NURS 6630 PSYCHOPHARMACOLOGY ACTUAL
MIDTERM EXAM SUMMER QRT 2025-
WALDEN UNIVERSITY
What is the strongest established risk factor for bipolar disorder? - Family history
Which disease state o a non-adherent patient is at greater risk for substance use violence, and
victimization as well as worse overall quality of life? - Schizophrenia
Patient is a 72 year old male with a past medical history significant for the atrial fibrillation and COPD
with a new diagnosis of major depression disorder. Based on his comorbid conditions, what
antidepressant would you recommend as first-line? - not TCA due to fib and age, not ADHD med
which of the following is an appropriate strategy for managing treatment resistant depression - SSRI
and SNRI
which of the following medications is best to AVOID in maintenance treatment of bipolar disorder
and why - antidepressants might contribute to an increase in mood episode freq1uency
An 8-year-old patient presents with severe hyperactivity, described as "ants in his pants." Based on
self-report from the patient, his parents, and his teacher; attention deficit hyperactivity disorder
(ADHD) is suspected. What medication is the PMNHP most likely to prescribe? - ANS: b.
Methylphenidate (Ritalin, Concerta)
Kevin is an adolescent who has been diagnosed with kleptomania. His parents are interested in
seeking pharmacological treatment. What does the PMHNP tell the parents regarding his treatment
options? - ANS: d.
"Naltrexone may be an appropriate option to discuss."
Which of the following substances has the highest probability of becoming dependent after a single
use? - ANS: c.
Nicotine
The nursing staff asks the PMHNP for additional education regarding the treatment of agitation in
dementia patients. Which of the following is correct? - ANS: c.
,The nurse should attempt to determine how the patient's environment may be impacting the
patient's mood.
A patient on chronic opioids is currently on oxycodone ER (OxyContin). The PMHNP is consulted to
treat underlying depression. Under which circumstance should the PMHNP order naloxone
(NARCAN)? - ANS: c.
The patient is somnolent and has 7 respirations per minute.
A patient with chronic insomnia asks the PMHNP if they can first try an over the-counter (OTC)
medication before one that needs to be prescribed to help the patient sleep. Which is the best
response by the PMHNP? - ANS: a.
"You can get melatonin over the counter, which will help with sleep onset."
The PMHNP is caring for a patient who experiences too much overstimulation and anxiety during
daytime hours. The patient agrees to a pharmacological treatment but states, "I don't want to feel
sedated or drowsy from the medicine." Which decision made by the PMHNP demonstrates proper
knowledge of this patient's symptoms and appropriate treatment options? - ANS: b.
Avoiding prescribing the patient a drug that blocks H1 receptors
Which of these statements is correct? - ANS: d.
Sedation is unusual with aripiprazole (ABILIFY)
The PMHNP is caring for a patient who openly admitted to drinking a quart of vodka daily. Prior to
prescribing this patient disulfiram (Antabuse), it is important for the PMHNP to: - ANS: d.
Evaluate the patient's willingness to abstain from alcohol
Mr. Peterson is meeting with the PMHNP to discuss healthier dietary habits. With a BMI of 33, Mr.
Peterson is obese and needs to modify his food intake. "Sometimes I think I'm addicted to food the
way some people are addicted to drugs," he says. Which statement best describes the
neurobiological parallels between food and drug addiction? - ANS: d.
There is decreased activation of the prefrontal cortex.
An 18-year-old female with a history of frequent headaches and a mood disorder is prescribed
topiramate (Topamax), 25 mg by mouth daily. The PMHNP understands that this medication is
effective in treating which condition(s) in this patient?` - ANS: c.
Migraines
,A patient you have been evaluating was admitted to the hospital with some abnormal lab work.
Hematology/oncology was consulted and diagnoses the patient with aplastic anemia and
agranulocytosis. Which medication was likely the culprit? - ANS: d.
Carbamazepine
Antipsychotics are doses at a level that blocks % of D2 receptors. - ANS: a.
50-70
The PMHNP is teaching a patient with a sleep disorder about taking diphenhydramine (Benadryl).
The patient is concerned about the side effects of the drug. What can the PMHNP teach the patient
about this treatment approach? - ANS: b
"It can cause blurred vision
A 9-year-old female patient presents with symptoms of both attention deficit hyperactivity disorder
(ADHD) and oppositional defiant disorder. In evaluating her symptoms, the PMHNP determines that
which of the following medications may be beneficial in augmenting stimulant medication? - ANS: b.
Guanfacine ER (Intuniv)
The PMHNP is assessing a patient who will be receiving phentermine (Adipex P)/topiramate
(Topamax) (Qsymia). Which of the following conditions/diseases will require further evaluation
before this medication can be prescribed? - ANS: b.
