NURS-6630N Test Week 11 Final Exam.

NURS-6630N Test Week 11 Final Exam. A patient diagnosed with obsessive compulsive disorder has been taking a high-dose SSRI and is participating in therapy twice a week. He reports an inability to carry out responsibilities due to consistent interferences of his obsessions and compulsions. The PMHNP knows that the next step would be which of the following? Selected Answer: B. Decrease his SSRI and add an MAOI.  Question 2 0 out of 1 points Which statement best describes a pharmacological approach to treating patients for impulsive aggression? Selected Answer: B. Atypical antipsychotics can increase subcortical dopaminergic stimulation. S - The Marketplace to Buy and Sell your Study Material Downloaded by: nursekev | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material  Question 3 1 out of 1 points The PMHNP evaluates a patient presenting with symptoms of dementia. Before the PMHNP considers treatment options, the patient must be assessed for other possible causes of dementia. Which of the following answers addresses both possible other causes of dementia and a rational treatment option for Dementia? Selected Answer: B. Possible other causes: hypothyroidism, adrenal insufficiency, hyperparathyroidism Possible treatment option: donepezil  Question 4 1 out of 1 points 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? Selected Answer: A. Donepezil (Aricept)  Question 5 0 out of 1 points The PMHNP is teaching parents about their child’s new prescription for Ritalin. What will the PMHNP include in the teaching? Selected Answer: D. There will be continued effects into the evening. Downloaded by: nursekev | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material  Question 6 1 out of 1 points The PMHNP prescribes gabapentin (Neurontin) for a patient’s chronic pain. How does the PMHNP anticipate the drug to work? Selected Answer: A. It will bind to the alpha-2-delta ligand subunit of voltage-sensitive calcium channels.  Question 7 1 out of 1 points An opioid-naive patient is taking MS Contin (morphine sulfate) to treat his pain that is secondary to cancer. Under what circumstances would the PMHNP order naloxone (Narcan) IM/SQ? Selected Answer: D. The patient’s vital signs are 98.4F temp, 88 pulse, 104/62 blood pressure, and 8 respirations.  Question 8 1 out of 1 points A patient is prescribed D-methylphenidate, 10-mg extended-release capsules. What should the PMHNP include when discussing the side effects with the patient? Selected Answer: C. The medication can affect your blood pressure.  Question 9 1 out of 1 points A young patient is prescribed Vyvanse. During the follow-up appointment, which comment made by the patient makes the PMHNP think that the dosing is being done incorrectly? Downloaded by: nursekev | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material Selected Answer: B. “I am unable to fall asleep at night.”  Question 10 1 out of 1 points A patient recovering from shingles presents with tenderness and sensitivity to the upper back. He states it is bothersome to put a shirt on most days. This patient has end stage renal disease (ESRD) and is scheduled to have hemodialysis tomorrow but states that he does not know how he can lie in a recliner for 3 hours feeling this uncomfortable. What will be the PMHNP’s priority? Selected Answer: C. Prescribe lidocaine 5%  Question 11 0 out of 1 points A 63-year-old patient presents with the following symptoms. The PMHNP determines which set of symptoms warrant prescribing a medication? Select the answer that is matched with an appropriate treatment. Selected Answer: C. Reduced ability to find the correct word is most problematic, and an appropriate treatment option would be memantine.  Question 12 1 out of 1 points The PMHNP is caring for a patient who openly admitted to drinking a quart of vodka daily. Prior to prescribing this patient disulfiram (Antabuse), it is important for the PMHNP to: Downloaded by: nursekev | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material Selected Answer: A. Evaluate the patient’s willingness to abstain from alcohol  Question 13 0 out of 1 points A PMHNP supervisor is discussing with a nursing student how stimulants and noradrenergic agents assist with ADHD symptoms. What is the appropriate response? Selected Answer: A. They both increase signal strength output dopamine (DA) and norepinephrine (NE).  Question 14 1 out of 1 points The PMHNP is assessing a female patient who has been taking lamotrigine (Lamictal) for migraine prophylaxis. After discovering that the patient has reached the maximum dose of this medication, the PMHNP decides to change the patient’s medication to zonisamide (Zonegran). In addition to evaluating this patient’s day-to-day activities, what should the PMHNP ensure that this patient understands? Selected Answer: D. This medication has unwanted side effects such as sedation, lack of coordination, and drowsiness.  Question 15 0 out of 0 points When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity? Downloaded by: nursekev | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material Selected Answer: Yes  Question 16 1 out of 1 points The PMHNP is teaching a patient with a sleep disorder about taking diphenhydramine (Benadryl). The patient is concerned about the side effects of the drug. What can the PMHNP teach the patient about this treatment approach? Selected Answer: B. “It can cause blurred vision.”  Question 17 1 out of 1 points The PMHNP is performing a quality assurance peer review of the chart of another PMHNP. Upon review, the PMHNP reviews the chart of an older adult patient in long-term care facility who has chronic insomnia. The chart indicates that the patient has been receiving hypnotics on a nightly basis. What does the PMHNP find problematic about this documentation? Selected Answer: B. Hypnotics have prolonged half-lives that can cause drug accumulation in the elderly.  