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A patient who has been drinking a six-pack of beer each night to relax after work has been having trouble staying asleep through the night. When she wakes up at 2 am she takes diphenhydramine 25 mg to help her fall back asleep, but this makes her sleep through the alarm clock and late for work. She also reports having a headache through midmorning until she gets her second cup of coffee. She thinks this is related to her alcohol use and has unsuccessfully tried to cut down several times in the past year. Which of the following disorders best describes this patient's condition?
A 30 y/o male who was started on sertraline for generalized anxiety disorder was also started on lorazepam 1 mg for sleep during the first 2 weeks as he was adjusting to the medication. At the 2 week follow-up visit his psychiatrist increased the sertraline, but the dose of lorazepam does not seem to be helping with sleep and the patient is requesting a high dose. Which of the following best describes the patient's condition? A. Dependence B. Addiction C. Tolerance D. Withdrawal - C. Tolerance
A patient is complaining of chronic back pain and requests a refill of his oxycodone prescription because the pain is so bad he becomes suicidal. As a result, his primary care provider referred him to the PMHNP. The patient states he can tell if he is late taking his next dose by even 1 hour in as he becomes very anxious, restless, irritable and begins sweating. he states that he is so worried about having pain attacks that much of his day is spent waiting to take the next dose. When he runs out of his medication between visits he buys some from his friend. Which of the following best describes the patient's condition? A. Dependence B. Addiction C. Tolerance D. Withdrawal - B. Addiction
A patient who has required increasing amounts of medication to achieve the desired effect and develops withdrawal symptoms when dosing is delayed is said to be: A. Dependent B. Tolerant C. Addicted D. In withdrawal - A. Dependent
A 61 y/o married woman who has been sober from alcohol use disorder for 25 years relapsed 3 weeks ago. She reports drinking 1.5L of vodka and half a liter of scotch daily. On exam she is emotionally labile ranging from irritable to crying, slurring her words, bilateral upper extremity fine tremor. Vitals: blood pressure 150/100, heart rate 110, respiratory rate 18, SpO2 98% room air. She reports feeling nauseous, sweating, and moderately anxious. What is the primary concern for this patient? A. Alcohol use disorder B. Generalized anxiety disorder C. Alcohol withdrawal D. Delirium tremens - C. Alcohol withdrawal
PMHNP Psychopharm Exam 7 2024
A 34 y/o man is inattentive, dysphoric, disinhibited, with impaired memory and psychomotor retardation. All of the following drugs of abuse may cause these symptoms except: A. Alcohol B. Opioids C. Cannabis
A patient who has been sober for 20 years is anticipating some major life changes in the next 3 months and is very worried about relapse. Which of the following actions should the PMHNP? A. Refer that patient to Alcoholics Anonymous B. Assess his coping strategies C. Offer the patient naltrexone to be used in the Sinclair method D. Refer the patient to in-patient rehab - B. Assess his coping strategies
Which of the following medications is preferred for a 21 y/o male with a history of polysubstance use disorder and difficulty with medication adherence? A. Naltrexone 50 mg PO only when planning to use substances B. Naltrexone 50 mg PO daily C. Naltrexone 380 mg IM monthly D. Methadone maintenance - C. Naltrexone 380 mg IM monthly
A 43 y/o man is requesting medication-assisted treatment for addiction with Suboxone and wans to begin immediately to "get his life back". What should the PMHNP do first? A. Assess his current level and history of use B. Prescribe Suboxone 2mg SL daily to start now C. Provider psychoeducation regarding Suboxone maintenance D. Refer the patient to an inpatient detox facility - A. Assess his current level and history of use
The PMHNP is evaluating a 45 y/o man in the emergency department; he has no past psychiatric history and presents with passive suicidal ideations and emotional lability. Which of the following tests is essential in helping formulate a preliminary diagnosis and treatment plan? A. 12-lead EKG B. Urine toxicology C. Complete blood count D. Liver profile - B. Urine toxicology
The physiological process in which structural changes occur in the brain, increasing the likelihood of addiction over time and increasing the risk of relapse after a period of sobriety is called: A. Cognitive restructuring B. Neuroadaptation C. Neurogenesis D. Cerebral ischemia - B. Neuroadaptation
A. Alcohol use disorder B. Withdrawal syndrome C. Caffeine use disorder D. Insomnia - A. Alcohol use disorder
A patient who has been sober for 7 days struggles with cravings and is fearful of relapse. He reports taking naltrexone daily. What agent should the PMHNP prescribe to help reduce his cravings? A. Citalopram B. Disulfiram C. Buprenorphine D. Thiamine - A. Citalopram
A patient with familial fatty liver disease and elevated liver enzymes secondary to alcohol use disorder is admitted for detox. Which of the following benzodiazepines should not be used? A. Temazepam B. Lorazepam C. Oxazepam D. Chlordiazepoxide - D. Chlordiazepoxide
Which of the following substances would be most likely to cause withdrawal symptoms? A. Alprazolam B. Diazepam C. Clonazepam D. Chlordiazepoxide - A. Alprazolam
C. Intoxication D. Lapse - D. Lapse
