Midterm Exam: NR547 / NR-547
(Latest ) Differential
Diagnosis in Psychiatric-Mental
Health across the Lifespan
Practicum | Questions and Answers
| 100% Correct | Grade A -
Chamberlain
Question:
First-generation antipsychotics, also known as typical antipsychotics,
Answer:
-effective for positive symptoms but have a higher incidence of unwanted side
effects, such as dystonia, parkinsonism, akathisia, and tardive dyskinesia,
which increase with long-term use.
-may be selected for a hospitalized client with psychosis when medication is
required to quickly target presenting positive symptoms.
,Question:
Erica is a 24-year-old with a newly diagnosed schizophreniform disorder. She
is a current smoker. She does not use alcohol or other drugs. She has no
medical history. Which of the following would be the least appropriate initial
medication for Erica?
a) Aripiprazole
b) Lurasidone
c) olanzapine
d) quetiapine
Answer:
Olanzapine requires up to 30% increased dosage for clients who smoke
concurrently. Initiating a medication that does not interact with smoking is
preferable.
Question:
Tony is a 56-year-old who has recently been diagnosed with schizophrenia. He
takes amiodarone for a history of cardiac dysrhythmias. He does not use
alcohol or other drugs. He is a nonsmoker. Which of the following is the most
appropriate medication for Tony?
a) Aripiprazole
b) Lurasidone
c) Quetiapine
d) risperidone
Answer:
Amiodarone is a moderate CYP3A4 inhibitor. Risperidone does not interact
with CYP3A4 inhibitors or inducers.
,Question:
Jenny is a 22-year-old who has been prescribed aripiprazole 15 mg/day for the
past 8 months. She has gained approximately 30 lbs. during treatment.
Jenny's psychiatric symptoms have been managed well on aripiprazole and
she has no other adverse effects. What is the most appropriate initial
intervention for Jenny?
a) switch to a different antipsychotic medication
b) prescribe metformin
c) refer to a bariatric specialist
Answer:
Prescribing metformin as an adjunct treatment to assist with weight loss
associated with antipsychotics is appropriate. Jenny is well-managed on the
current dose of aripiprazole; switching to a different medication is not
indicated at this time. Referral to a bariatric specialist may be indicated if the
client continues to gain weight but is not indicated as the most appropriate
initial intervention.
Question:
A client has been on clozapine for 9 months. Absolute neutrophil counts
(ANC) have consistently been less than 1500/microliter? At what frequency
should a CBC be drawn?
Answer:
With a normal baseline ANC, the CBC should be monitored weekly for 6
months; every 2 weeks for months 6-12; and monthly thereafter
, Question:
Scott is a 33-year-old who is currently without housing. He has been unable to
adhere to his prescribed oral medication regimen. The PMHNP recommends
a long-acting intramuscular form of medication. Scott is willing to try but
would like to receive the medication at the community clinic near the shelter
where he is staying. Which medication option is the least appropriate for
Scott at this time?
a) aripiprazole monohydrate
b) olanzapine
c) paliperidone palmitate
d) risperidone
Answer:
Olanzapine must be given in a registered health care facility with available
emergency medical services. The client receiving olanzapine must be
monitored for 3 hours post-injection.
Question:
Which of the following laboratory tests are indicated for a client who is taking
olanzapine?
a) BMI
b) CBC
c) HbA1C
d) Lipid panel
e) Kidney function tests
Answer:
Monitoring should include fasting glucose or hemoglobin A1C, lipid profile,
weight, and BMI at regular intervals during the first year of antipsychotic
therapy and then annually.
(Latest ) Differential
Diagnosis in Psychiatric-Mental
Health across the Lifespan
Practicum | Questions and Answers
| 100% Correct | Grade A -
Chamberlain
Question:
First-generation antipsychotics, also known as typical antipsychotics,
Answer:
-effective for positive symptoms but have a higher incidence of unwanted side
effects, such as dystonia, parkinsonism, akathisia, and tardive dyskinesia,
which increase with long-term use.
-may be selected for a hospitalized client with psychosis when medication is
required to quickly target presenting positive symptoms.
,Question:
Erica is a 24-year-old with a newly diagnosed schizophreniform disorder. She
is a current smoker. She does not use alcohol or other drugs. She has no
medical history. Which of the following would be the least appropriate initial
medication for Erica?
a) Aripiprazole
b) Lurasidone
c) olanzapine
d) quetiapine
Answer:
Olanzapine requires up to 30% increased dosage for clients who smoke
concurrently. Initiating a medication that does not interact with smoking is
preferable.
Question:
Tony is a 56-year-old who has recently been diagnosed with schizophrenia. He
takes amiodarone for a history of cardiac dysrhythmias. He does not use
alcohol or other drugs. He is a nonsmoker. Which of the following is the most
appropriate medication for Tony?
a) Aripiprazole
b) Lurasidone
c) Quetiapine
d) risperidone
Answer:
Amiodarone is a moderate CYP3A4 inhibitor. Risperidone does not interact
with CYP3A4 inhibitors or inducers.
,Question:
Jenny is a 22-year-old who has been prescribed aripiprazole 15 mg/day for the
past 8 months. She has gained approximately 30 lbs. during treatment.
Jenny's psychiatric symptoms have been managed well on aripiprazole and
she has no other adverse effects. What is the most appropriate initial
intervention for Jenny?
a) switch to a different antipsychotic medication
b) prescribe metformin
c) refer to a bariatric specialist
Answer:
Prescribing metformin as an adjunct treatment to assist with weight loss
associated with antipsychotics is appropriate. Jenny is well-managed on the
current dose of aripiprazole; switching to a different medication is not
indicated at this time. Referral to a bariatric specialist may be indicated if the
client continues to gain weight but is not indicated as the most appropriate
initial intervention.
Question:
A client has been on clozapine for 9 months. Absolute neutrophil counts
(ANC) have consistently been less than 1500/microliter? At what frequency
should a CBC be drawn?
Answer:
With a normal baseline ANC, the CBC should be monitored weekly for 6
months; every 2 weeks for months 6-12; and monthly thereafter
, Question:
Scott is a 33-year-old who is currently without housing. He has been unable to
adhere to his prescribed oral medication regimen. The PMHNP recommends
a long-acting intramuscular form of medication. Scott is willing to try but
would like to receive the medication at the community clinic near the shelter
where he is staying. Which medication option is the least appropriate for
Scott at this time?
a) aripiprazole monohydrate
b) olanzapine
c) paliperidone palmitate
d) risperidone
Answer:
Olanzapine must be given in a registered health care facility with available
emergency medical services. The client receiving olanzapine must be
monitored for 3 hours post-injection.
Question:
Which of the following laboratory tests are indicated for a client who is taking
olanzapine?
a) BMI
b) CBC
c) HbA1C
d) Lipid panel
e) Kidney function tests
Answer:
Monitoring should include fasting glucose or hemoglobin A1C, lipid profile,
weight, and BMI at regular intervals during the first year of antipsychotic
therapy and then annually.
