Psychopharm Exam 1 practice questions and answers

The PMHNP is evaluating a 68-year-old man for symptoms of major depression. While assessing the appearance of the patient, an obvious left-sided ptosis is noted. Which cranial nerve is directly linked to this condition? a. III b. IV c. V d. VI A A 55-year-old woman has been referred for a psychiatric evaluation for a change in personality, lack of impulse control, and increasingly reckless decision-making. Which area of the brain would be responsible for these symptoms? a. Parietal lobe b. Broca's area c. Wernicke's area d. Frontal lobe D A patient was recently started on a dopamine antagonist, and complains of breast tenderness and a milky discharge. What is the most likely explanation for these symptoms? a. Dopamine transmission in the nigrostriatal pathway b. Dopamine transmission in the tuberoinfundibular pathway c. Dopamine transmission in the mesolimbic pathway d. Dopamine increases throughout the basal ganglia B A patient who was recently started on haloperidol for psychosis begins to manifest hand tremor, and a shuffling gait. What is the most likely explanation for these symptoms? a. Dopamine transmission in the nigrostriatal pathway b. Dopamine transmission in the tuberoinfundibular pathway c. Dopamine transmission in the mesolimbic pathway d. Dopamine increases throughout the basal ganglia A A 72-year-old man with a comorbid history of uncontrolled hypertension is referred to the PMHNP for dementia secondary to depression. The mental status exam reveals difficulty speaking fluently, inappropriate and confabulated responses, incongruent affect, and poor judgment. A cerebrovascular accident in which region of the brain would better explain these symptoms? a. Parietal lobe b. Wernicke's area c. Broca's area d. Occipital lobe C Which region of the brain is associated with sensory integration, spatial awareness, and conscious awareness of the opposite side of the body? a. Occipital lobe b. Wernicke's area c. Broca's area d. Parietal lobe D A patient appears internally preoccupied and responding to auditory hallucination. This patient may have a pathology affecting which lobe of the brain? a. Temporal lobe b. Occipital lobe c. Parietal lobe d. Cerebellum A A patient presents with atypical symptoms of psychosis that include inconsistent auditory hallucinations without disorganization. What is the best definition of an EEG and its utility? a. Radiologic test utilizing magnets and radio waves to provide a detailed image of the structures of the brain b. Electrophysiologic test that depicts electrical activity on the surface of the brain c. A serum test to indicate nutritional deficiencies that inhibit the formation of neurotransmitters d. A neuropsychological test to distinguish psychosis from a psychosomatic illness. B Neurons that only travel from the body to the brain are called: a. Sensory neurons b. Motor neurons c. Inter neurons d. Astrocytes A The part of the neuron that takes in and receives messages is called: a. Dendrite b. Axon c. Synapse d. Node of Ranvier A What is the fatty layer that prevents interference and increases the speed of impulse transmission along the axon? a. Dendrite b. Axon c. Synapse d. Myelin sheath D Which of the following receives messages and conducts impulses to the soma? a. Dendrite b. Axon c. Synapse d. Myelin sheath A The junction between two neurons is known as the: a. Dendrite b. Node of Ranvier c. Synapse d. Soma C When explaining the means by which neurotransmitters relate to mental illness, a patient ask, "What is a neurotransmitter?" The best answer is: a. A fatty layer covering the axon b. A chemical messenger c. A nerve cell d. The space between nerve cells B A patient is diagnosed with major depressive disorder with the most prominent feature of apathy, anhedonia, and isolation. Which neurotransmitter is associated with the symptoms? a. Serotonin b. Gamma-amino benzoic acid (GABA) c. Dopamine d. Cannabinoids C The PMHNP prescribes fluoxetine to treat depression. Which neurotransmitter will be made readily available in the synapse? a. Dopamine b. Serotonin c. Gamma-amino benzoic acid (GABA) d. Acetylcholine B The PMHNP in the ED is evaluating a 68-year-old woman who was recently diagnosed with mild cognitive impairment and cannot remember the name of the medication that she has recently started 1 week ago. The patient is complaining of increased heart rate, sweating, and muscle spasms progressively worsening for the last 3 days. Which neurotransmitter is associated with this adverse effect? a. Serotonin b. Acetylcholine c. Gamma-amino benzoic acid (GABA) d. Dopamine B Which of the following neurotransmitters exert inhibition over neuronal function? a. Acetylcholine b. Cannabinoids c. Gamma-amino