6630 Walden University

6630 Walden University 6630 Walden University WALDEN U. - NURS - 6630N Psychopharmacologic Approaches to Treatment of Psychopathology Amber is a 26-year-old female who presents to the clinic 6 weeks postpartum. The patient states that she has been "feeling down" since the birth of her son. She is currently breastfeeding her...

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NURS6630 Final Exam: Walden University QUESTION 1 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? A. Stimulants B. Antidepressants C. Antipsychotics D. SSRIs QUESTION 2 The PMHNP ...

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• Question 1 1 out of 1 points During assessment a patient states “Why are you asking me about my heart, I am here for my head”, the PMHNP’s best response is: Selected Answer: D. “Anxiety can cause cortisol levels to increase and when this happens frequently it puts you at risk for comorbidities such as type 2 diabetes.” • Question 2 During gene expression, what must occur prior to a gene being expressed? 1 out of 1 points Selected Answers: A. Transcription factor must bind to the regulatory region within the cell’s nucleus. • Question 3 1 out of 1 points The PMNHP is assessing a 29-year-old client who takes antipsychotics that block D2 rec...

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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? 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? 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? Why does the PMHNP avoid prescribing clozapine (Clozaril) as a first-line treatment to the patient with psychosis and aggression? A. There is too high a risk of serious adverse side effects. B. It can exaggerate the psychotic symptoms. C. Clozapine (Clozaril) should not be used as high-dose monotherapy. D. There is no documentation that clozapine (Clozaril) is effective for patients who are violent. The PMHNP is caring for a patient on risperidone (Risperdal). Which action made by the PMHNP exhibits proper care for this patient? 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? 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? The PMHNP understands that slow-dose extended release stimulants are most appropriate for which patient with ADHD? A patient is prescribed D-methylphenidate, 10-mg extended-release capsules. What should the PMHNP include when discussing the side effects with the patient? A. The formulation can have delayed actions when taken with food. B. Sedation can be a common side effect of the drug. C. The medication can affect your blood pressure. D. This drug does not cause any dependency. The PMHNP is teaching parents about their child’s new prescription for Ritalin. What will the PMHNP include in the teaching? 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? 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? 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: A patient is being prescribed bupropion and is concerned about the side effects. What will the PMHNP tell the patient regarding bupropion? Which patient will receive a lower dose of guanfacine? 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? 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? 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? 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? 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...

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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? 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: An 8-year-old patient presents with severe hyperactivity, described as “ants in his pants.” Based on self-report from the patient, his parents, and his teacher; attention deficit hyperactivity disorder (ADHD) is suspected. What medication is the PMNHP most likely to prescribe? A 9-year-old female patient presents with symptoms of both attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder. In evaluating her symptoms, the PMHNP determines that which of the following medications may be beneficial in augmenting stimulant medication? Parents of a 12-year-old boy want to consider attention deficit hyperactivity disorder (ADHD) medication for their son. Which medication would the PMHNP start? 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? 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? A 26-year-old female patient with nicotine dependence and a history of anxiety presents with symptoms of attention deficit hyperactivity disorder (ADHD). Based on the assessment, what does the PMHNP consider? 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? A 43-year-old male patient is seeking clarification about treating attention deficit hyperactivity disorder (ADHD) in adults and how it differs from treating children, since his son is on medication to treat ADHD. The PMHNP conveys a major difference is which of the following? 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? Mrs. Rosen is a 49-year-old patient who is experiencing fibro-fog. What does the PMHNP prescribe for Mrs. Rosen to improve this condition? A 63-year-old patient presents with the following symptoms. The PMHNP determines which set of symptoms warrant prescribing a medication? Select the answer that is matched with an appropriate treatment. Reduced ability to remember names is most problematic, and an appropriate treatment option is memantine. A 71-year-old male patient comes to an appointment with his 65-year-old wife. They are both having concerns related to her memory and ability to recognize faces. The PMNHP is considering prescribing memantine (Namenda) based on the following symptoms: A 72-year-old male patient is in the early stages of Alzheimer’s disease. The PMHNP determines that improving memory is a key consideration in selecting a medication. Which of the following would be an appropriate choice? A 75-year-old male patient diagnosed with Alzheimer’s disease presents with agitation and aggressive behavior. The PMHNP determines which of the following to be the best treatment option? An 80-year-old female patient diagnosed with Stage II Alzheimer’s has a history of irritable bowel syndrome. Which cholinergic drug may be the best choice for treatment given the patient’s...