Question 18 1 out of 1 points A 14-year-old patient is prescribed Strattera and asks when the medicine should be taken. What does the PMHNP understand regarding the drug’s dosing profile? Downloaded by: nursekev | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material Selected Answer: B. The patient will have one or two doses a day.  Question 19 1 out of 1 points 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? Selected Answer: D. Both “A” & “B”  Question 20 1 out of 1 points The PMHNP is meeting with the parents of an 8-year-old patient who is receiving an initial prescription for D-amphetamine. The PMHNP demonstrates appropriate prescribing practices when she prescribes the following dose: Selected Answer: A. The child will be prescribed 2.5 mg.  Question 21 1 out of 1 points 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? Selected Answer: C. Guanfacine ER (Intuniv) Downloaded by: nursekev | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material  Question 22 0 out of 1 points The PMHNP is attempting to treat a patient’s chronic insomnia and wishes to start with an initial prescription that has a half-life of approximately 1–2 hours. What is the most appropriate prescription for the PMHNP to make? Selected Answer: C. Temazepam (Restoril)  Question 23 1 out of 1 points A 71-year-old male patient comes to an appointment with his 65-yearold wife. They are both having concerns related to her memory and ability to recognize faces. The PMNHP is considering prescribing memantine (Namenda) based on the following symptoms: Selected Answer: C. Amnesia, apraxia, agnosia  Question 24 1 out of 1 points The PMHNP is assessing a patient who has expressed suicidal intent and is now stating that he is hearing voices and sees people chasing him. The PMHNP identifies these symptoms to be associated with which of the following? Selected Answer: C. “Bath salt” intoxication Downloaded by: nursekev | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material  Question 25 1 out of 1 points The PMHNP is caring for a patient who reports excessive arousal at nighttime. What could the PMHNP use for a time-limited duration to shift the patient’s brain from a hyperactive state to a sleep state? Selected Answer: B. Benzodiazepines  Question 26 1 out of 1 points The PMHNP is selecting a medication treatment option for a patient who is exhibiting psychotic behaviors with poor impulse control and aggression. Of the available treatments, which can help temper some of the adverse effects or symptoms that are normally caused by D2 antagonism? Selected Answer: D. Second-generation, atypical antipsychotics  Question 27 1 out of 1 points 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? Selected Answer: D. All of the above  Question 28 1 out of 1 points A patient with chronic back pain has been prescribed a serotoninDownloaded by: nursekev | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material norepinephrine reuptake inhibitor (SNRI). How does the PMHNP describe the action of SNRIs on the inhibition of pain to the patient? Selected Answer: A. “The SNRI can increase noradrenergic neurotransmission in the descending spinal pathway to the dorsal horn.”  Question 29 1 out of 1 points An 18-year-old female with a history of frequent headaches and a mood disorder is prescribed topiramate (Topamax), 25 mg by mouth daily. The PMHNP understands that this medication is effective in treating which condition(s) in this patient? Selected Answer: A. Migraines  Question 30 1 out of 1 points Naltrexone (Revia), an opioid antagonist, is a medication that is used for which of the following conditions? Selected Answer: A. Alcoholism  Question 31 1 out of 1 points The PMHNP understands that slow-dose extended release stimulants are most appropriate for which patient with ADHD? Selected Answer: A. Downloaded by: nursekev | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material 8-year-old patient  Question 32 1 out of 1 points 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? Selected Answer: A. ADHD is often not the focus of treatment in adults with comorbid conditions.  Question 33 1 out of 1 points Which of the following is a true statement regarding the use of stimulants to treat attention deficit hyperactivity disorder (ADHD)? Selected Answer: B. Signal strength output is increased by dialing up the release of dopamine (DA) and norepinephrine (NE).  Question 34 1 out of 1 points Kevin is an adolescent who has been diagnosed with kleptomania. His parents are interested in seeking pharmacological treatment. What does the PMHNP tell the parents regarding his treatment options? Selected Answer: A. “Naltrexone may be an appropriate option to Downloaded by: nursekev | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material discuss.”  Question 35 1 out of 1 points 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? Selected Answer: D. Comorbidities are more common in adults, impacting the prescription of additional agents.  Question 36 1 out of 1 points 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? Selected Answer: A. Increase the dose of lamotrigine (Lamictal) to 25 mg twice daily.  Question 37 1 out of 1 points The PMHNP wants to use a symptom-based approach to treating a patient with fibromyalgia. How does the PMHNP go about treating this patient? Selected C. Downloaded by: nursekev | Distribution of this document is illegal S - The Marketplace to Buy and Sell your Study Material Answer: Matching the patient’s symptoms with the malfunctioning brain circuits and neurotransmitters that might mediate those symptoms.