NURS-6630N Test Week 11 Final Exam

Course NURS-6630N Test Week 11 Final Exam • Question 1 0 out of 1 points 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. • Question 3 0 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. • 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? 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: 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? 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? 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)