NURS 6630 EVALUATION TEST QUESTIONS AND
ANSWERS SET A+
✔✔A 9-year-old female patient presents with symptoms of both attention deficit
hyperactivity disorder (ADHD) and oppositional defiant disorder. In evaluating her
symptoms, the PMHNP determines that which of the following medications may be
beneficial in augmenting stimulant medication? - ✔✔ANS: b.
Guanfacine ER (Intuniv)
✔✔The PMHNP is assessing a patient who will be receiving phentermine (Adipex
P)/topiramate (Topamax) (Qsymia). Which of the following conditions/diseases will
require further evaluation before this medication can be prescribed? - ✔✔ANS: b.
Cardiovascular disease
✔✔The PMHNP wishes to prescribe a medication that reduces glutamate transmission
in an Alzheimer's patient. Which medication should the PMHNP prescribe? - ✔✔ANS: b.
Memantine (NAMENDA)
✔✔A patient with fibromyalgia and major depression needs to be treated for symptoms
of pain. Which is the PMHNP most likely to prescribe for this patient? - ✔✔ANS: d.
Duloxetine (Cymbalta)
✔✔A patient is prescribed D-methylphenidate, 10-mg extended-release capsules. What
should the PMHNP include when discussing the side effects with the patient? - ✔✔ANS:
c.
The medication can affect your blood pressure.
✔✔Which medication is an irreversible inhibitor of aldehyde dehydrogenase that creates
a negative and aversive response following ingestion of alcohol? - ✔✔ANS: c.
Disulfiram (ANTABUSE)
,✔✔An 80-year-old female patient diagnosed with Stage II Alzheimer's has a history of
irritable bowel syndrome. Which cholinergic drug may be the best choice for treatment
given the patient's gastrointestinal problems? - ✔✔ANS: a.
Donepezil (Aricept)
✔✔Mrs. Rosen is a 49-year-old patient who is experiencing fibro-fog. What does the
PMHNP prescribe for Mrs. Rosen to improve this condition? - ✔✔ANS: b.
All of these are correct
✔✔A 26-year-old female patient with nicotine dependence and a history of anxiety
presents with symptoms of attention deficit hyperactivity disorder (ADHD). Based on the
assessment, what does the PMHNP consider? - ✔✔ANS: a. ADHD is often not the
focus of treatment in adults with comorbid conditions.
✔✔Parents of a 12-year-old boy want to consider attention deficit hyperactivity disorder
(ADHD) medication for their son. Which medication would the PMHNP start? - ✔✔ANS:
d.
All of these could potentially treat their son's symptoms.
✔✔The PMHNP is assessing a patient who presents with elevated levels of brain
amyloid as noted by positron emission tomography (PET). What other factors will the
PMHNP consider before prescribing medication for this patient, and what medication
would the PMHNP want to avoid given these other factors? - ✔✔ANS: b.
ApoE4 genotype and avoid antihistamines if possible and Type 2 diabetes and avoid
olanzapine
✔✔Karen completes the Epworth sleepiness scale and scores abnormally high. She is
diagnosed with narcolepsy. The PMHNP prescribes a wake-promoting agent that is a
weak dopamine transporter antagonist. Which medication did the PMHNP prescribe? -
✔✔ANS: c.
Modafanil (PROVIGIL)
✔✔You have been consulted to evaluate a patient who presents with symptoms of
dementia. The patient is experiencing memory deficit, aphasia, apraxia, and agnosia.
Which treatment option is best for this patient? - ✔✔ANS: a.
Donepezil (ARICEPT)
✔✔Why does the PMHNP avoid prescribing clozapine (Clozaril) as a first-line treatment
to the patient with psychosis and aggression? - ✔✔ANS: c. There is too high a risk of
serious adverse side effects.
✔✔The PMHNP is caring for a patient with chronic insomnia who would benefit from
taking hypnotics. The PMHNP wants to prescribe the patient a drug with an ultra-short
half-life (1-3 hours). Which drug will the PMHNP prescribe? - ✔✔ANS: d.
,Triazolam (Halcion)
✔✔The PMHNP prescribes gabapentin (Neurontin) for a patient's chronic pain. How
does the PMHNP anticipate the drug to work? - ✔✔ANS: c.