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Why does the PMHNP avoid prescribing clozapine (Clozaril) as a first-line treatment to the patient with psychosis and aggression? A 75-year-old male patient diagnosed with Alzheimer’s disease presents with agitation and aggressive behavior. The PMHNP determines which of the following to be the best treatment option? A group of nursing students seeks further clarification from the PMHNP on how cholinesterase inhibitors are beneficial for Alzheimer’s disease patients. What is the appropriate response? The PMHNP understands that slow-dose extended release stimulants are most appropriate for which patient with ADHD? An 8-year-old patient presents with severe hyperactivity, described as “ants in his pants.” Based on self-report from the patient, his parents, and his teacher; attention deficit hyperactivity disorder (ADHD) is suspected. What medication is the PMNHP most likely to prescribe? A patient with fibromyalgia and major depression needs to be treated for symptoms of pain. Which is the PMHNP most likely to prescribe for this patient? Mrs. Kenner is concerned that her teenage daughter spends too much time on the Internet. She inquires about possible treatments for her daughter’s addiction. Which response by the PMHNP demonstrates understanding of pharmacologic approaches for compulsive disorders? An adult patient presents with a history of alcohol addiction and attention deficit hyperactivity disorder (ADHD). Given these comorbidities, the PMHNP determines which of the following medications may be the best treatment option? Which of the following is a true statement regarding the use of stimulants to treat attention deficit hyperactivity disorder (ADHD)? A 71-year-old male patient comes to an appointment with his 65-year-old wife. They are both having concerns related to her memory and ability to recognize faces. The PMNHP is considering prescribing memantine (Namenda) based on the following symptoms: 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: The PMHNP is assessing a patient who presents with elevated levels of brain amyloid as noted by positron emission tomography (PET). What other factors will the PMHNP consider before prescribing medication for this patient, and what medication would the PMHNP want to avoid given these other factors? The PMHNP is attempting to treat a patient’s chronic insomnia and wishes to start with an initial prescription that has a half-life of approximately 1–2 hours. What is the most appropriate prescription for the PMHNP to make? The PMHNP is caring for a patient on risperidone (Risperdal). Which action made by the PMHNP exhibits proper care for this patient? Buy now to view the complete solution

Mrs. Rosen is a 49-year-old patient who is experiencing fibro-fog. What does the PMHNP prescribe for Mrs. Rosen to improve this condition? 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? The PMHNP is caring for a patient who reports excessive arousal at nighttime. What could the PMHNP use for a time-limited duration to shift the patient’s brain from a hyperactive state to a sleep state? A patient addicted to heroin is receiving treatment for detoxification. He begins to experience tachycardia, tremors, and diaphoresis. What medication will the PMHNP prescribe for this patient? The PMHNP prescribes gabapentin (Neurontin) for a patient’s chronic pain. How does the PMHNP anticipate the drug to work? A patient with hypersexual disorder is being assessed for possible pharmacologic treatment. Why does the PMHNP prescribe an antiandrogen for this patient? Which statement best describes a pharmacological approach to treating patients for impulsive aggression nurs 6630 final exam A 26-year-old female patient with nicotine dependence and a history of anxiety presents with symptoms of attention deficit hyperactivity disorder (ADHD). Based on the assessment, what does the PMHNP consider? A patient with irritable bowel syndrome reports chronic stomach pain. The PMHNP wants to prescribe the patient an agent that will cause irrelevant nociceptive inputs from the pain to be ignored and no longer perceived as painful. Which drug will the PMHNP prescribe? Parents of a 12-year-old boy want to consider attention deficit hyperactivity disorder (ADHD) medication for their son. Which medication would the PMHNP start? Which of the following is a true statement regarding the use of stimulants to treat attention deficit hyperactivity disorder (ADHD)? Mr. Peterson is meeting with the PMHNP to discuss healthier dietary habits. With a BMI of 33, Mr. Peterson is obese and needs to modify his food intake. “Sometimes I think I’m addicted to food the way some people are addicted to drugs,” he says. Which statement best describes the neurobiological parallels between food and drug addiction? A 72-year-old male patient is in the early stages of Alzheimer’s disease. The PMHNP determines that improving memory is a key consideration in selecting a medication. Which of the following would be an appropriate choice? A patient is prescribed D-methylphenidate, 10-mg extended-release capsules. What should the PMHNP include when discussing the side effects with the patient? nurs 6630 final exam 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? The PMHNP is assessing a patient who has expressed suicidal intent and is now stating that he is hearing voices and sees people chasing him. The PMHNP identifies these symptoms to be associated with which of the following? An 80-year-old female patient diagnosed with Stage II Alzheimer’s has a history of irritable bowel syndrome. Which cholinergic drug may be the best choice for treatment given the patient’s gastrointestinal problems? A 63-year-old patient presents with the following symptoms. The PMHNP determines which set of symptoms warrant prescribing a medication? Select the answer that is matched with an appropriate treatment. The PMHNP is caring for a patient with chronic insomnia who is worried about pharmacological treatment because the patient does not want to experience dependence. Which pharmacological treatment approach will the PMHNP likely select for this patient for a limited duration, while searching and correcting the underlying pathology associated with the insomnia? nurs 6630 final exam The PMHNP is performing a quality assurance peer review of the chart of another PMHNP. Upon review...

