NR 668 CEA FINAL EXAM 2025 COMPREHENSIVE REVIEW TEST BANK
WITH 480 REAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS/ NR 668 CEA ALL YOU NEED TO PASS NUR 668//GRADED
A+
Helen is a 59 female who presents with occasional panic attacks and new onset "leg aches". She is on
ASA 81mg/day, Sertraline 150mg/day, Aripiprazole 2mg/day, Atorvastatin 20mg/day and Magnesium
OTC Daily PRN. Laboratory results are as follows: BUN 17, Creatinine 1.0, Sodium 139, CK 244 IU/L
and Hemoglobin of 13.1. Blood pressure of 130/80. Which medication could explain Helen's current
chief complaint and related laboratory abnormality?
a. Anemia secondary to acute blood loss
b. Statin induced myositis
c. Hyponatremia secondary to sertraline
d. Renal disease - answer-b. Statin induced myositis
*helen's laboratory results are relatively normal except for an elevated CK; statins are well known to
cause myalgias. There is no evidence of acute blood loss, hyponatremia or renal disease present here
A drug that binds to the same receptor as an agonist, but induces an opposite biological response, is
a(n):
a. Agonist
b. Inverse agonist
c. Antagonist
d. Partial agonist - answer-b. Inverse agonist
Keenan is an 72-year-old male admitted to the hospital with a diagnosis of delirium. Medications
with anticholinergic side effects are known to cause delirium. Which of the following medications are
most suspect in contributing to delirium?
a. Diphenhydramine
b. Docusate sodium
c. Rivastigmine
d. Donepezil - answer-a. Diphenhydramine
*diphenhydramine and similar medications are contraindicated in persons over 65 given their
elevated anticholinergic activity
,Which of the following is true about a drug with a narrow therapeutic index?
a. The plasma concentration required for a therapeutic effect is near the concentration that results in
toxic effects.
b. The drug with a narrow therapeutic index is associated with a prolonged half-life.
c. The toxic effects of all drugs are related to current renal function
d. The plasma concentration required for a therapeutic effect is below the toxic effect. - answer-
a. The plasma concentration required for a therapeutic effect is near the concentration that results in
toxic effects.
A patient has been taking valproic acid for mood stabilization from a manic episode but is still not
sleeping through the night. His last drug level was 50 mcg/mL. The PMHNP notices the patient seems
disoriented to time and is flapping his wrists. What should the PMHNP do next?
a. Augment with an atypical antipsychotic
b. Draw an ammonia level
c. Give the patient lactulose 20g PO
d. Increase the dose of valproic acid - answer-b. Draw an ammonia level
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. Dopamine
b. GABA
c. Acetylcholine
d. Serotonin - answer-c. Acetylcholine
Sunny is a 50-year -old female who presents to the clinic with a recent ECG tracing. Her QTC is
recorded at 327 ms. Mary is on Citalopram 40 mg daily x 3 years secondary to generalized anxiety
disorder. Given this information, you decide to do what?
a. Do nothing
b. Decrease the citalopram to 20mg daily
c. Switch to the bioequivalent of escitalopram at 40mg daily
,d. Repeat the ECG in 1 month to monitor for prolonged QTC - answer-a. Do nothing
*a QTC of 388 ms is considered normal; persons over 60 are limited to a daily dose of citalopram
20mg given the potential risk of prolonged QTC
Which is the key laboratory parameter for monitoring patients for clozapine-induced neutropenia?
a. RBC
b. WBC
c. PVC
d. ANC - answer-d. ANC
*the ANC count is the key laboratory parameter for monitoring patients for clozapine-induced
neutropenia
A 65 year old male has a history of MDD, CAD, CKD IV, CVA, HTN and arrhythmia. Which of the
following is the safest medication to treat MDD?
a. Fluvoxamine
b. Venlafaxine
c. Sertraline
d. Amitriptyline - answer-c. Sertraline
One of the most common electrolyte abnormalities associated with the use of psychotropic
medication is:
a. Hyponatremia
b. Hypernatremia
c. Hypercalcemia
d. Hyperkalemia - answer-a. Hyponatremia
Codeine is converted to morphine via CYP2D6 in the liver. This is an example of what?
a. Paradoxical reaction
b. Negative allosteric modulator
c. Prodrug
d. Positive allosteric modulator - answer-c. Prodrug
, *a prodrug is a medication that is converted into a pharmacological active drug via metabolism
A patient is started on lamotrigine for bipolar depression. The patient complained of a rash
comprised of blistering skin and mouth sores after a dose increase. The blood work reveals normal
renal and liver function. Which type of drug rash is most likely?
a. Stevens-Johnson syndrome
b. Psoriasis
c. Atopic dermatitis
d. DRESS syndrome - answer-a. Stevens-Johnson syndrome
When providing psychoeducation to the parents of a 20-year-old male with psychosis, which of the
following is considered a good prognostic indicator?
a. Delayed treatment with antipsychotics
b. Early onset
c. Substance induced
d. First degree family member with schizophrenia - answer-c. Substance induced
Pharmacodynamics describe which of the following?
a. How the drug affects the body
b. Drug inhibition
c. Absorption, distribution, metabolism and elimination
d. How the body affects the drug - answer-a. How the drug affects the body
Which of the following antipsychotics pose the least cardiometabolic risk?
