MSN 611 NKU Final exam with correct
|\ |\ |\ |\ |\ |\ |\
answers
A 65-year-old man presents with chronic insomnia. He
|\ |\ |\ |\ |\ |\ |\ |\
reports that his sleep has improved after beginning a new
|\ |\ |\ |\ |\ |\ |\ |\ |\
medication, but he is experiencing concerning adverse
|\ |\ |\ |\ |\ |\ |\ |\
effects. His wife noticed him sleepwalking, eating during
|\ |\ |\ |\ |\ |\ |\ |\
the night, and attempting to drive his car at night. The
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
patient has no recollection of these events and is
|\ |\ |\ |\ |\ |\ |\ |\ |\
concerned. Vitals signs are blood pressure 130/80 mmHg, |\ |\ |\ |\ |\ |\ |\ |\
heart rate 82 bpm, respiratory rate 18 breaths/min, and
|\ |\ |\ |\ |\ |\ |\ |\ |\
temperature 98.0 F (36.7 C). Physical examination is |\ |\ |\ |\ |\ |\ |\ |\
normal. What is the mechanism of action of the
|\ |\ |\ |\ |\ |\ |\ |\ |\
medication responsible for the patient's adverse effects? - |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔GABA-A receptor agonist
|\ |\ |\ |\ |\
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? - CORRECT ANSWERS ✔✔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? -
|\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔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? -
|\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔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? - CORRECT ANSWERS ✔✔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? -
|\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔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? - CORRECT ANSWERS ✔✔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? - CORRECT ANSWERS ✔✔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? - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔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.
|\ |\ |\ |\ |\ |\ |\ |\ |\
|\ |\ |\ |\ |\ |\ |\
answers
A 65-year-old man presents with chronic insomnia. He
|\ |\ |\ |\ |\ |\ |\ |\
reports that his sleep has improved after beginning a new
|\ |\ |\ |\ |\ |\ |\ |\ |\
medication, but he is experiencing concerning adverse
|\ |\ |\ |\ |\ |\ |\ |\
effects. His wife noticed him sleepwalking, eating during
|\ |\ |\ |\ |\ |\ |\ |\
the night, and attempting to drive his car at night. The
|\ |\ |\ |\ |\ |\ |\ |\ |\ |\ |\
patient has no recollection of these events and is
|\ |\ |\ |\ |\ |\ |\ |\ |\
concerned. Vitals signs are blood pressure 130/80 mmHg, |\ |\ |\ |\ |\ |\ |\ |\
heart rate 82 bpm, respiratory rate 18 breaths/min, and
|\ |\ |\ |\ |\ |\ |\ |\ |\
temperature 98.0 F (36.7 C). Physical examination is |\ |\ |\ |\ |\ |\ |\ |\
normal. What is the mechanism of action of the
|\ |\ |\ |\ |\ |\ |\ |\ |\
medication responsible for the patient's adverse effects? - |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔GABA-A receptor agonist
|\ |\ |\ |\ |\
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? - CORRECT ANSWERS ✔✔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? -
|\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔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? -
|\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔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? - CORRECT ANSWERS ✔✔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? -
|\ |\ |\ |\ |\ |\ |\ |\
CORRECT ANSWERS ✔✔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? - CORRECT ANSWERS ✔✔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? - CORRECT ANSWERS ✔✔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? - CORRECT
|\ |\ |\ |\ |\ |\ |\ |\ |\
ANSWERS ✔✔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.
|\ |\ |\ |\ |\ |\ |\ |\ |\