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The PMHNP is caring for a patient with fibromyalgia. Which second-line treatment does the PMHNP select that may be effective for managing this patient’s pain? The PMHNP is working with the student to care for a patient with diabetic peripheral neuropathic pain. The student asks the PMHNP why SSRIs are not consistently useful in treating this particular patient’s pain. What is the best response by the PMHNP? A patient is being …..bupropion and is concerned about the side effects. What will the PMHNP tell the patient regarding bupropion? The PMHNP prescribes an obese patient phentermine (Adipex-p)/topiramate ER (Topamax) (Qsymia), Why is topiramate (Topamax) often prescribed with phentermine (Adipex-P)? The PMHNP is performing a quality assurance peer review of the chart of another PMHNP. Upon review, the PMHNP reviews the chart of an older adult patient in long-term care facility who has chronic insomnia. NURS 6630 final Exam The chart indicates that the patient has been receiving hypnotics on a nightly basis. What does the PMHNP find problematic about this documentation? 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? A 9-year-old female patient presents with symptoms of both attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder. In evaluating her symptoms, the PMHNP determines that which of the following medications may be beneficial in augmenting stimulant medication? A patient with chronic insomnia and depression is taking trazodone (Oleptro) but complains of feeling drowsy during the day. What can the PMHNP do to reduce the drug’s daytime sedating effects? An opioid-naive patient is taking MS Contin (morphine sulfate) to treat his pain that is secondary to cancer. Under what circumstances would the PMHNP order naloxone (Narcan) IM/SQ? A 26-year-old female patient with nicotine dependence and a history of anxiety presents with symptoms of attention deficit hyperactivity disorder (ADHD). Based on the assessment, what does the PMHNP consider? The PMHNP prescribes gabapentin (Neurontin) for a patient’s chronic pain. How does the PMHNP anticipate the drug to work? Kevin is an adolescent who has been diagnosed with kleptomania. His parents are interested in seeking pharmacological treatment. What does the PMHNP tell the parents regarding his treatment options? 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. Nurs 6630 final exam What is the PMHNP most likely to do? Why does the PMHNP avoid prescribing clozapine (Clozaril) as a first-line treatment to the patient with psychosis and aggression? A patient with gambling disorder and no other psychiatric comorbidities is being treated with pharmacological agents. Which drug is the PMHNP most likely to prescribe? Which statement best describes a pharmacological approach to treating patients for impulsive aggression? The PMHNP understands that bupropion (Wellbutrin) is an effective way to assist patients with smoking cessation. Why is this medication effective for these patients? A patient with irritable bowel syndrome reports chronic stomach pain. NURS 6630 final exam The PMHNP wants to prescribe the patient an agent that will cause irrelevant nociceptive inputs from the pain to be ignored and no longer perceived as painful. Which drug will the PMHNP prescribe? Mr. Peterson is meeting with the PMHNP to discuss healthier dietary habits. With a BMI of 33, Mr. Peterson is obese and needs to modify his food intake. “Sometimes I think I’m addicted to food the way some people are addicted to drugs,” he says. Which statement best describes the neurobiological parallels between food and drug addiction? Parents of a 12-year-old boy want to consider attention deficit hyperactivity disorder (ADHD) me...

