NURS 6630 MIDTERM EXAM 4 – QUESTION AND ANSWERS



NURS 6630 MIDTERM EXAM 4 – QUESTION AND
ANSWERS
A noncompliant patient states, “Why do you want me to put this poison in my body?”
Identify the best response made by the psychiatric-mental health nurse practitioner
(PMHNP).


Selected C.
Answer: “Most medications that work in the brain will result in restoring an imbalance of one
or more neurotransmitters that your body already produces helping to alleviate your
symptoms .”

 Question 2
1 out of 1 points


Ms. Hill is currently being treated for schizophrenia but has stopped
taking her medications due to some side effects she claims she was
experiencing. She presents to the clinic today with worsening symptoms.
She is experiencing anhedonia, agitation, attentional impairment, and
affective blunting. Which one of the symptoms mentioned is considered a
positive symptom of schizophrenia?


Selected B.
Answer: Agitation
 Question 3
0 out of 1 points
Which statement about neurotransmitters and medications is true?


Selected D.
Answer: An imbalance of serotonin has been directly linked to depression. Following the
discovery of this neurotransmitter, pharmacologists were able to develop a well-
known drug- Prozac as the first medication used to restore the balance of
serotonin.

 Question 4
1 out of 1 points
When an unstable patient asks why it is necessary to add medications to his current
regimen, the PMHNP’s best response would be:


Selecte C.
d “Many psychiatric illnesses involve several dys-functioning neurotransmitter

, Answer: systems in the brain. Often, a single medication may only effect one or two of the
dys-functioning systems. The addition of another medication can work with the
current medication in stabilizing multiple neurotransmitter systems and help to
alleviate your symptoms.”

 Question 5
1 out of 1 points
During gene expression, what must occur prior to a gene being expressed?


Selected A.
Answers: Transcription factor must bind to the regulatory region within the
cell’s nucleus.
 Question 6
1 out of 1 points
While genes have potential to modify behavior, behavior can also modify genes. How do
genes impact this process?


Selected B.
Answer: Changes made to proteins lead to changes in
behavior.

 Question 7
1 out of 1 points
Though medications have the ability to target neurotransmitter release into the synapse by
the presynaptic neuron it is not always necessary. The PMHNP understands that this is
because:

Selected C.
Answer: Neurotransmitters can spread by
diffusion.

 Question 8
1 out of 1 points
Why is the cytochrome P450 enzyme system of significance to the PMHNP?


Selected B.
Answer: The bioavailability of the medication after it passes through the
stomach and liver can be altered.

 Question 9
1 out of 1 points
It is important for the PMHNP to recognize differences in pharmacokinetics to safely
prescribe and monitor medications. Which of the following statements does the
competent PMHNP identify as true?


Selected A.

, Answer: About 1 out of 5 Asians requires lower-than-normal doses of some
antidepressants and antipsychotics.

 Question 10
1 out of 1 points
As it relates to G-protein linked receptors, what does the PMHNP understand about
medications that are used in practice?


Selected A.
Answer: Most medications that act on G-protein linked receptors have
antagonistic traits.

 Question 11
1 out of 1 points
The PMHNP is considering prescribing a 49-year-old male clozapine (Clozaril) to treat his
schizophrenia and suicidal ideations. The PMHNP is aware that which factor may impact
the dose needed to effectively treat his condition:


Selected A.
Answer: The patient smokes
cigarettes.

 Question 12
0 out of 1 points
A patient is diagnosed with bipolar disorder and is currently taking carbamazepine
(Tegretol), aripiprazole (Abilify), and melatonin. The PMHNP has just written an order to
discontinue the carbamazepine (Tegretol) for drug-induced thrombocytopenia. The
PMHNP is aware that his next best action is to:


Selected B.
Answer: Write an order for a different mood
stabilizer

 Question 13
1 out of 1 points
A patient recently transferred following a suicide attempt has a history of schizophrenia,
depression, and fibromyalgia. He is currently taking Amitriptyline (Elavil), Lisinopril,
aspirin, and fluoxetine (Prozac). When assessing the psychiatric medications and the reason for
admission, what would be the best course of action for the PMHNP with this client?

Selected A.
Answer: Review Amitriptyline (Elavil)
level

 Question 14
0 out of 1 points
A patient with schizophrenia is given an inverse agonist that acts on the receptor 5HT
and neurotransmitter serotonin. What is the rationale for prescribing a medication such