NURS 6630 Week 11 Final Exam 2021 - GRADED A

Question 1 L. J. is a 55-year-old male who attended a funeral and found himself laughing during the service, but later that evening he was irritated with himself for what he had done. His wife said this was abnormal behavior and took him to his doctor to be evaluated. After L. J.’s MRI was reviewed, he was diagnosed with frontotemporal dementia. Which medication is recommended to help L. J. with his emotional outbursts? A . Memantine B . Escitalopram C . Donepezil D . Risperidone Response Feedback: under Treatment subtitle: “The behavioral features are sometimes helped by SSRIs, and these are the best-studied treatments for these disorders.” Question 2 When can buprenorphine be initiated in a patient who is suffering from an opioid overdose? A . As soon as the patient is stabilized B . It should be administered as soon as you find the patient unconscious C . Right after naloxone is administered to prevent the patient from going back into opioid overdose D . When the patient is experiencing mild-to-moderate symptoms of withdrawal Response Feedback: “To avoid this problem, the initial buprenorphine dose should not be administered until the patient demonstrates mild-to-moderate symptoms of withdrawal.” Question 3 Of the following neurotransmitters, which one(s) are known to be severely disrupted in the disease Dementia with Lewy Bodies? I. Acetylcholine II. Glutamate III. Dopamine IV. GABA V. Norepinephrine A . II only B . III only C . I and II D . I and III Response Feedback: under pathophysiology subtitle: “It is clear that both the cholinergic and dopaminergic neurotransmitter systems are severely disrupted.” Question 4 Choose the correct statement regarding medications used for alcoholism A . Disulfiram: NMDA receptor antagonist & GABAA agonist B . Naltrexone: µ-opioid receptor antagonist that reduces the reinforcement/euphoria produced by alcohol C . Acamprosate: enhances the effect of the inhibitory neurotransmitter gamma- aminobutyric acid on the GABA receptors by binding to a site that is distinct from the GABA binding site in the central nervous system. D . Lorazepam: inhibits alcohol dehydrogenase, leading to a buildup of acetaldehyde Response Feedback: Table 15-3 has the three MOAs listed for the FDA-approved treatments of alcoholism. Question 5 Patient is a 75-year-old female with a confirmed diagnosis of Alzheimer’s Disease. She is currently on Donepezil 10 mg daily. She is accompanied to your clinic today by her daughter, who informs you that her mother has recently had an increase in depressive symptoms. She has no history of mood disorders. She has a history of hypertension and tonic-clonic seizures, but both are controlled. Assuming this patient will be thoroughly evaluated for the diagnosis of depression, what would you recommend as initial therapy? A . Amitriptyline B . Doxepin C . Fluoxetine D . Bupropion Response Feedback: SSRIs are effective in treating depressive symptoms. Answer choices A & B are both TCAs and are advised against due to side effect profile and the fact this person is treatment naive (learned from previous exam) and answer choice D is contraindicated in a patient with seizures. Question 6 Which neurotransmitters are likely involved in the pathophysiology of withdrawal seizures? I. Serotonin II. Endorphins III. Glutamate IV. GABA V. Dopamine A . I and II B . II and V C . I and III D . III and IV Response Feedback: “Thus when an individual suddenly ceases alcohol use, the decrease in inhibitory effects in combination with fewer GABA receptors and increased glutamatergic discharge contributes to over-excitation and possible withdrawal seizures.” Question 7 Which medication below should be routine for all suspected cases of alcohol intoxication and dependence? ......