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The PMHNP is caring for a patient with fibromyalgia. Which second-line treatment does the PMHNP select that may be effective for managing this patient’s pain? The PMHNP is working with the student to care for a patient with diabetic peripheral neuropathic pain. The student asks the PMHNP why SSRIs are not consistently useful in treating this particular patient’s pain. What is the best response by the PMHNP? A patient is being …..bupropion and is concerned about the side effects. What will the PMHNP tell the patient regarding bupropion? The PMHNP prescribes an obese patient phentermine (Adipex-p)/topiramate ER (Topamax) (Qsymia), Why is topiramate (Topamax) often prescribed with phentermine (Adipex-P)? The PMHNP is performing a quality assurance peer review of the chart of another PMHNP. Upon review, the PMHNP reviews the chart of an older adult patient in long-term care facility who has chronic insomnia. NURS 6630 final Exam The chart indicates that the patient has been receiving hypnotics on a nightly basis. What does the PMHNP find problematic about this documentation? 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? A 9-year-old female patient presents with symptoms of both attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder. In evaluating her symptoms, the PMHNP determines that which of the following medications may be beneficial in augmenting stimulant medication? A patient with chronic insomnia and depression is taking trazodone (Oleptro) but complains of feeling drowsy during the day. What can the PMHNP do to reduce the drug’s daytime sedating effects? An opioid-naive patient is taking MS Contin (morphine sulfate) to treat his pain that is secondary to cancer. Under what circumstances would the PMHNP order naloxone (Narcan) IM/SQ? A 26-year-old female patient with nicotine dependence and a history of anxiety presents with symptoms of attention deficit hyperactivity disorder (ADHD). Based on the assessment, what does the PMHNP consider? The PMHNP prescribes gabapentin (Neurontin) for a patient’s chronic pain. How does the PMHNP anticipate the drug to work? Kevin is an adolescent who has been diagnosed with kleptomania. His parents are interested in seeking pharmacological treatment. What does the PMHNP tell the parents regarding his treatment options? 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. Nurs 6630 final exam What is the PMHNP most likely to do? Why does the PMHNP avoid prescribing clozapine (Clozaril) as a first-line treatment to the patient with psychosis and aggression? A patient with gambling disorder and no other psychiatric comorbidities is being treated with pharmacological agents. Which drug is the PMHNP most likely to prescribe? Which statement best describes a pharmacological approach to treating patients for impulsive aggression? The PMHNP understands that bupropion (Wellbutrin) is an effective way to assist patients with smoking cessation. Why is this medication effective for these patients? A patient with irritable bowel syndrome reports chronic stomach pain. NURS 6630 final exam The PMHNP wants to prescribe the patient an agent that will cause irrelevant nociceptive inputs from the pain to be ignored and no longer perceived as painful. Which drug will the PMHNP prescribe? Mr. Peterson is meeting with the PMHNP to discuss healthier dietary habits. With a BMI of 33, Mr. Peterson is obese and needs to modify his food intake. “Sometimes I think I’m addicted to food the way some people are addicted to drugs,” he says. Which statement best describes the neurobiological parallels between food and drug addiction? Parents of a 12-year-old boy want to consider attention deficit hyperactivity disorder (ADHD) me...

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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). Which statement about neurotransmitters and medications is true? When an unstable patient asks why it is necessary to add medications to his current regimen, the PMHNP’s best response would be: During gene expression, what must occur prior to a gene being expressed? While genes have potential to modify behavior, behavior can also modify genes. How do genes impact this process? Though medications have the ability to target neurotransmitters in the synapse, it is not always necessary. The PMHNP understands that this is because: Why is the cytochrome P450 enzyme system of significance to the PMHNP? 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? As it relates to G-protein linked receptors, what does the PMHNP understand about medications that are used in practice? 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: 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 Nurs 6630 Midterm exam 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). Which is the best action for the PMHNP to take for this patient? 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 as this? The PMHNP is caring for four patients. Which patient statement indicates that benzodiazepines would be beneficial? Harlow is a 42-year-old patient who is prescribed a drug that acts on ionotropic receptors. She is curious about the effects of the drug and how it will act on her symptoms. Which statement made by the PMHNP demonstrates proper understanding of Ms. Harlow’s prescription? A patient is seeking pharmacological treatment for smoking cessation. Which drug class does the PMHNP prescribe to the patient? The PMHNP is caring for a new patient who has been transferred from another office. When meeting with the new patient, the patient reports, “I feel like I am improving with the stabilizers.” The PMHNP immediately recognizes that the patient is describing which kind of drug? A patient presents with frequent episodes of mania. Which statement describes an appropriate treatment approach for this patient? The PHMNP is caring for a patient who would benefit from nicotine cholinergic, serotonin 3, or glycine receptors. What kind of agent does the PHMNP want to prescribe for this patient? Which statement ….by the patient suggests the patient will need to be treated with antipsychotics that target paranoid psychosis? A patient has been treated with a number of novel psychotropic drugs. How is it theoretically possible to identify cognitive improvement in the patient using neuropsychological assessment batteries after the pharmacologic therapy? McCullin is 64 years old with Parkinson’s disease. The PMHNP caring for Mr. McCullin wants to start him on a dopamine agonist to help manage...

