Psychopharmacology Exam Questions and Answers | Exams Nursing

PMHNP Psychopharm Exam 13 2024

In order to promote therapeutic drug effects, the Nurse Practitioner should always encourage

patients to - take their medication at the prescribed times.

A female patient with a diagnosis of type 1 diabetes mellitus has been experiencing

increasing neuropathic pain in recent months, a symptom that has not responded appreciably

to conventional analgesics. The patient's care provider has begun treatment with gabapentin

(Neurontin). How is the addition of this drug likely to influence the management of the

patient's existing drug regimen? - It is unlikely to influence the patient's other medications

because gabapentin does not interact with other drugs.

of the following assessment findings should an assisted living facility has begun taking daily

oral Following an assessment by her primary care provider, a 70-year-old resident of doses of

levothyroxine. Which prompt the nurse to withhold a scheduled dose of levothyroxine? - The

resident's apical heart rate is 112 beats/minute with a regular rhythm

processes protects the lower respiratory system? - Cilia sweep foreign material and mucus

upward toward the trachea and larynx where they can then be swallowed.

A 62-year-old man has been prescribed lovastatin. The Nurse Practitioner will instruct the

patient to take the medication - at bedtime.

A Nurse Practitioner who provides care for older adults is aware of the high incidence of drug

interactions in this population. When educating a group of seniors about the prevention of

drug interactions, the Nurse Practitioner should encourage them to - consult their care

provider before taking new over-the-counter medications.

A Nurse Practitioner is teaching an older adult patient about polypharmacy. Which of the

following statements best describe this term? - Taking several drugs simultaneously

A diabetic patient being treated for obesity tells the Nurse Practitioner that he is having

adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2

weeks as adjunct therapy. Which of the following adverse effects would need the Nurse

Practitioner's immediate attention? - Increased blood glucose

A 22 year old patient is transitioning from oral agents to insulin. He will be taking 20 units of

lantus at bedtime and regular insulin before meals. What instructions should the NP provide

about the timing and dose of regular insulin? - Take 1 unit of regular insulin for each 10

grams of carbohydrate to be consumed 15 minutes before each meal

decongestants should not be used chronically (>5 days) because they can cause - rebound

rhinitis/congestion

The parents of a 7-year-old boy who has just been diagnosed with allergic asthma are being

taught about their son's medication regimen by the nurse. The nurse is currently teaching the

parent's about the appropriate use of a "rescue drug" for acute exacerbations of their son's

asthma. What drug should the nurse suggests the parents to use in these situations? -

Albuterol

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PMHNP Psychopharm Exam 13 2024

In order to promote therapeutic drug effects, the Nurse Practitioner should always encourage patients to - take their medication at the prescribed times. A female patient with a diagnosis of type 1 diabetes mellitus has been experiencing increasing neuropathic pain in recent months, a symptom that has not responded appreciably to conventional analgesics. The patient's care provider has begun treatment with gabapentin (Neurontin). How is the addition of this drug likely to influence the management of the patient's existing drug regimen? - It is unlikely to influence the patient's other medications because gabapentin does not interact with other drugs. of the following assessment findings should an assisted living facility has begun taking daily oral Following an assessment by her primary care provider, a 70-year-old resident of doses of levothyroxine. Which prompt the nurse to withhold a scheduled dose of levothyroxine? - The resident's apical heart rate is 112 beats/minute with a regular rhythm processes protects the lower respiratory system? - Cilia sweep foreign material and mucus upward toward the trachea and larynx where they can then be swallowed. A 62-year-old man has been prescribed lovastatin. The Nurse Practitioner will instruct the patient to take the medication - at bedtime. A Nurse Practitioner who provides care for older adults is aware of the high incidence of drug interactions in this population. When educating a group of seniors about the prevention of drug interactions, the Nurse Practitioner should encourage them to - consult their care provider before taking new over-the-counter medications. A Nurse Practitioner is teaching an older adult patient about polypharmacy. Which of the following statements best describe this term? - Taking several drugs simultaneously A diabetic patient being treated for obesity tells the Nurse Practitioner that he is having adverse effects from his drug therapy. The patient has been taking dextroamphetamine for 2 weeks as adjunct therapy. Which of the following adverse effects would need the Nurse Practitioner's immediate attention? - Increased blood glucose A 22 year old patient is transitioning from oral agents to insulin. He will be taking 20 units of lantus at bedtime and regular insulin before meals. What instructions should the NP provide about the timing and dose of regular insulin? - Take 1 unit of regular insulin for each 10 grams of carbohydrate to be consumed 15 minutes before each meal decongestants should not be used chronically (>5 days) because they can cause - rebound rhinitis/congestion The parents of a 7-year-old boy who has just been diagnosed with allergic asthma are being taught about their son's medication regimen by the nurse. The nurse is currently teaching the parent's about the appropriate use of a "rescue drug" for acute exacerbations of their son's asthma. What drug should the nurse suggests the parents to use in these situations? - Albuterol

