NR 546 Final Practice Exam Psychopharmacology | Questions and Answers (Complete Solutions)

NR 546 Final Practice Exam Psychopharmacology | Questions and Answers (Complete Solutions) MAOIs (monoamine oxidase inhibitors) affect which neurotransmitters? A. Serotonin, Dopamine, Norepinephrine B. Serotonin, GABA, Glutamate C. Acetylcholine, Dopamine, Norepinephrine D. Dopamine, GABA, Acetylcholine Which of the following is considered first line treatment for depression? A. SSRI B. FGA C. SNRI D. MAOI When treating a patient for major depression disorder which medication would the PMHNP consider first? A. Depakote B. Selegiline C. Escitalopram D. Isocarboxazid Which of the following medication should be considered for a patient diagnosed with major depressive disorder who reports "always forgetting to take my pills"? A. Mirtazapine B. Fluvoxamine C. Fluoxetine D. Carbemazepine Which of the following medication has a black box warning of a life-threatening skin rash? A. Lithium B. Lamotrigine C. Lurasidone D. Lorazepam Which medication is considered the best tolerated SSRI? A. Venlafaxine B. Bupropion C. Setraline D. Escitalopram During a 4 week follow up appointment, Rashida, who is prescribed Sertraline 25mg qAM reports slight improvement in depression symptoms and tolerating medication well. Which of the following should the PMHNP do? A. Increase Setraline dose B. Switch to an SNRI C. Switch to a different SSRI D. Add Trazodone qHS for sleep. Which medication should be avoided for the 66 year patient diagnosed with major depressive disorder and anxiety with a reported fall 3 months ago? A. Citalopram B. Setraline C. Paroxetine D. Aripiprazole A patient reports upset stomach and diarrhea 3 days after taking new prescription of sertraline. Which of the following is the most appropriate response from the PMHNP? A. "Start doubling the dose of sertraline and your symptoms will begin to ease up". B. "Most side effects subside after 4-5 days. Your body is getting adjusted to the increased serotonin levels". C. "Stop taking it immediately and go to the local emergency department". D. "You must take Sertraline with food, otherwise you will continue to experience GI symptoms". During a 2 week follow up appointment, the patient reports no improvement in depressive symptoms with escitalopram. Which of the following statement made by the PMHNP is correct? A. "Let's discontinue escitalopram and start you on something stronger". B. "It can take up to 6 weeks before you notice improvements of depressive symptoms". C. "I am going to prescribe Trazodone. Take it at night to help you sleep". D. "Start taking two pills at a time". Duloxetine effects which two neurotransmitters? A. serotonin and norepinephrine B. serotonin and dopamine C. norepinephrine and GABA D. glutamate and acetylcholine Awura, a 70 year old patient diagnosed with major depressive disorder reports a recent 40 pound weight loss within the last 3 months. Which medication should the PMHNP consider adding to her medication regimen? A. quetiapine B. mirtazpine C. valproic acid D. paroxetine Which of the following symptoms is NOT an adverse effect associated with the acute use of opioids? A. Sedation B. Respiratory depression C. Immunosuppression D. Itching When dosing citalopram for Lynee, a 72 year old patient, the PMHNP understands to dose at 1/2 dose due to the increased risk of A. delirium B. polypharmacy C. falls D. QTc prolongation Which of the following medication class is approved for first line treatment for OCD? A. Atypical antipsychotics B. Benzodiazepines C. MAOI D. SSRI Which SSRI has a mild antihistamine effect? A. Paroxetine B. Fluoxetine C. Citalopram D. Sertraline Which medication should the PMHNP prescribe for a patient diagnosed with major depressive disorder but takes multiple medications for other chronic conditions? A. Sertraline B. Escitalopram C. Buspirone D. Clonazepam The patient reports suffering from insomnia and anxiety. Which SSRI should be prescribed? A. Paroxetine B. Duloxetine C. Fluoxetine D. Venlafaxine Tricyclic antidepressants (TCA) act as antagonists on which of the following neurotransmitters? A. Acetylcholine and Dopamine B. Histamine and Acetylcholine C. Dopamine and Histamine D. Serotonin and Norepinephrine Which foods should the PMHNP educate their patient to avoid while they are taking Selegiline? A. Nuts, milk and wheat B. Aged wine, cheeses, and meats C. Green leafy vegetables and tomatoes D. Grapefruit and grapefruit juice Which