benzoic acid (GABA) d. Dopamine C A patient with alcohol use disorder is admitted for detox in anticipation of admission to an inpatient rehabilitation facility. The patient takes metoprolol for hypertension, which he has forgotten to take today, and his last drink was 72 hours ago. Which tool should the PMHNP use to evaluate for symptoms of withdrawal? a. Hamilton Rating Scale for Depression b. Clinical Institute Withdrawal Assessment c. Vital signs d. Quick Inventory of Depressive Symptomatology B A 45-year-old man presents for a follow-up visit after starting on an SSRI 2 weeks ago for major depressive disorder. Which assessment tool would be the best indicator of progress? a. Geriatric Depression Scale b. The Young Mania Rating Scale c. Yale-Brown Obsessive Compulsive Scale d. Quick Inventory of Depressive Symptomatology D The PMHNP knows that the study of how the body absorbs, distributes, metabolizes, and excretes a medication is known as: a. Breakdown b. Pharmacokinetics c. Pharmacodynamics d. First-pass effect B After a drug is absorbed the substrate binds to protein for transport. Which portion of the drug is available for therapeutic effects? a. Bound b. Unbound c. Metabolized d. Excreted B A 19-year-old male is referred to the PMHNP by the student health office for alcohol use disorder. The patient states that on one occasion he passed out much sooner than he usually would with far less than he would usually drink. Upon further interview, the patient reveals the time he passed out was during a fraternity hazing in which he was butt- chugging (receiving a beer and vodka enema). What pharmacokinetic process was bypassed by this rectal administration route? a. Excretion b. Absorption c. Distribution d. First-pass effect D The PMHNP is monitoring a serum drug level for a medication with a 24-hour half-life. How many hours will it take to reach steady state? a. 48hours b. 72hours c. 96hours d. 120hours D A patient with schizophrenia was discharged from the hospital on olanzapine 5 mg twice a day. He immediately resumed smoking cigarettes and escalated to one pack per day. Upon presenting for his 1- week follow-up appointment, the patient reports he is having trouble sleeping and the voices have started to return. Which of the following actions should the PMHNP take? a. Send the patient to the ED for stabilization b. Change to another antipsychotic medication, and refer to a psychiatrist c. Increase his olanzapine, and schedule a follow-up visit in 2 days Tell him to stop smoking and give him a nicotine patch C A patient who has been stable on quetiapine (Seroquel XR) for 3 months has decided to start to drink grapefruit juice twice daily because she has heard it helps with weight loss. She calls to report that since her new diet she has been feeling fatigue and difficulty waking up in the morning. What is the best response by the PMHNP? a. "I will put in a new prescription for a lower dose of your medication." b. "Stop drinking the grapefruit juice and schedule an appointment to discuss the matter further." c. "I will prescribe you a stimulant and see you in 2 weeks." d. "You should make an appointment with your primary care provider for evaluation." B A 79-year-old female with no past psychiatric history is admitted with new onset auditory hallucinations. The patient states her most bothersome symptom is the voices, which have kept her from sleeping through the night for the last 3 weeks, and as a result, she is tired and irritable. Which medication should the PMHNP order for bedtime for sleep? a. Olanzapine 2.5mg PO b. Lorazepam 1mg PO c. Chlorpromazine 50mg PO Sertraline 50mg PO A A 16-year-old male with a history of smoking cigarettes and marijuana is being evaluated at the request of the school and parents. The child states that the reason he smokes is it "helps calm me down" as he is anxious all the time. Which of the following medications would be the best choice? a. Fluoxetine 20mg PO daily b. Clonazepam 0.5mg PO daily c. Vortioxetine 20mg daily d. Citalopram 5mg PO daily A A patient has had a pharmacogenomic test, which reveals he is an extensive metabolizer on CYP450, 1A2, 2D6, and 3A4. The PMHNP should prescribe: a. A lower than usual dose b. The usual dose c. A higher than usual dose A different medication B A woman in her 20th week of pregnancy has been resumed on lithium for bipolar disorder. The PMHNP knows that the patient may become subtherapeutic despite taking the medication as prescribed due to: a. Increased blood volume b. Increased fetal metabolism c. Reduced muscle mass d. Reduced blood volume A The PMHNP knows the relationship between drug concentration and effect on the body is known as: a. Pharmacology b. Pharmacokinetics c. Pharmacodynamics d. Physiology C