A 70-year-old woman with a history of atrial fibrillation takes digoxin and verapamil to control her health problem. Verapamil achieves a therapeutic effect by - blocking adrenergic receptors and producing antisympathetic effects. A patient receives 25 units of NPH insulin at 7.AM. At what time of day should the nurse advise the patient to be most alert for a potential hypoglycemic reaction? - Late afternoon A child with sinusitis has been on antibiotics for seven days and his symptoms are not improving., All of the following are options to prescribe for the patient now EXCEPT: - Amoxicillin/clavulanic acid The Nurse Practitioner's assessment of a community-dwelling adult suggests that the client may have drug allergies that have not been previously documented. What statement by the client would confirm this? - "I broke out in hives and got terribly itchy when I started a new prescription last year." A homeless man who is well known to care providers at the local hospital has been admitted to the emergency department after having a seizure outside a mall. The man is known to be a heavy alcohol user and is malnourished with a very low body mass index. How are this patient's characteristics likely to influence possible treatment with phenytoin? - The patient's protein deficit will likely increase the levels of the free drug in his blood. A patient has been prescribed a histamine-2 (H2) receptor antagonist for the treatment of GERD. Why are H2RAS more effective than H1 receptor antagonists in the treatment of diseases of the upper GI tract? - The parietal cells of the stomach have H2 receptors but not H1 receptors. A 24-year-old factory worker has been prescribed guaifenesin for the first time. Which of the following will be a priority assessment by the nurse before the patient's first dose? - The amount of alcohol consumption In light of her recent high blood pressure readings, a patient has been started on a thiazide diuretic and metoprolol (Lopressor), which is a beta-adrenergic blocker. What is the most likely rationale for using two medications to address the patient's hypertension? - Using the two drugs to treat a health problem may create a synergistic effect. A woman with numerous chronic health problems has been diagnosed with a benign gastric ulcer has begun treatment with ranitidine (Zantac). Which of the following teaching points should the nurse provide to this patient? - "Quitting smoking will significantly increase the chance that this drug will heal your ulcer." The APRN should educate a diabetic patient that beta blockers may mask the signs and symptoms of - hypoglycemia A patient has been prescribed a drug that can be self-administered at home. Which of the following would be the most important information for the nurse to relate to the patient concerning self-administration of a drug? - The therapeutic effects and possible adverse effects

should the Nurse Practitioner prioritize when planning this client's care? - Impaired Home Maintenance Management Mr. Nguyen, age 71, will soon be discharged home from the hospital after a successful coronary artery bypass graft (CABG). During patient education about his drug regimen, Mr. Nguyen's nurse should prioritize teach about - potential adverse effects of the drugs that Mr. Nguyen will be taking. A woman has a long history of seasonal allergies that are typically accompanied by rhinorrhea, red eyes, and frequent sneezing. Sneezes are a result of - a CNS reflex that is initiated by receptors in the nasal cavities. A 34-year-old male patient is prescribed methimazole (MMI). The Nurse Practitioner will advise him to report which of the following immediately? - Intolerance to cold A patient with a long history of alcohol abuse has been admitted to an acute medical unit with signs and symptoms of hepatic encephalopathy. His current medication orders include QID doses of oral lactulose. What desired outcomes should the nurse associate with this drug order? - Patient will have three to four loose bowel movements each day. The Nurse Practitioner is treating a patient that takes frequent doses of antacids for his heartburn and is also taking an enteric coded aspirin. What instructions should be provided to the patient? - The medications should be taken at least 2 hours apart. To minimize the risk of adverse effects of glucagon when given to an unconscious diabetic patient, as the patient regains consciousness, the nurse should - administer carbohydrates. An expected outcome for a patient who has just taken sublingual nitroglycerin should be - increased heart rate and decreased blood pressure. A 72-year-old man is taking Adderall XR for the treatment of narcolepsy. He is currently having problems with not being able to swallow large tablets or capsules. The man also wears dentures, which makes it even more difficult for him to swallow medication. He is in the clinic to talk to the nurse about his problem. The nurse will instruct him to - open the capsule and sprinkle the beads in applesauce. Mrs. Houston is a 78-year-old woman who resides in an assisted living facility. Her doctor prescribed digoxin at her last visit to the clinic and she has approached the nurse who makes regular visits to the assisted-living facility about this new drug. What teaching point should the nurse emphasize to Mrs. Houston? - The importance of having required laboratory work performed on time What critical piece of information is missing from the following medication order: Amoxicillin 250 mg every 8 hours? - Route 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 - use of alcohol. The Nurse Practitioner is performing patient education for a woman who will soon the Nurse Practitioner if there are any "bad side effects" that she should be aware begin treatment of