It will bind to the alpha-2-delta ligand subunit of voltage sensitive calcium channels.
✔✔A patient with chronic back pain has been prescribed a serotonin-norepinephrine
reuptake inhibitor (SNRI). How does the PMHNP describe the action of SNRIs on the
inhibition of pain to the patient? - ✔✔ANS: d.
"The SNRI can increase noradrenergic neurotransmission in the descending spinal
pathway to the dorsal horn."
✔✔The PMHNP is attempting to treat a patient's chronic pain by having the agent bind
the open channel conformation of VSCCs to block those channels with a "use-
dependent" form of inhibition. Which agent will the PMHNP most likely select? -
✔✔ANS: c.
Pregabalin (Lyrica)
✔✔The PMHNP is assessing a patient she has been treating with the diagnosis of
chronic pain. During the assessment, the patient states that he has recently been
having trouble getting to sleep and staying asleep. Based on this information, what
action is the PMHNP most likely to take? - ✔✔ANS: a.
Order hydroxyzine (Vistaril), 50 mg PRN or as needed
✔✔The PMHNP is caring for a patient on risperidone (Risperdal). Which action made by
the PMHNP exhibits proper care for this patient? - ✔✔ANS: d.
Titrating the dose by increasing it every 5-7 days
✔✔The PMHNP prescribed a patient lamotrigine (Lamictal), 25 mg by mouth daily, for
nerve pain 6 months ago. The patient suddenly presents to the office with the complaint
that the medication is no longer working and complains of increased pain. What action
will the PMHNP most likely take? - ✔✔ANS: c.
Increase the dose of lamotrigine (Lamictal) to 25 mg twice daily.
✔✔Mike wants to quit smoking. He has tried nicotine replacement and varenicline
without success. He has asked for another medication to help him kick his habit. The
PMHNP decides to try a medication that increases dopamine by prescribing a
medications that can increase both norepinephrine and dopamine. Which medication
did the PMHNP prescribe? - ✔✔ANS: b.
Bupropion (ZYBAN)
✔✔The PMHNP is treating a patient with depression and fibromyalgia. The PMHNP
chooses to prescribe a treatment that may help treat the patient's fibromyalgia and
depressive symptoms. Which medication is the PMHNP likely to choose? - ✔✔ANS: a.
, Amitriptyline (ELAVIL)
✔✔The PMHNP is teaching parents about their child's new prescription for Ritalin. What
will the PMHNP include in the teaching? - ✔✔ANS: c.
The second dose should be taken at lunch.
✔✔You decide to start a patient on lurasidone (LATUDA). Which of these counseling
points is correct? - ✔✔ANS: b
This medication must be taken with food.
✔✔Which of these characteristics does NOT meet the criteria for probably Alzheimer's
dementia? - ✔✔ANS: b.
Sudden onset
✔✔A 43-year-old male patient is seeking clarification about treating attention deficit
hyperactivity disorder (ADHD) in adults and how it differs from treating children, since
his son is on medication to treat ADHD. The PMHNP conveys a major difference is
which of the following? - ✔✔ANS: b.
Comorbidities are more common in adults, impacting the prescription of additional
agents.
✔✔A patient with irritable bowel syndrome reports chronic stomach pain. The PMHNP
wants to prescribe the patient an agent that will cause irrelevant nociceptive inputs from
the pain to be ignored and no longer perceived as painful. Which drug will the PMHNP
prescribe? - ✔✔ANS: c.
Duloxetine (Cymbalta)
✔✔A patient calls the clinic to ask about an over-the-counter sleep aid. What is the best
response? - ✔✔ANS: b.
"You can purchase a second-generation antihistamine to help you sleep."
✔✔The PMHNP is treating a patient for fibromyalgia and is considering prescribing
milnacipran (Savella). When prescribing this medication, which action is the PMHNP
likely to choose? - ✔✔ANS: c.
Split the daily dose into two doses after the first day.
✔✔A nursing students asks the PMHNP the difference between impulsivity and
compulsivity. Which of the following responses is correct? - ✔✔ANS: b.
Impulsivity is defined as acting with excessive forethought and compulsivity is defined
as actions that are considered appropriate but persistent.