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A male patient is to begin glyburide (Diabeta) for type 2 diabetes. Before the drug therapy begins, a priority action by the nurse will be to assess the patient’s The nurse should assess the patient’s alcohol consumption before therapy is initiated. Concomitant alcohol use increases the rate of glyburide metabolism and may cause a disulfiram-like reaction. Even though the patient’s blood pressure should be assessed, it is not as important as making sure that the patient is aware of the serious reaction that alcohol can cause while on glyburide. The amount of salt used in the patient’s diet is important as well as the patient’s potassium level, but not specifically in relation to the use of glyburide. The nurse will monitor alanine aminotransferase and total bilirubin levels, because a serious adverse effect of dantrolene is drug-induced hepatitis. The nurse will also educate the patient and family concerning signs and symptoms of hepatitis. Prothrombin time and partial thromboplastin time would be monitored for someone taking an anticoagulant, not for someone taking dantrolene. Urine specific gravity is part of a urinalysis and would be used to assess urinary function, which is not affected by dantrolene use. Follicle-stimulating hormone level is important to the female reproductive system and would not be assessed in a male. If the pulse rate is greater than 100 bpm, it is necessary to withhold a levothyroxine dose in an older adult. Anorexia, recent vaccination, and recent falls do not necessary indicate a need to withhold this medication. Dantrolene causes weakness because of its generalized reduction of muscle contraction. It is not associated with drug dependence, hyperglycemia, hypoglycemia, or hallucinations. Gabapentin is not metabolized and is excreted unchanged in the urine. Therefore, it is important to monitor renal function. Hepatic, cardiac, and respiratory functions are not compromised with this drug. Subcutaneous insulin therapy for type 1 diabetes frequently consists of daily injections of mixtures of short-acting regular insulin with intermediate-acting insulins; multiple doses of regular insulin before each meal in association with one or two daily doses of long-acting insulin may also be used. Frequent, fixed doses of rapid-acting or intermediate-acting insulin may result in unsafe blood sugar levels. The nurse should ask the patient to report immediately if he notices decreased cardiac rate, intolerance to cold, or weight gain. These are indications of hypothyroidism resulting from antithyroid therapy, and if the medication is continued unchanged, insidious goitrogenic hypothyroidism may occur. Vertigo, drowsiness, loss of appetite, and epigastric distress are possible adverse effects of the therapy but would not pr...

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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). 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? Which statement about neurotransmitters and medications is true? When an unstable patient asks why it is necessary to add medications to his current regimen, the PMHNP’s best response would be: During gene expression, what must occur prior to a gene being expressed? While genes have potential to modify behavior, behavior can also modify genes. How do genes impact this process? 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: Why is the cytochrome P450 enzyme system of significance to the PMHNP? 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? As it relates to G-protein linked receptors, what does the PMHNP understand about medications that are used in practice? 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: 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: 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? 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 as this? The PMHNP is caring for four patients. Which patient statement indicates that benzodiazepines would be beneficial? Ms. Harlow is a 42-year-old patient who is prescribed a drug that acts on ionotropic receptors. She is curious about the effects of the drug and how it will act on her symptoms. Which statement made by the PMHNP demonstrates proper understanding of Ms. Harlow’s prescription? A patient is seeking pharmacological treatment for smoking cessation. Which drug class does the PMHNP prescribe to the patient? The PMHNP is caring for a new patient who has been transferred from another office. When meeting with the new patient, the patient reports, “I feel like I am improving with the stabilizers.” The PMHNP immediately recognizes that the patient is describing which kind of drug? A patient presents with frequent episodes of mania. Which statement describes an appropriate treatment approach for this patient? What characteristics do the nicotinic, cholinergic, serotonin 3, and glycine receptors all have in common? Which statement made by the patient suggests the patient will need to be treated with antipsychotics that target paranoid psychosis? Mr. McCullin is 64 years old with Parkinson’s disease. The PMHNP caring for Mr. McCullin wants to start him on a dopamine agonist to help manage ...