neurotransmitter is associated with reward and addiction? A. Norepinephrine B. GABA C. Dopamine D. Histamine Emily, a 22 year old female, reports she is 4 weeks pregnant and wants to get clean from heroin. Which medication is most appropriate for Emily? A. Buprenorphine/ Naloxone B. Naltrexone C. Buprenorphine D. Methadone Which of the following is the most appropriate response made by the PMHNP to a breastfeeding patient inquiring about a prescription for buprenorphine? A. "You can breastfeed 6 hours after you take the buprenorphine". B. "You can only breastfeed before you take buprenorphine" C. "2 hours after taking buprenorphine, pump your breastmilk and discard it. You can resume breastfeeding afterwards". D. "You will need to transition to bottle feeding while taking buprenorphine". Keaton presents to the ED and reports daily drinking of 18 beers for nearly 20 years. Keaton reports a history of withdrawal seizures when he stops drinking. Which medication should the PMHNP order? A. disulfiram B. topiramate C. lorazepam D. naltrexone A patient reports wanting to abstain from alcohol use. They report a history of abusing opioids in the past, but they have not used any in the last several months. They are concerned that they are at risk of abusing opioids again. Which of the following is the best pharmaceutical option for this patient? A. diazepam B. naltrexone C. chlordiazepoxide D. acamprosate A Ellie-Ann, 31 year-old patient with a history of abusing opioids and binge drinking, reports they are not committed to abstain from using at this time. Which medication is appropriate for Ellie-Ann? A. disulfiram B. naloxone C. naltrexone d. lorazepam The PMHNP is treating a 27 year old patient diagnosed with ADHD who is actively trying to get pregnant. Which medication is most appropriate? A. Methylphenidate B. Lisdexamfetamine C. Atomoxetine D. Selegiline Which of the following statements best explains the monoamine hypothesis of depression? A. Depression is caused by a deficiency of monoamine neurotransmission. B. Depression is a result of chemical a chemical imbalance of monoamine neurotransmission. C. Depression is caused by an excess of monoamine neurotransmission. D. Depression is a result from maladaptive or irrational cognitions taking the form of distorted thoughts core beliefs and judgments Which combination therapy is considered first line for bipolar I, current manic episode, with depressive features? A. Bupropion + Aripiprazole . B. Lithium + Lamotrigine C. Valproic Acid + Duloxetine D. Atomoxetine + Risperidal Why should antidepressants be used in combination therapy with mood stabilizers when treating bipolar disorder? A. To target depression symptoms quickly and reduce rapid cycling of bipolar depression B. To reduce the gastrointestinal side effects caused by antidepressants. C. To decrease incidence of death by suicide in children and young adults. D. To increase patient medication adherence. Which of the following medication should be avoided when the patient has anxiety because it can exacerbate anxiety? A. Escitalopram B. Sertraline C. Fluvoxamine D. Duloxetine Which SSRI is most likely to cause discontinuation syndrome if abruptly stopped? A. Fluoxetine B. Selegiline C. Mirtazapine D. Paroxetine Which medication should not be prescribed to the patient with a seizure history? A. Venlafaxine B. Trazodone C. Bupropion D. Amitriptyline "Serotonin antagonist and reuptake inhibitor" describes the neurotransmitter actions for which medication? A. Citalopram B. Desvenlafaxine C. Trazodone D. Mirtazapine Which medication inhibits the reuptake of both norepinephrine and dopamine? A. Methylphenidate B. Bupropion C. Lithium D. Venlafaxine Which of the following statements made by the PMHMP is correct for patient medication education related to Trazodone? A. "If you had a seizure before, we should try a different medication". B. "If you experience a prolonged painful erection, get emergency help as soon as possible." C. "This medication can cause breast tissue enlargement in men". D. "The best time to take this medication is first thing in the morning to avoid insomnia at night". A patient has been admitted to the emergency department with a suspected overdose. Their EKG is noted to have a widened QRS complex. Which antidepressant does the PMHNP suspect the patient has overdosed on? A. Paroxetine B. Amitriptyline C. Phenelzine D. Isocarboxazid Tricyclic antidepressants (TCA) act as reuptake inhibitors on which of