PMHNP NU 670 Advanced Psychopharmacology & Health Promotion: Finals Review Q&A, Exams of Nursing

Download PMHNP NU 670 Advanced Psychopharmacology & Health Promotion: Finals Review Q&A and more Exams Nursing in PDF only on Docsity!

PMHNP NU 670

Advanced Psychopharmacology &

Health Promotion

LATEST FINALS REVIEW

Q & S

1. Which of the following neurotransmitters is primarily targeted by SSRIs?
   • a) Dopamine
   • b) Glutamate
   • c) Serotonin
   • d) Norepinephrine
   • Correct Answer : c) Serotonin
     • Rationale: SSRIs, or Selective Serotonin Reuptake Inhibitors, are designed to increase serotonin levels in the brain by inhibiting its reuptake.
2. Which of the following medications is considered a first-line treatment for bipolar disorder?
   • a) Fluoxetine
   • b) Lithium
   • c) Haloperidol
   • d) Clonazepam
   • Correct Answer : b) Lithium

• Rationale: Olanzapine is known to have a higher risk of causing weight gain, dyslipidemia, and Type 2 diabetes, making it highly associated with metabolic syndrome.

5. A patient with Major Depressive Disorder is being treated with a monoamine oxidase inhibitor (MAOI). Which of the following foods must be avoided to prevent a hypertensive crisis?

• a) Bananas
• b) Aged cheese
• c) Whole grain bread
• d) Apples
• Correct Answer : b) Aged cheese
• Rationale: MAOIs prevent the breakdown of tyramine, which is found in aged cheeses and can lead to dangerous increases in blood pressure. Fill-in-the-Blank Questions

6. The therapeutic plasma concentration range for lithium is typically __________ to __________ mEq/L.

• Correct Answer : 0.6 to 1.2 mEq/L
• Rationale: Maintaining lithium levels within this range is crucial for efficacy while minimizing the risk of toxicity.

7. The atypical antipsychotic __________ is approved for the treatment of bipolar depression.
   • Correct Answer : Quetiapine
     • Rationale: Quetiapine is one of the few atypical antipsychotics with FDA approval for bipolar depression.
8. Venlafaxine is an antidepressant that is classified as a __________ and __________ reuptake inhibitor.
   • Correct Answer : Serotonin and Norepinephrine
     • Rationale: Venlafaxine acts by inhibiting the reuptake of both serotonin and norepinephrine, categorizing it as an SNRI.
9. Long-term use of antipsychotics can lead to a condition characterized by repetitive, involuntary movements called __________.
   • Correct Answer : Tardive Dyskinesia
     • Rationale: Tardive dyskinesia is a serious, often irreversible side effect associated with prolonged antipsychotic use.
10. Clozapine is known for its efficacy in treatment-resistant schizophrenia but requires regular monitoring due to the risk of __________.

• Rationale: Most benzodiazepines are metabolized hepatically via oxidation, although specific pathways can vary.

14. True or False: Bupropion is contraindicated in patients with a history of seizures.

• Correct Answer : True
• Rationale: Bupropion lowers the seizure threshold, increasing the risk of convulsions in susceptible individuals.

15. True or False: Second-generation antipsychotics are entirely free from extrapyramidal side effects.

• Correct Answer : False
• Rationale: While second-generation antipsychotics tend to have a lower risk compared to first-generation ones, they are not free from extrapyramidal side effects. Multiple Response Questions

16. Which of the following are common side effects of TCAs (Tricyclic Antidepressants)? Select all that apply.

• a) Sedation
• b) Orthostatic hypotension
• c) Urinary retention

• d) Weight loss
• Correct Answer : a) Sedation, b) Orthostatic hypotension, c) Urinary retention
• Rationale: TCAs commonly cause sedation, orthostatic hypotension, and anticholinergic effects such as urinary retention.

17. Which medications are appropriate for use in treating generalized anxiety disorder? Select all that apply.

• a) Alprazolam
• b) Buspirone
• c) Phenelzine
• d) Duloxetine
• Correct Answer : a) Alprazolam, b) Buspirone, d) Duloxetine
• Rationale: Alprazolam is a benzodiazepine, Buspirone is an anxiolytic, and Duloxetine is an SNRI, all of which can be effective in treating anxiety.

18. A patient is experiencing extrapyramidal symptoms (EPS) from antipsychotic medication. Which interventions can help manage these symptoms? Select all that apply.

• a) Administer diphenhydramine
• b) Lower the dose of the antipsychotic

• c) Hypertension
• d) Alcohol use disorder
• Correct Answer : a) Bulimia, b) Epilepsy
  • Rationale: Bupropion is contraindicated in bulimia and epilepsy due to increased risk of seizures. Additional Questions

21. Which neurotransmitter's reuptake is specifically inhibited by atomoxetine, making it useful in the treatment of ADHD?