✔✔The PMHNP is working with the student to care for a patient with diabetic peripheral
neuropathic pain. The student asks the PMHNP why SSRIs are not consistently useful
ANSWERS SET A+
✔✔A 9-year-old female patient presents with symptoms of both attention deficit
hyperactivity disorder (ADHD) and oppositional defiant disorder. In evaluating her
symptoms, the PMHNP determines that which of the following medications may be
beneficial in augmenting stimulant medication? - ✔✔ANS: b.
Guanfacine ER (Intuniv)
✔✔The PMHNP is assessing a patient who will be receiving phentermine (Adipex
P)/topiramate (Topamax) (Qsymia). Which of the following conditions/diseases will
require further evaluation before this medication can be prescribed? - ✔✔ANS: b.
Cardiovascular disease
✔✔The PMHNP wishes to prescribe a medication that reduces glutamate transmission
in an Alzheimer's patient. Which medication should the PMHNP prescribe? - ✔✔ANS: b.
Memantine (NAMENDA)
✔✔A patient with fibromyalgia and major depression needs to be treated for symptoms
of pain. Which is the PMHNP most likely to prescribe for this patient? - ✔✔ANS: d.
Duloxetine (Cymbalta)
✔✔A patient is prescribed D-methylphenidate, 10-mg extended-release capsules. What
should the PMHNP include when discussing the side effects with the patient? - ✔✔ANS:
c.
The medication can affect your blood pressure.
✔✔Which medication is an irreversible inhibitor of aldehyde dehydrogenase that creates
a negative and aversive response following ingestion of alcohol? - ✔✔ANS: c.
Disulfiram (ANTABUSE)
,✔✔An 80-year-old female patient diagnosed with Stage II Alzheimer's has a history of
irritable bowel syndrome. Which cholinergic drug may be the best choice for treatment
given the patient's gastrointestinal problems? - ✔✔ANS: a.
Donepezil (Aricept)
✔✔Mrs. Rosen is a 49-year-old patient who is experiencing fibro-fog. What does the
PMHNP prescribe for Mrs. Rosen to improve this condition? - ✔✔ANS: b.
All of these are correct
✔✔A 26-year-old female patient with nicotine dependence and a history of anxiety
presents with symptoms of attention deficit hyperactivity disorder (ADHD). Based on the
assessment, what does the PMHNP consider? - ✔✔ANS: a. ADHD is often not the
focus of treatment in adults with comorbid conditions.
✔✔Parents of a 12-year-old boy want to consider attention deficit hyperactivity disorder
(ADHD) medication for their son. Which medication would the PMHNP start? - ✔✔ANS:
d.
All of these could potentially treat their son's symptoms.
✔✔The PMHNP is assessing a patient who presents with elevated levels of brain
amyloid as noted by positron emission tomography (PET). What other factors will the
PMHNP consider before prescribing medication for this patient, and what medication
would the PMHNP want to avoid given these other factors? - ✔✔ANS: b.
ApoE4 genotype and avoid antihistamines if possible and Type 2 diabetes and avoid
olanzapine
✔✔Karen completes the Epworth sleepiness scale and scores abnormally high. She is
diagnosed with narcolepsy. The PMHNP prescribes a wake-promoting agent that is a
weak dopamine transporter antagonist. Which medication did the PMHNP prescribe? -
✔✔ANS: c.
Modafanil (PROVIGIL)
✔✔You have been consulted to evaluate a patient who presents with symptoms of
dementia. The patient is experiencing memory deficit, aphasia, apraxia, and agnosia.
Which treatment option is best for this patient? - ✔✔ANS: a.
Donepezil (ARICEPT)
✔✔Why does the PMHNP avoid prescribing clozapine (Clozaril) as a first-line treatment
to the patient with psychosis and aggression? - ✔✔ANS: c. There is too high a risk of
serious adverse side effects.
✔✔The PMHNP is caring for a patient with chronic insomnia who would benefit from
taking hypnotics. The PMHNP wants to prescribe the patient a drug with an ultra-short
half-life (1-3 hours). Which drug will the PMHNP prescribe? - ✔✔ANS: d.
,Triazolam (Halcion)
✔✔The PMHNP prescribes gabapentin (Neurontin) for a patient's chronic pain. How
does the PMHNP anticipate the drug to work? - ✔✔ANS: c.
It will bind to the alpha-2-delta ligand subunit of voltage sensitive calcium channels.
