NURS 6512 Approaches to Health Final Exam

• Question 1 1 out of 1 points What will the PMHNP most likely prescribe to a patient with psychotic aggression who needs to manage the top-down cortical control and the excessive drive from striatal hyperactivity? Selected Answer: C. Antipsychot ics • Question 2 1 out of 1 points The PMHNP is selecting a medication treatment option for a patient who is exhibiting psychotic behaviors with poor impulse control and aggression. Of the available treatments, which can help temper some of the adverse effects or symptoms that are normally caused by D2 antagonism? Selected Answer: D. Second-generation, atypical antipsychotics • Question 3 1 out of 1 points The PMHNP is discussing dopamine D2 receptor occupancy and its association with aggressive behaviors in patients with the student. Why does the PMHNP prescribe a standard dose of atypical antipsychotics? Selected Answer: C. The doses are based on achieving 60% D2 receptor occupancy. • Question 4 1 out of 1 points Why does the PMHNP avoid prescribing clozapine (Clozaril) as a first-line treatment to the patient with psychosis and aggression? Selected Answer: A. There is too high a risk of serious adverse side effects. • Question 5 1 out of 1 points The PMHNP is caring for a patient on risperidone (Risperdal). Which action made by the PMHNP exhibits proper care for this patient? /p? Selected Answer: C. Titrating the dose by increasing it every 5–7 days • Question 6 1 out of 1 points The PMHNP wants to prescribe Mr. Barber a mood stabilizer that will target aggressive and impulsive symptoms by decreasing dopaminergic neurotransmission. Which mood stabilizer will the PMHNP select? Selected Answer: A. Lithium (Lithane) • Question 7 1 out of 1 points The parents of a 7-year-old patient with ADHD are concerned about the effects of stimulants on their child. The parents prefer to start pharmacological treatment with a non-stimulant. Which medication will the PMHNP will most likely prescribe? Selected Answer: A. Stratt era • Question 8 1 out of 1 points The PMHNP understands that slow-dose extended release stimulants are most appropriate for which patient with ADHD? Selected Answer: A. 8-year-old patient • Question 9 1 out of 1 points A patient is prescribed D-methylphenidate, 10-mg extended-release capsules. What should the PMHNP include when discussing the side effects with the patient? Selected Answer: C. The medication can affect your blood pressure. • Question 10 1 out of 1 points The PMHNP is teaching parents about their child’s new prescription for Ritalin. What will the PMHNP include in the teaching? Selected Answer: A. The second dose should be taken at lunch. • Question 11 1 out of 1 points A young patient is prescribed Vyvanse. During the follow-up appointment, which comment made by the patient makes the PMHNP think that the dosing is being done incorrectly? Selected Answer: B. “I am unable to fall asleep at night.” • Question 12 1 out of 1 points A 14-year-old patient is prescribed Strattera and asks when the medicine should be taken. What does the PMHNP understand regarding the drug’s dosing profile? Selected Answer: B. The patient will have one or two doses a day. • Question 13 0 out of 1 points The PMHNP is meeting with the parents of an 8-year-old patient who is receiving an initial prescription for D-amphetamine. The PMHNP demonstrates appropriate prescribing practices when she prescribes the following dose: Selected Answer: D. The child will take 10–40 mg, daily. • Question 14 1 out of 1 points A patient is being prescribed bupropion and is concerned about the side effects. What will the PMHNP tell the patient regarding bupropion? Selected Answer: C. It can cause cardiac arrhythmias. • Question 15 Which patient will receive a lower dose of guanfacine? 1 out of 1 points Selected Answer: D. Patient with kidney disease • Question 16 1 out of 1 points 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? Selected Answer: A. Migrain es • Question 17 1 out of 1 points The PMHNP is treating a patient for fibromyalgia and is considering prescribing milnacipran (Savella). When prescribing this medication, which action is the PMHNP likely to choose? Selected Answer: C. Split the daily dose into two doses after the first day. • Question 18 1 out of 1 points The PMHNP is assessing a patient she has been treating with the diagnosis of chronic pain. During the assessment, the patient states that he has recently been having trouble getting to sleep and staying asleep. Based on this information, what action is the PMHNP most likely to take? Selected Answer: A. Order hydroxyzine (Vistaril), 50 mg PRN or as needed • Question 19 1 out of 1 points The PMHNP is assessing a female patient who has been taking lamotrigine (Lamictal) for migraine prophylaxis. After discovering that the patient has reached the maximum dose of this medication, the PMHNP decides to change the patient’s medication to zonisamide (Zonegran). In addition to evaluating this patient’s day-to-day activities, what should the PMHNP ensure that this patient understands? Selected Answer: D. This medication has unwanted side effects such as sedation, lack of coordination, and drowsiness. • Question 20 1 out of 1 points A patient recovering from shingles presents with tenderness and sensitivity to the upper back. He states it is bothersome to put a shirt on most days. This patient has end stage renal disease (ESRD) and is scheduled to have hemodialysis tomorrow but states that he does not know how he can lie in a recliner for 3 hours feeling this uncomfortable. What will be the PMHNP’s priority? Selected Answer: C. Prescribe lidocaine 5% • Question 21 1 out of 1 points The PMHNP prescribed a patient lamotrigine (Lamictal), 25 mg by mouth daily, for nerve pain 6 months ago. The patient suddenly presents to the office with the complaint that the medication is no longer working and complains of increased pain. What action will the PMHNP most likely take? Selected Answer: A. Increase the dose of lamotrigine (Lamictal) to 25 mg twice daily. • Question 22 0 out of 1 points An elderly woman with a history of Alzheimer’s disease, coronary artery disease, and myocardial infarction had a fall at home 3 months ago that resulted in her receiving an open reduction internal fixation. While assessing this patient, the PMHNP is made aware that the patient continues to experience mild to moderate pain. What is the PMHNP most likely to do? Selected Answer: B. Order ibuprofen (Motrin) because she may need long-term treatment and chronic pain is not uncommon. • Question 23 1 out of 1 points The PMHNP is assessing a 49-year-old male with a history of depression, post-traumatic stress disorder (PTSD), alcoholism with malnutrition, diabetes mellitus type 2, and hypertension. His physical assessment is unremarkable with the exception of peripheral edema bilaterally to his lower extremities and a chief complaint of pain with numbness and tingling to each leg 5/10. The PMHNP starts this patient on a low dose of doxepin (Sinequan). What is the next action that must be taken by the PMHNP? Selected Answer: A. Orders liver function tests. • Question 24 1 out of 1 points The PMHNP is evaluating a 30-year-old female patient who states that she notices pain and a drastic change in mood before the start of her menstrual cycle. The patient states that she has tried diet and lifestyle changes but nothing has worked. What will the PMHNP most likely do? Selected Answer: C. Prescribe desvenlafaxine (Pristiq), 50 mg daily