NURS 660 EXAM 4 QUESTIONS WITH FULLY SOLVED &
UPDATED ANSWERS.
1) Which medication is contraindicated with liver impairment? -- Answer ✔✔
t t t t t t t t t t
Atomoxine (Strattera) t
2) What is one of the birth defects associated with Lithium? -- Answer ✔✔ Ebstein's
t t t t t t t t t t t t t t
anomaly
3) Which SSRI drug causes cardiovascular malformations in the first trimester of
t t t t t t t t t t t
pregnancy? -- Answer ✔✔ Paroxetine (Paxil) t t t t t
4) Mechanism of action of a stimulant for ADHD Methylphenidate and amphetamine? -
t t t t t t t t t t t
- Answer ✔✔ increases the intrasynaptic levels of both dopamine and
t t t t t t t t t t t
norepinephrine
5) What causes nicotine withdrawal symptoms? -- Answer ✔✔ Nicotine alpha 4 beta 2
t t t t t t t t t t t t t
post synaptic receptors desensitizes receptors which leads to addiction. Re-
t t t t t t t t t
sensitization of the nicotine receptors leads to withdrawal t t t t t t t
6) A patient diagnosed with ADHD can't stay focused or solve work-related problems
t t t t t t t t t t t t
difficulty maintaining attention sustained and problem-solving. What area of the
t t t t t t t t t t
brain is involved? -- Answer ✔✔ Dorsal lateral prefrontal cortex (CTSC loop)
t t t t t t t t t t t
7) What part of the brain is associated with selective attention? -- Answer ✔✔ Dorsal
t t t t t t t t t t t t t t
anterior singlunate t
8) What part of the brain is associated with hyperactivity? -- Answer ✔✔ Prefrontal
t t t t t t t t t t t t t
motor cortex t
, 9) What part of the brain is associated with impulsivity? -- Answer ✔✔ Orbitofrontal
t t t t t t t t t t t t t
cortex
10) Atomoxetine (Strattera) lacks abuse potential because of what -- Answer ✔✔ t t t t t t t t t t t
increases dopamine in the dorsal prefrontal cortex and not in the nucleus
t t t t t t t t t t t t
accumbens
11) What fetal malformation does valproate cause? -- Answer ✔✔ Spina bifida
t t t t t t t t t t
12) What region of the brain is hypothesized to cause impulsivity? -- Answer ✔✔ ventral
t t t t t t t t t t t t t
tstriatum
13) What region of the brain controls compulsivity? -- Answer ✔✔ Dorsal striatum
t t t t t t t t t t t
14) What is the MOA of atomoxetine (Strattera)? -- Answer ✔✔ Selective
t t t t t t t t t t t
Norepinephrine Reuptake Inhibitor: Boosts neurotransmitter norepinephrine/ t t t t t t
noradrenaline and may also increase dopamine in prefrontal cortex • Blocks t t t t t t t t t t t
norepinephrine reuptake pumps, also known as norepinephrine transporters • t t t t t t t t
15) Amaloid precursor protein is first cleaved by what enzyme -- Answer ✔✔ Alpha-
t t t t t t t t t t t t
secretase
16) What does paroxetine do to Strattera in the body? -- Answer ✔✔ increases the
t t t t t t t t t t t t t t
effect of the drug in the body
t t t t t t
17) If a patient is taking paroxetine and starts Strattera what should change about the
t t t t t t t t t t t t t t
Strattera dose? -- Answer ✔✔ The dose should be decreased
t t t t t t t t t
18) An Alzheimer's patient has been taking 4mg of rivastigmine what side effects might
t t t t t t t t t t t t t
you anticipate and why? -- Answer ✔✔ GI side effects; inhibits peripheral uptake of
t t t t t t t t t t t t t t
ACH and butyrylcholine
t t
19) Which neurotransmitters lead to euphoria and abuse in a patient with marijuana
t t t t t t t t t t t t
abuse and ADHD. -- Answer ✔✔ Pulsatile delivery of stimulants can cause a
t t t t t t t t t t t t t
UPDATED ANSWERS.
