NSG 533 Advanced Pharmacology Test 1 Week 4 Questions with Answers Graded A+

29. What monitoring parameters should be followed in a 10-year-old initiated on fluoxetine for SAD? A. Suicidal Ideation B. School performance C. Anxiety Symptoms D. Nausea, headache, stomach ache E. All of the above: E 30. Which of the following GAD patients is most likely to be a CYP 2C19 poor metabolizer and will have an exaggerated response to diazepam 5 mg three times daily with increased sedation and CNS and cognitive side effects? A. 25-year-old white woman B. 25-year-old black woman C. 45-year-old black man D. 45-year-old Asian man E. 45-year-old white man: D 31. AD is a 58-year-old man who presents to your clinic with the complaint that he "just can't sleep at night." Upon further questioning, he reports that he typically falls asleep without problem but wakes up multiple times throughout the night. Which of the following sleep disorders could AD possibly have? A. Insomnia B. Obstructive sleep apnea C. Narcolepsy D. Restless legs syndrome E. All of the above: E NSG 533 Advanced Pharmacology Test 1 Week 4 Questions with Answers 8 / 12 32. RS is a 28-year-old man with a history of obsessive-compulsive disorder who reports that he kicks his legs during the night, which wakes him up. He reports that he does not really have any symptoms of restless legs syndrome, but the leg kicking frequently awakens him in the middle of the night and causes him to be sleepy during the daytime. RS has a body mass index of 21 kg/m2 and is normotensive, and his wife says he does not snore or stop breathing during sleep. What would you recommend for RS? A. Temazepam 15 mg at bedtime B. Polysomnography C. Pramipexole 0.5 mg at bedtime D. Multiple sleep latency test E. Gabapentin 300 mg at bedtime: A 33. Regarding therapies for the treatment of insomnia all of the following are correct except: A. Sedating antidepressants are commonly used to treat insomnia despite few good studies that document efficacy for insomnia. B. Nonbenzodiazepines (zolpidem, zaleplon, eszopiclone) are generally associated with less rebound insomnia than traditional benzodiazepines. C. Based on efficacy studies, BZDRAs and ramelteon are the drugs of choice for the treatment of insomnia. D. Suvorexant is an orexin receptor antagonist used for insomnia that is novel because it is not a controlled substance. E. All of the above are correct.: D 34. Which of the following is a consequence of unidentified and untreated sleep disorders? A. Hypertension B. Motor vehicle accidents C. Excessive daytime sleepiness D. Irritability E. All of the above: E 35. BB is a 48-year-old man with a history of RLS. Over the past year, his RLS has gotten worse, and he has increased the dose of his pramipexole therapy to 1 mg prior to bedtime. His symptoms started appearing earlier in the day, and he had new symptoms in his arms. What strategy should be implemented to manage his symptom NSG 533 Advanced Pharmacology Test 1 Week 4 Questions with Answers 9 / 12 augmentation? A. Switch to a shorter-acting dopaminergic agent B. Switch to a longer-acting dopaminergic agent C. Increase the dose of pramipexole D. Check serum ferritin and replete iron if necessary E. Both B and D: E 36. TQ is a 51-year-old woman who presents to your clinic today with a complaint of difficulty initiating sleep. She goes to bed at 10 PM and awakens at 6 AM but frequently does not fall asleep for 1.5 to 2 hours. This problem has persisted for 9 months. TQ also has a history of alcohol abuse. Based on the available information, which agent would be the best choice to treat TQ's complaint? A. Ramelteon B. Temazepam C. Flurazepam D. Eszopiclone E. Amitriptyline: A 37. BL is a 24-year-old college student with narcolepsy (no cataplexy) who is taking methylphenidate 20 mg/day (he takes this at 8 AM before his first class). Currently, this works well at reducing sleepiness in the morning, but next semester, BL will have morning and late afternoon classes and is worried he will not be able to stay awake for afternoon classes. Which of the following might be the best strategy for the upcoming semester? A. Methylphenidate 10 mg twice daily (8 AM and 6 PM) B. Methylphenidate 20 mg SR twice daily and 10 mg prn afternoon sleepiness C. Dextroamphetamine 10 mg/day (8 AM) D. Sodium Oxybate 2.25 g at bedtime and 3 hours later E. Selegiline 10 mg/day at 8 AM: B 38. JM is a 38-year-old man traveling to Europe on business. He asks you for a recommendation to treat jet lag upon his arrival. Based on the available evidence, which agent would you recommend? A. Valerian B. Diphenhydramine C. Mirtazapine D. Melatonin E. Quazepam: D