Cardiovascular disease
The PMHNP wishes to prescribe a medication that reduces glutamate transmission in an Alzheimer's
patient. Which medication should the PMHNP prescribe? - ANS: b.
Memantine (NAMENDA)
A patient with fibromyalgia and major depression needs to be treated for symptoms of pain. Which
is the PMHNP most likely to prescribe for this patient? - ANS: d.
Duloxetine (Cymbalta)
A patient is prescribed D-methylphenidate, 10-mg extended-release capsules. What should the
PMHNP include when discussing the side effects with the patient? - ANS: c.
The medication can affect your blood pressure.
, Which medication is an irreversible inhibitor of aldehyde dehydrogenase that creates a negative and
aversive response following ingestion of alcohol? - ANS: c.
Disulfiram (ANTABUSE)
An 80-year-old female patient diagnosed with Stage II Alzheimer's has a history of irritable bowel
syndrome. Which cholinergic drug may be the best choice for treatment given the patient's
gastrointestinal problems? - ANS: a.
Donepezil (Aricept)
Mrs. Rosen is a 49-year-old patient who is experiencing fibro-fog. What does the PMHNP prescribe
for Mrs. Rosen to improve this condition? - ANS: b.
All of these are correct
A 26-year-old female patient with nicotine dependence and a history of anxiety presents with
symptoms of attention deficit hyperactivity disorder (ADHD). Based on the assessment, what does
the PMHNP consider? - ANS: a. ADHD is often not the focus of treatment in adults with comorbid
conditions.
Parents of a 12-year-old boy want to consider attention deficit hyperactivity disorder (ADHD)
medication for their son. Which medication would the PMHNP start? - ANS: d.
All of these could potentially treat their son's symptoms.
The PMHNP is assessing a patient who presents with elevated levels of brain amyloid as noted by
positron emission tomography (PET). What other factors will the PMHNP consider before prescribing
medication for this patient, and what medication would the PMHNP want to avoid given these other
factors? - ANS: b.
ApoE4 genotype and avoid antihistamines if possible and Type 2 diabetes and avoid olanzapine
Karen completes the Epworth sleepiness scale and scores abnormally high. She is diagnosed with
narcolepsy. The PMHNP prescribes a wake-promoting agent that is a weak dopamine transporter
antagonist. Which medication did the PMHNP prescribe? - ANS: c.
Modafanil (PROVIGIL)
MIDTERM EXAM SUMMER QRT 2025-
WALDEN UNIVERSITY
What is the strongest established risk factor for bipolar disorder? - Family history
Which disease state o a non-adherent patient is at greater risk for substance use violence, and
victimization as well as worse overall quality of life? - Schizophrenia
Patient is a 72 year old male with a past medical history significant for the atrial fibrillation and COPD
with a new diagnosis of major depression disorder. Based on his comorbid conditions, what
antidepressant would you recommend as first-line? - not TCA due to fib and age, not ADHD med
which of the following is an appropriate strategy for managing treatment resistant depression - SSRI
and SNRI
which of the following medications is best to AVOID in maintenance treatment of bipolar disorder
and why - antidepressants might contribute to an increase in mood episode freq1uency
An 8-year-old patient presents with severe hyperactivity, described as "ants in his pants." Based on
self-report from the patient, his parents, and his teacher; attention deficit hyperactivity disorder
(ADHD) is suspected. What medication is the PMNHP most likely to prescribe? - ANS: b.
Methylphenidate (Ritalin, Concerta)
Kevin is an adolescent who has been diagnosed with kleptomania. His parents are interested in
seeking pharmacological treatment. What does the PMHNP tell the parents regarding his treatment
options? - ANS: d.
"Naltrexone may be an appropriate option to discuss."
Which of the following substances has the highest probability of becoming dependent after a single
use? - ANS: c.
Nicotine
The nursing staff asks the PMHNP for additional education regarding the treatment of agitation in
dementia patients. Which of the following is correct? - ANS: c.
,The nurse should attempt to determine how the patient's environment may be impacting the
patient's mood.
A patient on chronic opioids is currently on oxycodone ER (OxyContin). The PMHNP is consulted to
treat underlying depression. Under which circumstance should the PMHNP order naloxone
(NARCAN)? - ANS: c.
The patient is somnolent and has 7 respirations per minute.
A patient with chronic insomnia asks the PMHNP if they can first try an over the-counter (OTC)
medication before one that needs to be prescribed to help the patient sleep. Which is the best
response by the PMHNP? - ANS: a.
"You can get melatonin over the counter, which will help with sleep onset."