1) Which medication is contraindicated with liver impairment? -- Answer ✔✔
t t t t t t t t t t
Atomoxine (Strattera) t
2) What is one of the birth defects associated with Lithium? -- Answer ✔✔ Ebstein's
t t t t t t t t t t t t t t
anomaly
3) Which SSRI drug causes cardiovascular malformations in the first trimester of
t t t t t t t t t t t
pregnancy? -- Answer ✔✔ Paroxetine (Paxil) t t t t t
4) Mechanism of action of a stimulant for ADHD Methylphenidate and amphetamine? -
t t t t t t t t t t t
- Answer ✔✔ increases the intrasynaptic levels of both dopamine and
t t t t t t t t t t t
norepinephrine
5) What causes nicotine withdrawal symptoms? -- Answer ✔✔ Nicotine alpha 4 beta 2
t t t t t t t t t t t t t
post synaptic receptors desensitizes receptors which leads to addiction. Re-
t t t t t t t t t
sensitization of the nicotine receptors leads to withdrawal t t t t t t t
6) A patient diagnosed with ADHD can't stay focused or solve work-related problems
t t t t t t t t t t t t
difficulty maintaining attention sustained and problem-solving. What area of the
t t t t t t t t t t
brain is involved? -- Answer ✔✔ Dorsal lateral prefrontal cortex (CTSC loop)
t t t t t t t t t t t
7) What part of the brain is associated with selective attention? -- Answer ✔✔ Dorsal
t t t t t t t t t t t t t t
anterior singlunate t
8) What part of the brain is associated with hyperactivity? -- Answer ✔✔ Prefrontal
t t t t t t t t t t t t t
motor cortex t
, 9) What part of the brain is associated with impulsivity? -- Answer ✔✔ Orbitofrontal
t t t t t t t t t t t t t
cortex
10) Atomoxetine (Strattera) lacks abuse potential because of what -- Answer ✔✔ t t t t t t t t t t t
increases dopamine in the dorsal prefrontal cortex and not in the nucleus
t t t t t t t t t t t t
accumbens
11) What fetal malformation does valproate cause? -- Answer ✔✔ Spina bifida
t t t t t t t t t t
12) What region of the brain is hypothesized to cause impulsivity? -- Answer ✔✔ ventral
t t t t t t t t t t t t t
tstriatum
13) What region of the brain controls compulsivity? -- Answer ✔✔ Dorsal striatum
t t t t t t t t t t t
14) What is the MOA of atomoxetine (Strattera)? -- Answer ✔✔ Selective
t t t t t t t t t t t
Norepinephrine Reuptake Inhibitor: Boosts neurotransmitter norepinephrine/ t t t t t t
noradrenaline and may also increase dopamine in prefrontal cortex • Blocks t t t t t t t t t t t
norepinephrine reuptake pumps, also known as norepinephrine transporters • t t t t t t t t
15) Amaloid precursor protein is first cleaved by what enzyme -- Answer ✔✔ Alpha-
t t t t t t t t t t t t
secretase
16) What does paroxetine do to Strattera in the body? -- Answer ✔✔ increases the
t t t t t t t t t t t t t t
effect of the drug in the body
t t t t t t
17) If a patient is taking paroxetine and starts Strattera what should change about the
t t t t t t t t t t t t t t
Strattera dose? -- Answer ✔✔ The dose should be decreased
t t t t t t t t t
18) An Alzheimer's patient has been taking 4mg of rivastigmine what side effects might
t t t t t t t t t t t t t
you anticipate and why? -- Answer ✔✔ GI side effects; inhibits peripheral uptake of
t t t t t t t t t t t t t t
ACH and butyrylcholine
t t
19) Which neurotransmitters lead to euphoria and abuse in a patient with marijuana
t t t t t t t t t t t t
abuse and ADHD. -- Answer ✔✔ Pulsatile delivery of stimulants can cause a
t t t t t t t t t t t t t