PMHNP Psychopharm Exam 7 2024
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
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 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 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 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?
