NR 577 Exam 4 V1 | NR 577 Primary Care
Management of Adolescents and Adults | Actual
Q&A with Rationale (NR577 Exam 4) |
Chamberlain University
1. A 24-year-old patient presents with symptoms of Major Depressive Disorder (MDD).
According to the DSM-5, which symptom is required for a diagnosis?
A. Psychomotor agitation
B. Significant weight loss
C. Anhedonia or depressed mood
D. Feelings of worthlessness
Correct Answer: C
Explanation: To diagnose MDD, the patient must exhibit at least five symptoms during a
two-week period. One of those symptoms must be either a depressed mood or a loss of
interest or pleasure, also known as anhedonia. Other symptoms like weight changes or
feelings of worthlessness support the diagnosis but are not mandatory primary criteria.
2. Which of the following is considered a first-line pharmacological treatment for Generalized
Anxiety Disorder (GAD)?
A. Buspirone (Buspar)
B. Alprazolam (Xanax)
C. Quetiapine (Seroquel)
,D. Sertraline (Zoloft)
Correct Answer: D
Explanation: Selective Serotonin Reuptake Inhibitors (SSRIs) such as Sertraline are the
primary first-line treatment for GAD. They are preferred over benzodiazepines due to the
risk of dependence and tolerance associated with the latter. Treatment typically involves a
slow titration to avoid initial increases in anxiety.
3. A patient with Bipolar I disorder is being managed with Lithium. What is the most critical
lab value to monitor to prevent toxicity?
A. Serum Potassium
B. Blood Urea Nitrogen
C. Serum Sodium
D. Liver Transaminases
Correct Answer: C
Explanation: Serum sodium levels are critical because lithium is handled by the kidneys in
a manner similar to sodium. Hyponatremia or dehydration can lead to increased lithium
reabsorption, resulting in toxic levels. Patients should be educated to maintain consistent
salt and fluid intake.
4. In the management of a patient with a suspected Migraine without aura, which medication
class is contraindicated if the patient has a history of Ischemic Heart Disease?
A. NSAIDs
, B. Triptans
C. Beta-Blockers
D. Acetaminophen
Correct Answer: B
Explanation: Triptans are 5-HT1B/1D receptor agonists that cause vasoconstriction of
cranial arteries. Because they can also cause coronary vasospasm, they are strictly
contraindicated in patients with coronary artery disease or uncontrolled hypertension. The
provider must assess cardiovascular risk before prescribing this class of abortive therapy.
5. A 70-year-old male presents with a resting ‘pill-rolling’ tremor and bradykinesia. Which
neurotransmitter deficiency is primary in this condition?
A. Acetylcholine
B. Serotonin
C. Dopamine
D. GABA
Correct Answer: C
Explanation: Parkinson’s disease is characterized by the progressive loss of dopaminergic
neurons in the substantia nigra. The resulting dopamine deficiency leads to the classic
motor symptoms of tremor, rigidity, and bradykinesia. Treatment focuses on replenishing
dopamine levels or mimicking its action in the brain.
Management of Adolescents and Adults | Actual
Q&A with Rationale (NR577 Exam 4) |
Chamberlain University
1. A 24-year-old patient presents with symptoms of Major Depressive Disorder (MDD).
According to the DSM-5, which symptom is required for a diagnosis?
A. Psychomotor agitation
B. Significant weight loss
C. Anhedonia or depressed mood
D. Feelings of worthlessness
Correct Answer: C
Explanation: To diagnose MDD, the patient must exhibit at least five symptoms during a
two-week period. One of those symptoms must be either a depressed mood or a loss of
interest or pleasure, also known as anhedonia. Other symptoms like weight changes or
feelings of worthlessness support the diagnosis but are not mandatory primary criteria.
2. Which of the following is considered a first-line pharmacological treatment for Generalized
Anxiety Disorder (GAD)?
A. Buspirone (Buspar)
B. Alprazolam (Xanax)
C. Quetiapine (Seroquel)
,D. Sertraline (Zoloft)
Correct Answer: D
Explanation: Selective Serotonin Reuptake Inhibitors (SSRIs) such as Sertraline are the
primary first-line treatment for GAD. They are preferred over benzodiazepines due to the
risk of dependence and tolerance associated with the latter. Treatment typically involves a
slow titration to avoid initial increases in anxiety.
3. A patient with Bipolar I disorder is being managed with Lithium. What is the most critical
lab value to monitor to prevent toxicity?
A. Serum Potassium
B. Blood Urea Nitrogen
C. Serum Sodium
D. Liver Transaminases
Correct Answer: C
Explanation: Serum sodium levels are critical because lithium is handled by the kidneys in
a manner similar to sodium. Hyponatremia or dehydration can lead to increased lithium
reabsorption, resulting in toxic levels. Patients should be educated to maintain consistent
salt and fluid intake.
4. In the management of a patient with a suspected Migraine without aura, which medication
class is contraindicated if the patient has a history of Ischemic Heart Disease?
A. NSAIDs
, B. Triptans
C. Beta-Blockers
D. Acetaminophen
Correct Answer: B
Explanation: Triptans are 5-HT1B/1D receptor agonists that cause vasoconstriction of
cranial arteries. Because they can also cause coronary vasospasm, they are strictly
contraindicated in patients with coronary artery disease or uncontrolled hypertension. The
provider must assess cardiovascular risk before prescribing this class of abortive therapy.
5. A 70-year-old male presents with a resting ‘pill-rolling’ tremor and bradykinesia. Which
neurotransmitter deficiency is primary in this condition?
A. Acetylcholine
B. Serotonin
C. Dopamine
D. GABA
Correct Answer: C
Explanation: Parkinson’s disease is characterized by the progressive loss of dopaminergic
neurons in the substantia nigra. The resulting dopamine deficiency leads to the classic
motor symptoms of tremor, rigidity, and bradykinesia. Treatment focuses on replenishing
dopamine levels or mimicking its action in the brain.
