NKU MSN 611 FINAL EXAM SCRIPT 2026
FULL QUESTIONS AND ANSWERS
ALREADY PASSED
⩥ A 26-year-old woman is brought to the emergency department with an
acute severe headache. Her partner reports that it started 6 hours ago and
that she vomited several times at home. The patient is holding her hands
over her eyes and reports severe unilateral retroorbital throbbing pain.
She has no significant past medical history and takes no regular
medications. Her vital signs are within normal limits. There is no gross
neurological deficit on examination of the cranial nerves and limbs.
Given the most likely diagnosis, what is the mechanism of action of the
best drug for the acute treatment of this patient's condition? Answer:
Cerebral vasoconstriction
⩥ A 42-year-old man presents with a 6-month history of severe,
throbbing headaches that are generally unilateral, worsened by light and
sound, and occur biweekly and occasionally interrupt his workday. He
has no significant improvement with ibuprofen, naproxen, or
acetaminophen. Vital signs are blood pressure 139/80 mmHg, heart rate
82 bpm, respiratory rate 14 breaths/min, and temperature 98.0 F (36.7
C). Physical examination is normal. Which of the following effects is
caused by the most appropriate treatment option? Answer: Constriction
of cerebral blood vessels.
,⩥ A 20-year-old woman presents with a severe headache. She is G2P1 at
32 weeks gestation. Her blood pressure is 201/98 mm Hg. A urine
dipstick shows 3+ protein. Preparations are made for an emergency
cesarean section. She is started on a continuous intravenous infusion of
magnesium sulfate for the prevention of seizures. What is a severe, yet
preventable, complication of continuous intravenous magnesium sulfate
therapy? Answer: Respiratory depression
⩥ A 55-year-old man presents with difficulty passing urine and
suprapubic discomfort for the past 2 days. His symptoms are
progressively worsening. The patient's past medical history is significant
for depression, and he was recently started on a new medication due to
refractory symptoms. The physical examination reveals tachycardia, a
dry mouth, and suprapubic fullness. What is the class of medication that
is responsible for this patient's presenting symptoms? Answer: Tricyclic
antidepressants
⩥ A 55-year-old man presents with a 1-month history of insomnia and
fatigue. He states that he has been unable to complete work tasks and no
longer enjoys his hobbies or going out with friends. He also reports a
decreased appetite and bouts of crying. The patient has a past medical
history of seizures, hypothyroidism, diabetes mellitus, and asthma. His
blood pressure is 110/75 mm Hg, and his heart rate is 75 bpm. The
clinician prescribes venlafaxine. Which of the following conditions
requires caution when using venlafaxine in this patient? Answer:
Seizures
,⩥ A 34-year-old woman has been troubled by migraine headaches that
typically occur 5 to 6 times monthly. Treatment of the headaches when
they occur is moderately successful. She asks whether there is anything
she can do to reduce the frequency with which these headaches occur.
She also has been troubled by long-standing mood issues, with episodes
that are weeks long where she feels sad. What therapy might be
recommended that can both reduce the frequency of her migraine attacks
and may also be useful in improving her mood? Answer: Venlafaxine
⩥ A patient is diagnosed with metabolic acidosis. His medication record
shows that he is prescribed diclofenac, atenolol, albuterol, and
topiramate. Which of these medications is most likely responsible for the
patient's condition? Answer: Topiramate
⩥ A 60-year-old man is brought to the emergency department after an
episode of syncope. The patient was watching television when he felt
light-headed and lost consciousness. He regained consciousness after a
minute spontaneously. The patient's past medical history is significant
for hypertension, diabetes, and peripheral neuropathy. His medications
include metformin, hydrochlorothiazide, and amitriptyline. ECG in the
emergency department shows a QT interval of 480 ms. What is the
mechanism of action of the drug responsible for this patient's symptoms
and ECG findings? Answer: Blocking the reuptake of both serotonin and
norepinephrine neurotransmitters
⩥ A 23-year-old man recently started taking a new medication for a
long-standing history of hallucinations, poor eye contact, flat affect, and
poor work performance. After six days of using this medication, this
, patient presents to the emergency department with acute neck stiffness.
On exam, his head is rotated to the left and flexed in a fixed position.
The medication used by this patient mainly works by blocking which of
the following receptor? Answer: Dopamine receptor
⩥ A 40-year-old man is brought to the emergency department due to a
severe headache for the past hour. His symptoms started 2 hours after
having dinner with his family. On further questioning, his wife reveals
that they had pizza and red wine for dinner. On physical exam, he
appears anxious and tremulous. Medical history includes atypical
depression being treated with phenelzine. He does not smoke or use
illicit drugs. Which of the following Is the most likely finding? Answer:
Hypertension
⩥ A 25-year-old woman presents with depression resistant to multiple
classes of antidepressants. A nonselective monoamine oxidase inhibitor
(MAOI) is prescribed. Which of the following should be included in
patient counseling regarding the prevention of one of the most serious
adverse effects of this drug? Answer: Avoid tyramine-containing foods
⩥ A 48-year-old man with a 20-pack-year smoking history presents with
3 weeks of insomnia, anhedonia, and decreased concentration after
losing his father to lung cancer. He worries that he will die of cancer and
be unable to provide for his family. He often feels down and spends
most of his day in bed. He has lost 5 lbs (2.2 kg) over the past 2 weeks
due to poor appetite. He denies suicidal ideation and would like to quit
smoking. What is the best pharmacotherapy for this patient? Answer:
Bupropion
FULL QUESTIONS AND ANSWERS
ALREADY PASSED
⩥ A 26-year-old woman is brought to the emergency department with an
acute severe headache. Her partner reports that it started 6 hours ago and
that she vomited several times at home. The patient is holding her hands
over her eyes and reports severe unilateral retroorbital throbbing pain.