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During assessment a patient states “Why are you asking me about my heart, I am here for my head”, the PMHNP’s best response is: During gene expression, what must occur prior to a gene being expressed? The PMNHP is assessing a 29-year-old client who takes antipsychotics that block D2 receptors. This client has begun to develop a common side effect of this medication. What is this side effect? After ordering flumazenil (Rumazicon) the PMHNP cautions the staff to monitor for which possible effect? A patient is prescribed 50 mg of desvenlafaxine to take every other day for major depressive disorder. What does the PMHNP understand about this patient? A patient is prescribed sertraline to treat panic disorder. Knowing that sertraline can initially cause anxiety or insomnia, what should the PMHNP do? 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: A patient is diagnosed with schizophrenia. What increases the patient’s potential to mediate the cognitive symptoms of the disease? The PMHNP spends a session with a client and notices behaviors correlating with a potential manic episode. All of the following are possible manic symptoms the PMHNP could observe except: A patient who is prescribe MAO inhibitors asks about whether he can continue taking pseudoephedrine to relieve his congestion. Which response by the PMHNP indicates proper understanding of drug-drug interactions? Fluoxetine (Prozac) has been prescribe for a client with depression. Which of the following statements is true regarding the action of this medication? A patient was diagnose with GAD 4 weeks ago and was placed on Clonazepam (klonopin) twice a day and citalopram (citalopram (celexa)) once daily. When he asks the PMHNP why it is necessary to wean him off of the Clonazepam (klonopin) the best response is: Ms. Skidmore presents for a follow-up appointment after being prescribe phenelzine (Nardil), and reports “I take my 45 mg pill, three times a day, just like I’m supposed to.” What does the PMHNP understand about this patient? A patient diagnosed with PTSD is prescribe propranolol (Inderal) and the PMHNP understands that he was prescribed this medication for what purpose: What characteristics do the nicotinic, cholinergic, serotonin 3, and glycine receptors all have in common? A patient who was prescribe an MAO inhibitor is learning about dietary modifications. Which statement made by the PMHNP demonstrates proper teaching of the food-drug interactions for MAO inhibitors? When an unstable patient asks why it is necessary to add medications to his current regimen, the PMHNP’s best response would be: A patient is being prescribe a sedating antidepressant, but is ….about weight gain. Which medication is most likely to be prescribe to addresses the patient’s concerns? A nurse overhears that a patient has failed single therapy with an SSRI and SNRI. She also learns that the patient has been on dual SSRI/SNRI therapy without adequate symptom control. She approaches the PMHNP and asks what the next treatment option could be in this seemingly treatment-resistant patient. The PMHNP tells the nurse she will treat the patient with the following regimen: Mr. Gordon is a middle-aged patient who is taking antipsychotics. When meeting with the PMHNP, he reports positive responses to the medication, stating, “I really feel as though the effects of my depression are going away.” Which receptor action in antipsychotic medications is believed to be the most beneficial in producing the effects described by Mr. Gordon? A patient is seeking pharmacological treatment for smoking cessation. Which drug class does the PMHNP prescribe to the patient? A 45 year old female client with allergic rhinitis and normal blood pressure has had no reduction in depressive symptoms after trying bupropion, paroxeti...