✔✔A patient with chronic back pain has been prescribed a serotonin-norepinephrine
reuptake inhibitor (SNRI). How does the PMHNP describe the action of SNRIs on the
inhibition of pain to the patient? - ✔✔ANS: d.
"The SNRI can increase noradrenergic neurotransmission in the descending spinal
pathway to the dorsal horn."
✔✔The PMHNP is attempting to treat a patient's chronic pain by having the agent bind
the open channel conformation of VSCCs to block those channels with a "use-
dependent" form of inhibition. Which agent will the PMHNP most likely select? -
✔✔ANS: c.
Pregabalin (Lyrica)
✔✔The PMHNP is assessing a patient she has been treating with the diagnosis of
chronic pain. During the assessment, the patient states that he has recently been
having trouble getting to sleep and staying asleep. Based on this information, what
action is the PMHNP most likely to take? - ✔✔ANS: a.
Order hydroxyzine (Vistaril), 50 mg PRN or as needed
✔✔The PMHNP is caring for a patient on risperidone (Risperdal). Which action made by
the PMHNP exhibits proper care for this patient? - ✔✔ANS: d.
Titrating the dose by increasing it every 5-7 days
✔✔The PMHNP prescribed a patient lamotrigine (Lamictal), 25 mg by mouth daily, for
nerve pain 6 months ago. The patient suddenly presents to the office with the complaint
that the medication is no longer working and complains of increased pain. What action
will the PMHNP most likely take? - ✔✔ANS: c.
Increase the dose of lamotrigine (Lamictal) to 25 mg twice daily.
✔✔Mike wants to quit smoking. He has tried nicotine replacement and varenicline
without success. He has asked for another medication to help him kick his habit. The
PMHNP decides to try a medication that increases dopamine by prescribing a
medications that can increase both norepinephrine and dopamine. Which medication
did the PMHNP prescribe? - ✔✔ANS: b.
Bupropion (ZYBAN)
✔✔The PMHNP is treating a patient with depression and fibromyalgia. The PMHNP
chooses to prescribe a treatment that may help treat the patient's fibromyalgia and
depressive symptoms. Which medication is the PMHNP likely to choose? - ✔✔ANS: a.
, Amitriptyline (ELAVIL)
✔✔The PMHNP is teaching parents about their child's new prescription for Ritalin. What
will the PMHNP include in the teaching? - ✔✔ANS: c.
The second dose should be taken at lunch.
✔✔You decide to start a patient on lurasidone (LATUDA). Which of these counseling
points is correct? - ✔✔ANS: b
This medication must be taken with food.
✔✔Which of these characteristics does NOT meet the criteria for probably Alzheimer's
dementia? - ✔✔ANS: b.
Sudden onset
✔✔A 43-year-old male patient is seeking clarification about treating attention deficit
hyperactivity disorder (ADHD) in adults and how it differs from treating children, since
his son is on medication to treat ADHD. The PMHNP conveys a major difference is
which of the following? - ✔✔ANS: b.
Comorbidities are more common in adults, impacting the prescription of additional
agents.
✔✔A patient with irritable bowel syndrome reports chronic stomach pain. The PMHNP
wants to prescribe the patient an agent that will cause irrelevant nociceptive inputs from
the pain to be ignored and no longer perceived as painful. Which drug will the PMHNP
prescribe? - ✔✔ANS: c.
Duloxetine (Cymbalta)
✔✔A patient calls the clinic to ask about an over-the-counter sleep aid. What is the best
response? - ✔✔ANS: b.
"You can purchase a second-generation antihistamine to help you sleep."
✔✔The PMHNP is treating a patient for fibromyalgia and is considering prescribing
milnacipran (Savella). When prescribing this medication, which action is the PMHNP
likely to choose? - ✔✔ANS: c.
Split the daily dose into two doses after the first day.
✔✔A nursing students asks the PMHNP the difference between impulsivity and
compulsivity. Which of the following responses is correct? - ✔✔ANS: b.
Impulsivity is defined as acting with excessive forethought and compulsivity is defined
as actions that are considered appropriate but persistent.
✔✔The PMHNP is working with the student to care for a patient with diabetic peripheral
neuropathic pain. The student asks the PMHNP why SSRIs are not consistently useful