The PMHNP is caring for a patient who experiences too much overstimulation and anxiety during
daytime hours. The patient agrees to a pharmacological treatment but states, "I don't want to feel
sedated or drowsy from the medicine." Which decision made by the PMHNP demonstrates proper
knowledge of this patient's symptoms and appropriate treatment options? - ANS: b.
Avoiding prescribing the patient a drug that blocks H1 receptors
Which of these statements is correct? - ANS: d.
Sedation is unusual with aripiprazole (ABILIFY)
The PMHNP is caring for a patient who openly admitted to drinking a quart of vodka daily. Prior to
prescribing this patient disulfiram (Antabuse), it is important for the PMHNP to: - ANS: d.
Evaluate the patient's willingness to abstain from alcohol
Mr. Peterson is meeting with the PMHNP to discuss healthier dietary habits. With a BMI of 33, Mr.
Peterson is obese and needs to modify his food intake. "Sometimes I think I'm addicted to food the
way some people are addicted to drugs," he says. Which statement best describes the
neurobiological parallels between food and drug addiction? - ANS: d.
There is decreased activation of the prefrontal cortex.
An 18-year-old female with a history of frequent headaches and a mood disorder is prescribed
topiramate (Topamax), 25 mg by mouth daily. The PMHNP understands that this medication is
effective in treating which condition(s) in this patient?` - ANS: c.
Migraines
,A patient you have been evaluating was admitted to the hospital with some abnormal lab work.
Hematology/oncology was consulted and diagnoses the patient with aplastic anemia and
agranulocytosis. Which medication was likely the culprit? - ANS: d.
Carbamazepine
Antipsychotics are doses at a level that blocks % of D2 receptors. - ANS: a.
50-70
The PMHNP is teaching a patient with a sleep disorder about taking diphenhydramine (Benadryl).
The patient is concerned about the side effects of the drug. What can the PMHNP teach the patient
about this treatment approach? - ANS: b
"It can cause blurred vision
A 9-year-old female patient presents with symptoms of both attention deficit hyperactivity disorder
(ADHD) and oppositional defiant disorder. In evaluating her symptoms, the PMHNP determines that
which of the following medications may be beneficial in augmenting stimulant medication? - ANS: b.
Guanfacine ER (Intuniv)
The PMHNP is assessing a patient who will be receiving phentermine (Adipex P)/topiramate
(Topamax) (Qsymia). Which of the following conditions/diseases will require further evaluation
before this medication can be prescribed? - ANS: b.
Cardiovascular disease
The PMHNP wishes to prescribe a medication that reduces glutamate transmission in an Alzheimer's
patient. Which medication should the PMHNP prescribe? - ANS: b.
Memantine (NAMENDA)
A patient with fibromyalgia and major depression needs to be treated for symptoms of pain. Which
is the PMHNP most likely to prescribe for this patient? - ANS: d.
Duloxetine (Cymbalta)
A patient is prescribed D-methylphenidate, 10-mg extended-release capsules. What should the
PMHNP include when discussing the side effects with the patient? - ANS: c.
The medication can affect your blood pressure.
, Which medication is an irreversible inhibitor of aldehyde dehydrogenase that creates a negative and
aversive response following ingestion of alcohol? - ANS: c.
Disulfiram (ANTABUSE)
An 80-year-old female patient diagnosed with Stage II Alzheimer's has a history of irritable bowel
syndrome. Which cholinergic drug may be the best choice for treatment given the patient's
gastrointestinal problems? - ANS: a.
Donepezil (Aricept)
Mrs. Rosen is a 49-year-old patient who is experiencing fibro-fog. What does the PMHNP prescribe
for Mrs. Rosen to improve this condition? - ANS: b.
All of these are correct
A 26-year-old female patient with nicotine dependence and a history of anxiety presents with
symptoms of attention deficit hyperactivity disorder (ADHD). Based on the assessment, what does
the PMHNP consider? - ANS: a. ADHD is often not the focus of treatment in adults with comorbid
conditions.
Parents of a 12-year-old boy want to consider attention deficit hyperactivity disorder (ADHD)
medication for their son. Which medication would the PMHNP start? - ANS: d.
All of these could potentially treat their son's symptoms.
The PMHNP is assessing a patient who presents with elevated levels of brain amyloid as noted by
positron emission tomography (PET). What other factors will the PMHNP consider before prescribing
medication for this patient, and what medication would the PMHNP want to avoid given these other
factors? - ANS: b.
ApoE4 genotype and avoid antihistamines if possible and Type 2 diabetes and avoid olanzapine
Karen completes the Epworth sleepiness scale and scores abnormally high. She is diagnosed with
narcolepsy. The PMHNP prescribes a wake-promoting agent that is a weak dopamine transporter
antagonist. Which medication did the PMHNP prescribe? - ANS: c.
Modafanil (PROVIGIL)