the following neurotransmitters? A. Norepinephrine and Serotonin B. GABA and Acetylcholine C. Dopamine and Histamine D. Histamine and Acetylcholine Which medication is safest for 28 year old patient, diagnosed with major depressive disorder, who is actively trying to conceive? A. Sertraline B. Topiramate C. Lithium D. Paroxetine Which best describes serotonin syndrome? A. Occurs when serotonergic medications deplete levels of norepinephrine in the body. B. Occurs when serotonergic medications build an abnormally high levels of serotonin in the body. C. Occurs when serotonergic medications are abruptly discontinued. D. Occurs when serotonergic medications interact with foods containing high levels of tyramine. Which of the following medications is a serotonin norepinephrine receptor agonist? A. Bupropion B. Mirtazapine C. Trazodone D. Nortripyline Which medication should the PMHNP consider prescribing for the patient diagnosed with bipolar disorder reporting suicidal ideations? A. Valproic acid B. Lithium C. Escitalopram D. Ziprazadone For the past week, Amiee who is prescribed lithium reports using NSAIDs to treat tension headache. Which of the following should the PMHNP anticipate? A. decreased levels of lithium B. QTC prolongation C. elevated levels of lithium D. mild diffuse rash throughout body The PMHNP increased their patient's lithium dose from 300mg daily to 600mg daily. When should the patient's lithium level be monitored next? A. 3 months for 1 year after dosage change B. Next follow up appointment in 6 months C. Within the next 14 days D. 5 days after dosage change Rebecca presents for treatment of moderate depression. Her medical history includes the use of four medications for comorbid physical diagnoses. Which medication is least likely to interact with other prescriptions? A.Fluoxetine B. Duloxetine C. Paroxetine D. Escitalopram Lithium levels can be decreased by which of the following? A. Aripiprazole B. Grapefruit C. ACE inhibitors D. Coffee Patient presents to the ED with the following symptoms: tachycardia, hypertension, and mydriasis. Floor staff reports the patient is constantly making sexual advances towards them. Which substance is this patient most likely intoxicated from? A. Marijuana B. Benzodiazepines C. Methamphetamine D. Cocaine PMHNP was called to assess a patient in the emergency room who reports bruxism. Which recreational stimulant is this patient most likely withdrawing from? A. Marijuana B. MDMA C. Methamphetamines D. Methylphenidate Which antidepressant is paired most appropriately with its mechanism of action? A. Mirtazapine - serotonin norepinephrine receptor agonist B. Topiramate- serotonin norepinephrine reuptake inhibitor C. Bupropion- serotonin antagonist and reuptake inhibitor D. Trazodone- serotonin reuptake inhibitor Which of the following best describes the signs and symptoms of intoxication from opiates? A. Sedation, amnesia, and ataxia B. Euphoria, miosis, and decreased gag reflex C. Delirium, hallucinations, and tremor D. Agitation, mydriasis, and tachycardia PMHNP was called to assess a patient in the emergency room who required 5 nurses to restraint them due to increased agitation. Upon assessment the PMHNP noted the patient had nystagmus. Which substance is this patient most likely intoxicated from? A. LSD B. Herion C. PCP D. Cocaine Which antidepressant is pharmacologically similar to a combination of an SSRI and buspirone? A. Vilazodone B. Trazodone C. Venlafaxine D. Valproic Acid Which of the following statements best defines impulsivity? A. Repetitive behavior that has no adaptive functioning. B. The inability to terminate ongoing actions. C. Behavior that is performed as a means of avoiding perceived negative consequences. D. The inability to stop initiating actions with disregard for the negative consequences of these actions Which neural circuit is associated with reward and addiction? A. Mesolimbic pathway B. Tuberoinfundibular pathway C. Nigrosstriatal pathway D. Mesocortical pathway A client walked into the emergency department and tells the PMHNP that she has run out of money for herion and feels like they are about to start detoxing. Which symptoms are most associated with herion withdrawal? A. Miosis, depression, and increased appetite. B. Mydrasis, euphoria, and agitation C. Mydrasis, piloerection, and diarrhea D. Miosis, CNS depression, and decreased gag reflex Which neurotransmitter is associated with reward and addiction? A. Norepinephrine B. Serotonin