Higher
-Nicotine is an inducer of the CYP 1A2 enzyme, so it lowers the concentration of
drugs. Therefore, a higher dose of olanzapine may be needed to control his
symptoms.
Ernesto, a 60-year-old, presents to the PMHNP with report of having anxiety,
frequent occurrences of feeling frozen in place and like his heart is pounding out of
his chest, as well as having difficulty sleeping.
The PMHNP suspects the client has an elevated level of which neurotransmitter? -
ANSWER -Norepinephrine
-responsible for the regulation of fight or flight responses and can impact mood
and sleep.
Which of the following is the best medication class for the PMHNP to prescribe
for Ernesto to address his elevated norepinephrine levels? - ANSWER -selective
serotonin reuptake inhibitor would block the reuptake of serotonin, leaving a larger
amount of serotonin available. Increasing the amount of serotonin would help
regulate the feelings of fear and anxiety. Reducing the occurrence of fear would
help reduce the release of norepinephrine.
A serotonin and norepinephrine reuptake inhibitor would prevent the reuptake of
norepinephrine, which would not reduce the level of norepinephrine as needed.
Benzodiazepines increase the levels of GABA and do not impact norepinephrine.
A monoamine oxidase inhibitor would increase levels of norepinephrine.
During a follow up appointment after 4 weeks, the PMHNP should assess for the
need to add which medication to Ernesto's treatment plan? - ANSWER -The nurse
should assess for sexual dysfunction and anticipate the potential need for a
phosphodiesterase inhibitor such as sildenafil (Viagra).
-After 4 to 6 weeks, the client should be experiencing full effects of the SSRI, so
the need for a short-term medication like a benzodiazepine or a beta blocker are
Answers Verified 100% Correct
Excitatory neurotransmitters: - ANSWER -increase the likelihood that the neuron
will fire an action potential
inhibitory neurotransmitters: - ANSWER -decrease the likelihood that a neuron
will fire an action
neurotransmitters that most impact mental health can be classified into four major
categories: - ANSWER -cholinergics
-acetylcholine
monoamines
-norepinephrine, dopamine, serotonin, histamine
amino acids
-gamma- amino-butyric acid and glutamate
neuropeptides
Inhibitors: VISA CKGQ - ANSWER -Valproate
Isoniazid
Sulfonamides
Amiodarone
Chloramphenicol
Ketoconazole
Grapefruit Juice
Quinidine
-decrease medication metabolism
Inducers: CRAP GPS - ANSWER -Carbamazepine
,Rifampin
Alcohol
Phenytoin
Griseofulvin
Phenobarbital
Sulfonylureas
-increase medication metabolism
neurotransmitters that may be responsible for a client's symptoms of depression -
ANSWER -Imbalanced levels of acetylcholine, norepinephrine, serotonin,
histamine, or glutamate can contribute to symptoms of depression
client who is a poor metabolizer: - ANSWER -has a lower concentration of the
necessary enzyme to metabolize a drug, which results in higher blood
concentrations of the drug.
-increase the risk of side effects and adverse reactions
Why is trazodone not used as a front-line antidepressant - ANSWER -Its
antidepressant that has a secondary effect of blocking histamine and adrenergic
receptors
-causes sedation and somnolence and as a result
*often used as an adjunct in therapy when a depressed patient has difficulty
sleeping
effect on neurotransmitters and side effects: Selective Serotonin Reuptake
Inhibitors (SSRIs) - ANSWER -Inhibits the reuptake of serotonin, which can cause
nausea, agitation, headache, and sexual dysfunction
effect on neurotransmitters and side effects: Serotonin and Norepinephrine
Reuptake Inhibitors (SNRIs) - ANSWER -Inhibits the reuptake of serotonin and
norepinephrine, which can cause nausea, sweating, insomnia, tremors, sexual
dysfunction
, effect on neurotransmitters and side effects: Tricyclic Antidepressants - ANSWER
--Inhibits the reuptake of serotonin and norepinephrine, which can cause sexual
dysfunction
-Blocks norepinephrine receptors, which can cause hypotension and tachycardia
-Blocks histamine receptors, which can cause sedation and weight gain
-Blocks acetylcholine receptors, which can cause dry mouth, constipation, blurred
vision, and urinary retention
effect on neurotransmitters and side effects: Monoamine Oxidase Inhibitors
(MAOIs) - ANSWER -Increases norepinephrine and serotonin by inhibiting the
enzyme that inactivates it, which can cause sedation, dizziness, sexual dysfunction,
and hypertensive crisis
effect on neurotransmitters and side effects: Benzodiazepines - ANSWER -
Increases the receptor affinity for GABA, which can cause dependence and
confusion
effect on neurotransmitters and side effects: Bupropion - ANSWER -Inhibits the
reuptake of norepinephrine and dopamine, which can cause insomnia, dry mouth,
tremors, and seizures
antagonist - ANSWER -causes a conformational change that stabilizes the receptor
in the baseline state and thus is "silent."
-blocks the action of a neurotransmitter
agonists - ANSWER -fully stimulate G-protein-linked receptors
partial agonists - ANSWER -stimulate receptors to a lesser degree than an agonist
or natural neurotransmitter
SSRIs, SNRIs, and tricyclic antidepressants increase ________ levels.
___________ do not impact serotonin levels. - ANSWER -increase serotonin
levels.
Benzodiazepines do not impact serotonin levels.
, Is nicotine an inducer or an inhibitor of the CYP 1A2 enzyme? - ANSWER -
inducer
Nicotine is an inducer of the CYP 1A2 enzyme. Does the PMHNP anticipate
Joshua may need a higher or lower dose of olanzapine to achieve a therapeutic
response? - ANSWER -Higher
-Nicotine is an inducer of the CYP 1A2 enzyme, so it lowers the concentration of
drugs. Therefore, a higher dose of olanzapine may be needed to control his
symptoms.
Ernesto, a 60-year-old, presents to the PMHNP with report of having anxiety,
frequent occurrences of feeling frozen in place and like his heart is pounding out of
his chest, as well as having difficulty sleeping.
The PMHNP suspects the client has an elevated level of which neurotransmitter? -
ANSWER -Norepinephrine
-responsible for the regulation of fight or flight responses and can impact mood
and sleep.
Which of the following is the best medication class for the PMHNP to prescribe
for Ernesto to address his elevated norepinephrine levels? - ANSWER -selective
serotonin reuptake inhibitor would block the reuptake of serotonin, leaving a larger
amount of serotonin available. Increasing the amount of serotonin would help
regulate the feelings of fear and anxiety. Reducing the occurrence of fear would
help reduce the release of norepinephrine.
A serotonin and norepinephrine reuptake inhibitor would prevent the reuptake of
norepinephrine, which would not reduce the level of norepinephrine as needed.
Benzodiazepines increase the levels of GABA and do not impact norepinephrine.
A monoamine oxidase inhibitor would increase levels of norepinephrine.
During a follow up appointment after 4 weeks, the PMHNP should assess for the
need to add which medication to Ernesto's treatment plan? - ANSWER -The nurse
should assess for sexual dysfunction and anticipate the potential need for a
phosphodiesterase inhibitor such as sildenafil (Viagra).
-After 4 to 6 weeks, the client should be experiencing full effects of the SSRI, so
the need for a short-term medication like a benzodiazepine or a beta blocker are
