NR-546 Midterm Exam (Latest Update )
Advanced Pharmacology Psychopharmacology for
the PMHNP Questions with 100% Correct Verified
Answers [Grade A] – Chamberlain
What should the PMHNP consider when prescribing chemical restraints? - correct
answer -allergy status
-prior med hx for adverse drug reactions r/t the meds ordered in the chemical
restraint
-state regulations regarding chemical restrains must be reviewed
How does reviewing the genetic makeup of a client help guide the PMHNP in selecting
medication for clients? - correct answer -Genetic testing can assist by providing more
information on how clients may respond to certain psychotropic medications
-provides information on how a client may break down and metabolize medications
based on the cytochrome P450 system.
Which of the following is the best medication class for the PMHNP to prescribe for
Ernesto to address his elevated norepinephrine levels? - correct answer selective
serotonin reuptake inhibitor would block the reuptake of serotonin, leaving a larger
amount of serotonin available. Increasing the amount of serotonin would help regulate
the feelings of fear and anxiety. Reducing the occurrence of fear would help reduce the
release of norepinephrine.
A serotonin and norepinephrine reuptake inhibitor would prevent the reuptake of
norepinephrine, which would not reduce the level of norepinephrine as needed.
Benzodiazepines increase the levels of GABA and do not impact norepinephrine. A
monoamine oxidase inhibitor would increase levels of norepinephrine.
During a follow up appointment after 4 weeks, the PMHNP should assess for the need
to add which medication to Ernesto's treatment plan? - correct answer The nurse
should assess for sexual dysfunction and anticipate the potential need for a
phosphodiesterase inhibitor such as sildenafil (Viagra).
-After 4 to 6 weeks, the client should be experiencing full effects of the SSRI, so the
need for a short-term medication like a benzodiazepine or a beta blocker are not
anticipated. St. John's Wort is contraindicated with an SSRI and can cause serotonin
syndrome.
Glu - correct answer Glutamate
-amino acid
-excitatory neurotransmitter
-"workhorse" of the brain-can affect almost every neuron in the brain
-affects: energy, memory, learning, neural plasticity
, NR-546 Midterm Exam (Latest Update )
Advanced Pharmacology Psychopharmacology for
the PMHNP Questions with 100% Correct Verified
Answers [Grade A] – Chamberlain
-relay sensory info. and regulate spinal and motor reflexes
-too much: schizophrenia, epilepsy, mania
-receptors: NMDA, AMPA
Are the PMHNP and other staff liable if the client has an allergic reaction or adverse
side effects to the drugs used for chemical restraint? - correct answer No.
The client has been court-ordered to take the prescribed medications and the standing
order for chemical restraints is approved. The PMHNP and other staff are not liable if
the patient has an allergic reaction or adverse side effects.
GABA - correct answer inhibitory neurotransmitter
-decrease neuroexcitability across the brain
-"chill", take the edge off stress, help people calm down, relax, destress, sleep
-to little: may experience anxiety or schizophrenia
-slows down everything, even breathing
-affect executive function and motor coordination, increase risk for accidents
-Increased levels of gamma-aminobutyric acid have a calming effect.
5HT - correct answer Serotonin
-help regulate mood
-makes relaxed, comfortable, decreases stress, regulate sleep, arousal, libido,
aggression, pain perception
NE - correct answer norepinephrine
-monoamine neurotransmitter
-focus and productivity
-too much due to stress, meds, caffein, stimulants can cause: nervous, antsy, affect
focus
DA - correct answer dopamine
-monoamine neurotransmitter
-regulate mood
-associated with executive function, ability to perform well, be organized, emotional
intelligence
-movement and coordination
-to little: lose pleasure, interest, alertness, self-confidence, parkinson's disease
-to much: schizophrenia and psychosis
-reward center: can lead to addiction
, NR-546 Midterm Exam (Latest Update )
Advanced Pharmacology Psychopharmacology for
the PMHNP Questions with 100% Correct Verified
Answers [Grade A] – Chamberlain
-has own pathways
Ach - correct answer acetylcholine
-in CNS: affects arousal, motivation, attention, learning, REM sleep, impacts sleep, pain
perception, memory
-in PNS: makes you sweat and salivate
-link between brain and muscles
-not enough: Alzheimer's, Parkinson's, Schizophrenia
-too much: Depression
-Role in addiction
-Receptors: nicotinic & muscarinic
Histamine (Neurotransmitter) - correct answer Histamine impacts alertness, pain
sensation, and inflammatory responses; increased levels result in depression.