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When an unstable patient asks why it is necessary to add medications to his current regimen, the PMHNP’s best response would be: The PMHNP is meeting with a new mother who would like to begin taking medication again to treat her bipolar depression; she is breastfeeding her 2-month old daughter. The PMHNP recognizes that which of the following medications is contraindicated for this patient? Mr. Gordon is a middle-aged client who was started on antidepressant monotherapy for depression. After beginning this medication, the PMHNP noticed that this client seemed to swing into a hypomanic episode. What can the PMHNP infer from this behavior change? A patient presents with frequent episodes of mania. Which statement describes an appropriate treatment approach for this patient? The student inquires about antipsychotic medications. Which response by the PMHNP describes the factors that contribute to reduced risk of extrapyramidal symptoms (EPS) for patients who take antipsychotics? After ordering flumazenil (Rumazicon) the PMHNP cautions the staff to monitor for which possible effect? The PMHNP is caring for a patient who is taking antipsychotics heard the psychiatrist tell the patient that the patient would be placed on a different antipsychotic agent called an atypical antipsychotic. What neurotransmitters will this new medication work on? While genes have potential to modify behavior, behavior can also modify genes. How do genes impact this process? Mrs. Schwartzman is a 52-year-old client with schizophrenia and no established history of depression. When meeting with the PMHNP, she presents with apathy and withdrawn social behavior, and she reports a loss of joy from enjoyable activities since starting her new medication. What does the PMHNP infer from this encounter with the client? A nursing student is seeking clarification on the use of anticonvulsants to treat depression and is unclear about most effective outcomes. Which of the following agents does the PMHNP convey as having uncertain outcomes? As it relates to G-protein linked receptors, what does the PMHNP understand about medications that are used in practice? A patient is seeking pharmacological treatment for smoking cessation. Which drug class does the PMHNP prescribe to the patient? The PMHNP is caring for a patient with schizophrenia and is considering a variety of treatment approaches. The PHMNP selects a viable treatment that is consistent with the “dopamine hypothesis of schizophrenia.” What action does the PMHNP anticipate this treatment having on the patient? 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: A patient is being prescribed a sedating antidepressant, but is concerned about weight gain. Which medication is most likely to be prescribed to addresses the patient’s concerns? The PMHNP is caring for several patients who present with various symptoms and health issues. For which patient does the PMHNP prescribe pregabalin (Lyrica)? Which statement about neurotransmitters and medications is true? A patient is prescribed 50 mg of desvenlafaxine to take every other day for major depressive disorder. What does the PMHNP understand about this patient? 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 as this? A patient who was prescribed an MAO inhibitor is learning about dietary modifications. Which statement made by the PMHNP demonstrates proper teaching of the food-drug interactions for MAO inhibitors? The PMHNP evaluates the patient for “fear conditioning” when he asks: The PMHNP recognizes that which patient would be contraindicated for antidepressant monotherapy? When completing this exam, did you comply with Walden University’s...

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When an unstable patient asks why it is necessary to add medications to his current regimen, the PMHNP’s best response would be: The PMHNP is meeting with a new mother who would like to begin taking medication again to treat her bipolar depression; she is breastfeeding her 2-month old daughter. The PMHNP recognizes that which of the following medications is contraindicated for this patient? Mr. Gordon is a middle-aged client who was started on antidepressant monotherapy for depression. After beginning this medication, the PMHNP noticed that this client seemed to swing into a hypomanic episode. What can the PMHNP infer from this behavior change? A patient presents with frequent episodes of mania. Which statement describes an appropriate treatment approach for this patient? The student inquires about antipsychotic medications. Which response by the PMHNP describes the factors that contribute to reduced risk of extrapyramidal symptoms (EPS) for patients who take antipsychotics? After ordering flumazenil (Rumazicon) the PMHNP cautions the staff to monitor for which possible effect? The PMHNP is caring for a patient who is taking antipsychotics heard the psychiatrist tell the patient that the patient would be placed on a different antipsychotic agent called an atypical antipsychotic. What neurotransmitters will this new medication work on? While genes have potential to modify behavior, behavior can also modify genes. How do genes impact this process? Mrs. Schwartzman is a 52-year-old client with schizophrenia and no established history of depression. When meeting with the PMHNP, she presents with apathy and withdrawn social behavior, and she reports a loss of joy from enjoyable activities since starting her new medication. What does the PMHNP infer from this encounter with the client? A nursing student is seeking clarification on the use of anticonvulsants to treat depression and is unclear about most effective outcomes. Which of the following agents does the PMHNP convey as having uncertain outcomes? As it relates to G-protein linked receptors, what does the PMHNP understand about medications that are used in practice? A patient is seeking pharmacological treatment for smoking cessation. Which drug class does the PMHNP prescribe to the patient? The PMHNP is caring for a patient with schizophrenia and is considering a variety of treatment approaches. The PHMNP selects a viable treatment that is consistent with the “dopamine hypothesis of schizophrenia.” What action does the PMHNP anticipate this treatment having on the patient? 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: A patient is being prescribed a sedating antidepressant, but is concerned about weight gain. Which medication is most likely to be prescribed to addresses the patient’s concerns? The PMHNP is caring for several patients who present with various symptoms and health issues. For which patient does the PMHNP prescribe pregabalin (Lyrica)? Which statement about neurotransmitters and medications is true? A patient is prescribed 50 mg of desvenlafaxine to take every other day for major depressive disorder. What does the PMHNP understand about this patient? 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 as this? A patient who was prescribed an MAO inhibitor is learning about dietary modifications. Which statement made by the PMHNP demonstrates proper teaching of the food-drug interactions for MAO inhibitors? The PMHNP evaluates the patient for “fear conditioning” when he asks: The PMHNP recognizes that which patient would be contraindicated for antidepressant monotherapy? When completing this exam, did you comply with Walden University’s...