She has no significant past medical history and takes no regular
medications. Her vital signs are within normal limits. There is no gross
neurological deficit on examination of the cranial nerves and limbs.
Given the most likely diagnosis, what is the mechanism of action of the
best drug for the acute treatment of this patient's condition? Answer:
Cerebral vasoconstriction
⩥ A 42-year-old man presents with a 6-month history of severe,
throbbing headaches that are generally unilateral, worsened by light and
sound, and occur biweekly and occasionally interrupt his workday. He
has no significant improvement with ibuprofen, naproxen, or
acetaminophen. Vital signs are blood pressure 139/80 mmHg, heart rate
82 bpm, respiratory rate 14 breaths/min, and temperature 98.0 F (36.7
C). Physical examination is normal. Which of the following effects is
caused by the most appropriate treatment option? Answer: Constriction
of cerebral blood vessels.
,⩥ A 20-year-old woman presents with a severe headache. She is G2P1 at
32 weeks gestation. Her blood pressure is 201/98 mm Hg. A urine
dipstick shows 3+ protein. Preparations are made for an emergency
cesarean section. She is started on a continuous intravenous infusion of
magnesium sulfate for the prevention of seizures. What is a severe, yet
preventable, complication of continuous intravenous magnesium sulfate
therapy? Answer: Respiratory depression
⩥ A 55-year-old man presents with difficulty passing urine and
suprapubic discomfort for the past 2 days. His symptoms are
progressively worsening. The patient's past medical history is significant
for depression, and he was recently started on a new medication due to
refractory symptoms. The physical examination reveals tachycardia, a
dry mouth, and suprapubic fullness. What is the class of medication that
is responsible for this patient's presenting symptoms? Answer: Tricyclic
antidepressants
⩥ A 55-year-old man presents with a 1-month history of insomnia and
fatigue. He states that he has been unable to complete work tasks and no
longer enjoys his hobbies or going out with friends. He also reports a
decreased appetite and bouts of crying. The patient has a past medical
history of seizures, hypothyroidism, diabetes mellitus, and asthma. His
blood pressure is 110/75 mm Hg, and his heart rate is 75 bpm. The
clinician prescribes venlafaxine. Which of the following conditions
requires caution when using venlafaxine in this patient? Answer:
Seizures
,⩥ A 34-year-old woman has been troubled by migraine headaches that
typically occur 5 to 6 times monthly. Treatment of the headaches when
they occur is moderately successful. She asks whether there is anything
she can do to reduce the frequency with which these headaches occur.
She also has been troubled by long-standing mood issues, with episodes
that are weeks long where she feels sad. What therapy might be
recommended that can both reduce the frequency of her migraine attacks
and may also be useful in improving her mood? Answer: Venlafaxine
⩥ A patient is diagnosed with metabolic acidosis. His medication record
shows that he is prescribed diclofenac, atenolol, albuterol, and
topiramate. Which of these medications is most likely responsible for the
patient's condition? Answer: Topiramate
⩥ A 60-year-old man is brought to the emergency department after an
episode of syncope. The patient was watching television when he felt
light-headed and lost consciousness. He regained consciousness after a
minute spontaneously. The patient's past medical history is significant
for hypertension, diabetes, and peripheral neuropathy. His medications
include metformin, hydrochlorothiazide, and amitriptyline. ECG in the
emergency department shows a QT interval of 480 ms. What is the
mechanism of action of the drug responsible for this patient's symptoms
and ECG findings? Answer: Blocking the reuptake of both serotonin and
norepinephrine neurotransmitters
⩥ A 23-year-old man recently started taking a new medication for a
long-standing history of hallucinations, poor eye contact, flat affect, and
poor work performance. After six days of using this medication, this
, patient presents to the emergency department with acute neck stiffness.
On exam, his head is rotated to the left and flexed in a fixed position.
The medication used by this patient mainly works by blocking which of
the following receptor? Answer: Dopamine receptor
⩥ A 40-year-old man is brought to the emergency department due to a
severe headache for the past hour. His symptoms started 2 hours after
having dinner with his family. On further questioning, his wife reveals
that they had pizza and red wine for dinner. On physical exam, he
appears anxious and tremulous. Medical history includes atypical
depression being treated with phenelzine. He does not smoke or use
illicit drugs. Which of the following Is the most likely finding? Answer:
Hypertension
⩥ A 25-year-old woman presents with depression resistant to multiple
classes of antidepressants. A nonselective monoamine oxidase inhibitor
(MAOI) is prescribed. Which of the following should be included in
patient counseling regarding the prevention of one of the most serious
adverse effects of this drug? Answer: Avoid tyramine-containing foods
⩥ A 48-year-old man with a 20-pack-year smoking history presents with
3 weeks of insomnia, anhedonia, and decreased concentration after
losing his father to lung cancer. He worries that he will die of cancer and
be unable to provide for his family. He often feels down and spends
most of his day in bed. He has lost 5 lbs (2.2 kg) over the past 2 weeks
due to poor appetite. He denies suicidal ideation and would like to quit
smoking. What is the best pharmacotherapy for this patient? Answer:
Bupropion