Melatonin (neurotransmitter) - correct answer Act at MT1-3 G-protein coupled
receptors
Sleep/wake cycle
insomnia: melatonin agonists
Psychotropic drug metabolism may be impacted by factors such as: - correct answer -
age
-smoking
-caffeine intake
-other medications
-Some drugs or foods may inhibit or induce the rate of drug metabolism.
One-third of psychotropic drugs bind to a ______________, and one-third bind to
___________________. - correct answer neurotransmitter, G-protein-linked receptors.
The six main neurotransmitters are: - correct answer serotonin (5HT)
norepinephrine (NE)
dopamine (DA)
acetylcholine (Ach)
glutamate (Glu)
gamma-aminobutyric acid (GABA)
, NR-546 Midterm Exam (Latest Update )
Advanced Pharmacology Psychopharmacology for
the PMHNP Questions with 100% Correct Verified
Answers [Grade A] – Chamberlain
Signal transduction cascades can produce: - correct answer downstream (delayed)
and/or long-lasting effects
-explains why some psychopharmacological drugs do not provide an immediate
response but require time to see the drug effects
Signal transduction cascades - correct answer communication from the genome of the
presynaptic neuron to the genome of the postsynaptic neuron, and then back from the
genome of the postsynaptic neuron to the genome of the presynaptic neuron via
retrograde neurotransmission
-process involves long strings of chemical messages within both presynaptic and
postsynaptic neurons
-initial events occur in less than a second, but the long-term consequences are
mediated by downstream messengers that take hours to days to activate, yet can last
for many days or even for the lifetime of a synapse or neuron
-somewhat akin to a molecular "pony express"
Signal transduction cascades: Each molecular site within the cascade of transduction
of chemical and electrical messages is a potential location for: - correct answer a
malfunction associated with a mental illness
-also a potential target for a psychotropic drug
Retrograde
transcription factor - correct answer A regulatory protein that binds to DNA and
affects transcription of specific genes.
antipsychotic meds - correct answer primarily used for schizophrenia & psychotic
disorders
-also used as adjunctive meds for management of tx-resistant depression & other
conditions
-not curative
-decrease/control symptoms/improve quality of life
Schizophrenia - correct answer a disturbance that must last for 6 months or longer,
including at least one month of positive symptoms or negative symptoms
-neurodevelopmental, brain disorder
-psychological condition involving chronic or repeated episodes of psychosis
cause: combination of genetics and environmental factors
Advanced Pharmacology Psychopharmacology for
the PMHNP Questions with 100% Correct Verified
Answers [Grade A] – Chamberlain
What should the PMHNP consider when prescribing chemical restraints? - correct
answer -allergy status
-prior med hx for adverse drug reactions r/t the meds ordered in the chemical
restraint
-state regulations regarding chemical restrains must be reviewed
How does reviewing the genetic makeup of a client help guide the PMHNP in selecting
medication for clients? - correct answer -Genetic testing can assist by providing more
information on how clients may respond to certain psychotropic medications
-provides information on how a client may break down and metabolize medications
based on the cytochrome P450 system.
Which of the following is the best medication class for the PMHNP to prescribe for
Ernesto to address his elevated norepinephrine levels? - correct answer selective
serotonin reuptake inhibitor would block the reuptake of serotonin, leaving a larger
amount of serotonin available. Increasing the amount of serotonin would help regulate
the feelings of fear and anxiety. Reducing the occurrence of fear would help reduce the
release of norepinephrine.
A serotonin and norepinephrine reuptake inhibitor would prevent the reuptake of
norepinephrine, which would not reduce the level of norepinephrine as needed.
Benzodiazepines increase the levels of GABA and do not impact norepinephrine. A
monoamine oxidase inhibitor would increase levels of norepinephrine.
During a follow up appointment after 4 weeks, the PMHNP should assess for the need
to add which medication to Ernesto's treatment plan? - correct answer The nurse
should assess for sexual dysfunction and anticipate the potential need for a
phosphodiesterase inhibitor such as sildenafil (Viagra).
-After 4 to 6 weeks, the client should be experiencing full effects of the SSRI, so the
need for a short-term medication like a benzodiazepine or a beta blocker are not
anticipated. St. John's Wort is contraindicated with an SSRI and can cause serotonin
syndrome.
Glu - correct answer Glutamate
-amino acid
-excitatory neurotransmitter
-"workhorse" of the brain-can affect almost every neuron in the brain
-affects: energy, memory, learning, neural plasticity
, NR-546 Midterm Exam (Latest Update )
Advanced Pharmacology Psychopharmacology for
the PMHNP Questions with 100% Correct Verified
Answers [Grade A] – Chamberlain
-relay sensory info. and regulate spinal and motor reflexes
-too much: schizophrenia, epilepsy, mania
-receptors: NMDA, AMPA
Are the PMHNP and other staff liable if the client has an allergic reaction or adverse
side effects to the drugs used for chemical restraint? - correct answer No.