• a) Serotonin
• b) Norepinephrine
• c) Dopamine
• d) Acetylcholine
• Correct Answer : b) Norepinephrine
• Rationale: Atomoxetine is a norepinephrine reuptake inhibitor used in ADHD management.

22. A patient taking clozapine must have regular blood draws primarily to monitor which blood parameter?

• a) White blood cell (WBC) count
• b) Hemoglobin

• c) Platelets
• d) Lymphocytes
• Correct Answer : a) White blood cell (WBC) count
  • Rationale: Clozapine can cause agranulocytosis, necessitating regular monitoring of WBC count.

23. Which of the following medications has a risk of causing the 'cheese effect' with MAOIs?

• a) Levodopa
• b) Amphetamines
• c) Beta-blockers
• d) ACE inhibitors
• Correct Answer : a) Levodopa
• Rationale: Levodopa can significantly increase blood pressure if used with MAOIs, causing hypertensive crises known as the 'cheese effect.'

24. The reuptake of which neurotransmitter is modulated by the antidepressant class SNRIs, besides serotonin?

• Correct Answer : Norepinephrine
• Rationale: Serotonin-Norepinephrine Reuptake Inhibitors target both serotonin and norepinephrine to alleviate symptoms of depression.

• Rationale: Stimulant medications, such as amphetamines, primarily increase dopaminergic activity, which is beneficial in managing ADHD symptoms.

28. Choose the antipsychotics that significantly prolong the QT interval. Select all that apply.

• a) Ziprasidone
• b) Clozapine
• c) Quetiapine
• d) Thioridazine
• Correct Answer : a) Ziprasidone, d) Thioridazine
• Rationale: Both Ziprasidone and Thioridazine are known to prolong the QT interval and can increase the risk of arrhythmias.

29. In pediatric populations, which medication is most commonly prescribed for the management of obsessive- compulsive disorder?

• Correct Answer : Sertraline
• Rationale: Sertraline, an SSRI, is one of the few medications approved for treating OCD in children.

30. Which atypical antipsychotic also acts as a partial agonist at 5 - HT1A receptors, contributing to its efficacy?

• Correct Answer : Aripiprazole
  • Rationale: Aripiprazole's action on 5-HT1A receptors, along with dopamine D2 modulation, contributes to its therapeutic effects in bipolar disorder and schizophrenia. Question: A 72-year-old patient with a history of depression and anxiety presents with new-onset insomnia and agitation. Which of the following medications is most likely to be contributing to these symptoms? a) Sertraline b) Trazodone c) Amitriptyline d) Bupropion Answer : c) Amitriptyline Rationale: Amitriptyline is a tricyclic antidepressant known to cause anticholinergic side effects, including insomnia and agitation, especially in older adults. Question: A 25-year-old patient with bipolar disorder is experiencing a manic episode. Which of the following medications is the most appropriate first-line treatment?

Rationale: Stimulants like methylphenidate can cause insomnia, especially when taken later in the day. Fill-in-the-Blank: Question: __ is a common side effect of antipsychotic medications that can manifest as involuntary movements of the tongue, face, and limbs. Answer : Tardive dyskinesia Question: The __ is a measure used to assess the severity of depression symptoms. Answer : Hamilton Depression Rating Scale (HDRS) True/False: Question: Benzodiazepines are the first-line treatment for generalized anxiety disorder.

Answer : False Rationale: While benzodiazepines can be effective for short- term relief, they are not recommended as first-line treatment due to their addictive potential and risk of tolerance. Question: Selective serotonin reuptake inhibitors (SSRIs) are generally considered safe for use during pregnancy. Answer : False Rationale: While some SSRIs are considered safer than others, all antidepressants carry a risk of complications during pregnancy. Multiple Response: Question: Which of the following medications are used to treat obsessive-compulsive disorder (OCD)? a) Fluoxetine b) Clomipramine c) Risperidone

insipidus. Seizures are not a common side effect of lithium therapy. Multiple Choice: Question: A patient with schizophrenia is experiencing auditory hallucinations and disorganized thinking. Which of the following medications is most likely to be prescribed? a) Fluoxetine b) Haloperidol c) Lorazepam d) Bupropion Answer : b) Haloperidol Rationale: Haloperidol is a typical antipsychotic medication commonly used to treat the positive symptoms of schizophrenia, such as hallucinations and delusions. Question: A patient with panic disorder is experiencing frequent panic attacks. Which of the following medications is most likely to be prescribed?

a) Amitriptyline b) Venlafaxine c) Alprazolam d) Lithium Answer : c) Alprazolam Rationale: Alprazolam is a benzodiazepine commonly used for the acute treatment of panic attacks. Question: A patient with major depressive disorder is experiencing significant sleep disturbances. Which of the following medications is most likely to be prescribed to improve sleep? a) Trazodone b) Mirtazapine c) Bupropion d) Escitalopram Answer : a) Trazodone