a. Clozaril
b. Olanzapine
c. Quetiapine
d. Ziprasidone - answer-d. Ziprasidone
*ziprasidone and aripiprazole are two examples of antipsychotics a/w lower cardiometabolic risk
WITH 480 REAL EXAM QUESTIONS AND CORRECT DETAILED
ANSWERS/ NR 668 CEA ALL YOU NEED TO PASS NUR 668//GRADED
A+
Helen is a 59 female who presents with occasional panic attacks and new onset "leg aches". She is on
ASA 81mg/day, Sertraline 150mg/day, Aripiprazole 2mg/day, Atorvastatin 20mg/day and Magnesium
OTC Daily PRN. Laboratory results are as follows: BUN 17, Creatinine 1.0, Sodium 139, CK 244 IU/L
and Hemoglobin of 13.1. Blood pressure of 130/80. Which medication could explain Helen's current
chief complaint and related laboratory abnormality?
a. Anemia secondary to acute blood loss
b. Statin induced myositis
c. Hyponatremia secondary to sertraline
d. Renal disease - answer-b. Statin induced myositis
*helen's laboratory results are relatively normal except for an elevated CK; statins are well known to
cause myalgias. There is no evidence of acute blood loss, hyponatremia or renal disease present here
A drug that binds to the same receptor as an agonist, but induces an opposite biological response, is
a(n):
a. Agonist
b. Inverse agonist
c. Antagonist
d. Partial agonist - answer-b. Inverse agonist
Keenan is an 72-year-old male admitted to the hospital with a diagnosis of delirium. Medications
with anticholinergic side effects are known to cause delirium. Which of the following medications are
most suspect in contributing to delirium?
a. Diphenhydramine
b. Docusate sodium
c. Rivastigmine
d. Donepezil - answer-a. Diphenhydramine
*diphenhydramine and similar medications are contraindicated in persons over 65 given their
elevated anticholinergic activity
,Which of the following is true about a drug with a narrow therapeutic index?
a. The plasma concentration required for a therapeutic effect is near the concentration that results in
toxic effects.
b. The drug with a narrow therapeutic index is associated with a prolonged half-life.
c. The toxic effects of all drugs are related to current renal function
d. The plasma concentration required for a therapeutic effect is below the toxic effect. - answer-
a. The plasma concentration required for a therapeutic effect is near the concentration that results in
toxic effects.
A patient has been taking valproic acid for mood stabilization from a manic episode but is still not
sleeping through the night. His last drug level was 50 mcg/mL. The PMHNP notices the patient seems
disoriented to time and is flapping his wrists. What should the PMHNP do next?
a. Augment with an atypical antipsychotic
b. Draw an ammonia level
c. Give the patient lactulose 20g PO
d. Increase the dose of valproic acid - answer-b. Draw an ammonia level
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. Dopamine
b. GABA
c. Acetylcholine
d. Serotonin - answer-c. Acetylcholine
Sunny is a 50-year -old female who presents to the clinic with a recent ECG tracing. Her QTC is
recorded at 327 ms. Mary is on Citalopram 40 mg daily x 3 years secondary to generalized anxiety
disorder. Given this information, you decide to do what?
a. Do nothing
b. Decrease the citalopram to 20mg daily
c. Switch to the bioequivalent of escitalopram at 40mg daily
,d. Repeat the ECG in 1 month to monitor for prolonged QTC - answer-a. Do nothing
*a QTC of 388 ms is considered normal; persons over 60 are limited to a daily dose of citalopram
20mg given the potential risk of prolonged QTC
Which is the key laboratory parameter for monitoring patients for clozapine-induced neutropenia?
a. RBC
b. WBC
c. PVC
d. ANC - answer-d. ANC
*the ANC count is the key laboratory parameter for monitoring patients for clozapine-induced
neutropenia
A 65 year old male has a history of MDD, CAD, CKD IV, CVA, HTN and arrhythmia. Which of the
following is the safest medication to treat MDD?
a. Fluvoxamine
b. Venlafaxine
c. Sertraline
d. Amitriptyline - answer-c. Sertraline
One of the most common electrolyte abnormalities associated with the use of psychotropic
medication is:
a. Hyponatremia
b. Hypernatremia
c. Hypercalcemia
d. Hyperkalemia - answer-a. Hyponatremia
Codeine is converted to morphine via CYP2D6 in the liver. This is an example of what?
a. Paradoxical reaction
b. Negative allosteric modulator
c. Prodrug
d. Positive allosteric modulator - answer-c. Prodrug
, *a prodrug is a medication that is converted into a pharmacological active drug via metabolism
A patient is started on lamotrigine for bipolar depression. The patient complained of a rash
comprised of blistering skin and mouth sores after a dose increase. The blood work reveals normal
renal and liver function. Which type of drug rash is most likely?
a. Stevens-Johnson syndrome
b. Psoriasis
c. Atopic dermatitis
d. DRESS syndrome - answer-a. Stevens-Johnson syndrome
When providing psychoeducation to the parents of a 20-year-old male with psychosis, which of the
following is considered a good prognostic indicator?
a. Delayed treatment with antipsychotics
b. Early onset
c. Substance induced
d. First degree family member with schizophrenia - answer-c. Substance induced
Pharmacodynamics describe which of the following?
a. How the drug affects the body
b. Drug inhibition
c. Absorption, distribution, metabolism and elimination
d. How the body affects the drug - answer-a. How the drug affects the body
Which of the following antipsychotics pose the least cardiometabolic risk?
a. Clozaril
b. Olanzapine
c. Quetiapine
d. Ziprasidone - answer-d. Ziprasidone
*ziprasidone and aripiprazole are two examples of antipsychotics a/w lower cardiometabolic risk