The client has been court-ordered to take the prescribed medications and the standing
order for chemical restraints is approved. The PMHNP and other staff are not liable if
the patient has an allergic reaction or adverse side effects.
GABA - correct answer inhibitory neurotransmitter
-decrease neuroexcitability across the brain
-"chill", take the edge off stress, help people calm down, relax, destress, sleep
-to little: may experience anxiety or schizophrenia
-slows down everything, even breathing
-affect executive function and motor coordination, increase risk for accidents
-Increased levels of gamma-aminobutyric acid have a calming effect.
5HT - correct answer Serotonin
-help regulate mood
-makes relaxed, comfortable, decreases stress, regulate sleep, arousal, libido,
aggression, pain perception
NE - correct answer norepinephrine
-monoamine neurotransmitter
-focus and productivity
-too much due to stress, meds, caffein, stimulants can cause: nervous, antsy, affect
focus
DA - correct answer dopamine
-monoamine neurotransmitter
-regulate mood
-associated with executive function, ability to perform well, be organized, emotional
intelligence
-movement and coordination
-to little: lose pleasure, interest, alertness, self-confidence, parkinson's disease
-to much: schizophrenia and psychosis
-reward center: can lead to addiction
, NR-546 Midterm Exam (Latest Update )
Advanced Pharmacology Psychopharmacology for
the PMHNP Questions with 100% Correct Verified
Answers [Grade A] – Chamberlain
-has own pathways
Ach - correct answer acetylcholine
-in CNS: affects arousal, motivation, attention, learning, REM sleep, impacts sleep, pain
perception, memory
-in PNS: makes you sweat and salivate
-link between brain and muscles
-not enough: Alzheimer's, Parkinson's, Schizophrenia
-too much: Depression
-Role in addiction
-Receptors: nicotinic & muscarinic
Histamine (Neurotransmitter) - correct answer Histamine impacts alertness, pain
sensation, and inflammatory responses; increased levels result in depression.
Melatonin (neurotransmitter) - correct answer Act at MT1-3 G-protein coupled
receptors
Sleep/wake cycle
insomnia: melatonin agonists
Psychotropic drug metabolism may be impacted by factors such as: - correct answer -
age
-smoking
-caffeine intake
-other medications
-Some drugs or foods may inhibit or induce the rate of drug metabolism.
One-third of psychotropic drugs bind to a ______________, and one-third bind to
___________________. - correct answer neurotransmitter, G-protein-linked receptors.
The six main neurotransmitters are: - correct answer serotonin (5HT)
norepinephrine (NE)
dopamine (DA)
acetylcholine (Ach)
glutamate (Glu)
gamma-aminobutyric acid (GABA)
, NR-546 Midterm Exam (Latest Update )
Advanced Pharmacology Psychopharmacology for
the PMHNP Questions with 100% Correct Verified
Answers [Grade A] – Chamberlain
Signal transduction cascades can produce: - correct answer downstream (delayed)
and/or long-lasting effects
-explains why some psychopharmacological drugs do not provide an immediate
response but require time to see the drug effects
Signal transduction cascades - correct answer communication from the genome of the
presynaptic neuron to the genome of the postsynaptic neuron, and then back from the
genome of the postsynaptic neuron to the genome of the presynaptic neuron via
retrograde neurotransmission
-process involves long strings of chemical messages within both presynaptic and
postsynaptic neurons
-initial events occur in less than a second, but the long-term consequences are
mediated by downstream messengers that take hours to days to activate, yet can last
for many days or even for the lifetime of a synapse or neuron
-somewhat akin to a molecular "pony express"
Signal transduction cascades: Each molecular site within the cascade of transduction
of chemical and electrical messages is a potential location for: - correct answer a
malfunction associated with a mental illness
-also a potential target for a psychotropic drug
Retrograde
transcription factor - correct answer A regulatory protein that binds to DNA and
affects transcription of specific genes.
antipsychotic meds - correct answer primarily used for schizophrenia & psychotic
disorders
-also used as adjunctive meds for management of tx-resistant depression & other
conditions
-not curative
-decrease/control symptoms/improve quality of life
Schizophrenia - correct answer a disturbance that must last for 6 months or longer,
including at least one month of positive symptoms or negative symptoms
-neurodevelopmental, brain disorder
-psychological condition involving chronic or repeated episodes of psychosis
cause: combination of genetics and environmental factors
