Complete Solutions
A 16-year-old boy with a history of substance use disorder
reports fatigue, apathy, and anhedonia almost every day and his
mother reports increasing irritability and raging behavior. The
boy says he smokes marijuana daily just to feel good and is
unwilling to give it up. The mother wants some sort of
medication to help him feel better so that he stops smoking
marijuana. The PMHNP agrees to prescribe fluoxetine 20 mg
daily. What is the most common side effect associated with this
medication? Correct Answers Nausea
A 45-year-old man who takes olanzapine 5 mg twice daily for
psychosis reports a perpetual sense of restlessness and an
inability to sit still. He says, "sometimes it gets so bad I want to
jump out of my own skin." Which of the following is the most
likely explanation? Correct Answers Akathisia
A 60-year-old male recently underwent repair of a right
fractured hip. He developed a post-operative delirium. He has
been awake for 52 hours and ripped off his surgical dressing.
Treatment for delirium in this scenario may include what?
Correct Answers Hanging a clock and calendar in view of the
patient
One would want to avoid benzodiazepines in the elderly and
especially benzodiazepines with long half lives when treating
delirium. Tramadol use has been associated with delirium. H1
Antagonisets contribute to anticholinergice burden, which is
considered a risk factor for delirium.
, 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? Correct
Answers Olanzapine 2.5 mg PO
A drug that binds to the same receptor as an agonist, but induces
an opposite biological response, is a(n) Correct Answers
Inverse agonist
A patient has had a pharmacogenomic test, which reveals he is
an extensive metabolizer on CYP450, 1A2, 2D6, and 3A4. The
PMHNP should prescribe: Correct Answers The usual dose
A patient who had previously reported feeling much better on
her antidepressant suddenly says the "drug seems to have
stopped working. This is known as: Correct Answers
Tachyphylaxis
A patient who has been taking paroxetine for 3 years wants to
come off due to sexual side effects. He had gradually tried to
wean the dose on his own but noticed a feelings of dizziness,
fatigue, headaches, anxiety, and electric-like shocks in his head.
These findings are most consistent with SSRI discontinuation.
What would be a reasonable action for the PMHNP to take?
Correct Answers Prescribe the patient fluoxetine for 1 week