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When an unstable patient asks why it is necessary to add medications to his current regimen, the PMHNP’s best response would be: The PMHNP is meeting with a new mother who would like to begin taking medication again to treat her bipolar depression; she is breastfeeding her 2-month old daughter. The PMHNP recognizes that which of the following medications is contraindicated for this patient? Mr. Gordon is a middle-aged client who was started on antidepressant monotherapy for depression. After beginning this medication, the PMHNP noticed that this client seemed to swing into a hypomanic episode. What can the PMHNP infer from this behavior change? A patient presents with frequent episodes of mania. Which statement describes an appropriate treatment approach for this patient? The student inquires about antipsychotic medications. Which response by the PMHNP describes the factors that contribute to reduced risk of extrapyramidal symptoms (EPS) for patients who take antipsychotics? After ordering flumazenil (Rumazicon) the PMHNP cautions the staff to monitor for which possible effect? The PMHNP is caring for a patient who is taking antipsychotics heard the psychiatrist tell the patient that the patient would be placed on a different antipsychotic agent called an atypical antipsychotic. What neurotransmitters will this new medication work on? While genes have potential to modify behavior, behavior can also modify genes. How do genes impact this process? Mrs. Schwartzman is a 52-year-old client with schizophrenia and no established history of depression. When meeting with the PMHNP, she presents with apathy and withdrawn social behavior, and she reports a loss of joy from enjoyable activities since starting her new medication. What does the PMHNP infer from this encounter with the client? A nursing student is seeking clarification on the use of anticonvulsants to treat depression and is unclear about most effective outcomes. Which of the following agents does the PMHNP convey as having uncertain outcomes? As it relates to G-protein linked receptors, what does the PMHNP understand about medications that are used in practice? A patient is seeking pharmacological treatment for smoking cessation. Which drug class does the PMHNP prescribe to the patient? The PMHNP is caring for a patient with schizophrenia and is considering a variety of treatment approaches. The PHMNP selects a viable treatment that is consistent with the “dopamine hypothesis of schizophrenia.” What action does the PMHNP anticipate this treatment having on the patient? 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: A patient is being prescribed a sedating antidepressant, but is concerned about weight gain. Which medication is most likely to be prescribed to addresses the patient’s concerns? The PMHNP is caring for several patients who present with various symptoms and health issues. For which patient does the PMHNP prescribe pregabalin (Lyrica)? Which statement about neurotransmitters and medications is true? A patient is prescribed 50 mg of desvenlafaxine to take every other day for major depressive disorder. What does the PMHNP understand about this patient? 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 as this? A patient who was prescribed an MAO inhibitor is learning about dietary modifications. Which statement made by the PMHNP demonstrates proper teaching of the food-drug interactions for MAO inhibitors? The PMHNP evaluates the patient for “fear conditioning” when he asks: The PMHNP recognizes that which patient would be contraindicated for antidepressant monotherapy? When completing this exam, did you comply with Walden University’s...

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Question 1 If a patient is being managed for chronic pain and is not getting better after months of therapy with multiple agents (i.e., NSAIDs with opioids, muscle relaxants with NSAIDs, etc.), what should be your next step in helping the patient? I. Add a high-dose opioid if patient is not already o...

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NURS 6630 Final Exam,NURS 6630 Midterm Exam / NURS6630 Final Exam,NURS6630 Midterm Exam / ...

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QUESTION 1 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? A. Stimulants B. Antidepressants C. Antipsychotics D. SSRIs QUESTION 2 The PMHNP is selecting a medication treatment option for a patient who is exhibiting psyc...

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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 Answer: C. “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 Answer: B. Agitation  Question 3 0 out of 1 points Which statement about neurotransmitters and medications is true? Selected Answer: D. An imbalance of serotonin has been directl...

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