hyperlipidemia with simvastatin (Zocor). The patient has asked of. Which of the following statements should underlie the nurse's response? - Most patients tolerate statins well, with minor muscle aches being among the most common adverse effects. A 66-year-old woman has a complex medical history that includes poorly- controlled type 1 diabetes, renal failure as a result of diabetic nephropathy and chronic heart failure (CHF). Her care provider has recently added spironolactone (Aldactone) to the woman's medication regimen. The nurse should consequently assess for signs and symptoms of - hyperkalemia. A Nurse Practitioner is caring for a 70-year-old patient who is taking desmopressin (DDAVP). The patient has a history of cardiovascular disease. The nurse will prioritize the assessment of which of the following? - Electrolyte levels A Nurse Practitioner is providing care for a patient who suffered extensive burns to his extremities during a recent industrial accident. Topical lidocaine gel has been ordered to be applied to the surfaces of all his burns in order to achieve adequate pain control. When considering this order, the Nurse Practitioner should be aware that - there is a risk of systemic absorption of the lidocaine through the patient's traumatized skin. A Nurse Practitioner receives an order to administer a critically ill patient two drugs immediately (stat). The Nurse Practitioner begins the process by - consulting a drug guide for compatibility. A patient has been admitted to the ICU because of multiple traumas due to a motor vehicle accident. The physician has ordered propofol (Diprivan) to be used for maintenance of sedation. Before administration of propofol, a priority assessment by the nurse would be to check for a history of - seizure disorders. A female patient has been taking prednisone for her asthma for 1 month. The nurse will teach her to gradually decrease her dose of prednisone to avoid - adrenal insufficiency. A clinic Nurse Practitioner has been assigned a 49-year-old female patient who has a history of diabetes. A recent diagnosis of hypertension has been made, and the patient has been prescribed a thiazide diuretic and labetalol. The patient will be scheduled to return to the clinic once a month for the next 6 months. A priority action by the Nurse Practitioner will be to - monitor the patient's blood pressure. A patient has GERD and is taking ranitidine (Zantac). She continues to have gastric discomfort and asks whether she can take an antacid. Which of the following is an appropriate response by the nurse? - "Yes, but be sure to wait at least 2 hours to take the antacid after you take the ranitidine." Which of the following statements best defines how a chemical becomes termed a drug? - A chemical must have a proven therapeutic value or efficacy without severe toxicity or damaging properties to become a drug. A Nurse Practitioner is caring for a 73-year-old man who is receiving drug therapy. He is beginning to exhibit signs of decline in his renal system, yet his current serum creatinine level is normal. The Nurse Practitioner will base the patient's plan of care on the understanding that there is - a decrease in the amount of creatinine to be filtered.

fever. The best form of Tylenol to give the child, considering her presentation, would be - suppository. A 20-year-old woman calls the clinic at 5 PM and reports to the Nurse Practitioner that she forgot to take her morning dose of fexofenadine (Allegra). She usually takes her evening dose at 8 PM. She wants to know what she should do. The Nurse Practitioner will instruct her to - forget about the morning dose and take the evening dose. A Nurse Practitioner is the cardiac care unit is preparing to hang an intravenous who has just been admitted. What is the dose of dofetilide (Tikosyn) for a patient most likely goal of this intervention? - To convert the patient's atrial fibrillation to normal sinus rhythm A patient in need of myocardial infarction sulfinpyrazone for gout. Which of the following most closely for? prophylaxis has been prescribed will the nurse monitor the patient - Bleeding A 33-year-old woman has irritable bowel syndrome (IBS). The physician has prescribed simethicone the nurse monitor most closely (Mylicon) for her discomfort. Which of the during the patient's drug therapy? following will - Increased abdominal pain and vomiting Which of the following is TRUE about long acting beta agonist use in asthma patients? - It can be combined with an inhaled corticosteroid to improve asthma control A 79-year-old woman with a medical history that includes osteoporosis has recently moved to a long-term care facility. Medication reconciliation indicates that the woman has been taking calcitonin, salmon for several years. The nurse should recognize that the most likely route for the administration of this drug is - intranasal. A 58-year-old man is prescribed dicyclomine (Bentyl) for irritable bowel syndrome. In which of the following conditions is dicyclomine therapy contraindicated? - Glaucoma A 62 year old male who had a myocardial infarction one year ago is being seen for hypertension. Which medication has the best evidence in mortality rate? - Beta blocker A patient is taking cholestyramine. The Nurse Practitioner will assess for which of the following common adverse effects of the drug? - Constipation A Nurse Practitioner is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no adverse effects. Since her move, however, she reports "dizzy spells and weakness" and feels that the drug is no longer effective. The Nurse Practitioner suspects that the change in the effectiveness of the drug is related to - the impact of the warmer climate on the patient's physical state. A patient with diabetes has had a cough for 1 week and has been prescribed a cough syrup (an expectorant). What special instructions should the nurse include in the patient teaching for this situation? - Monitor glucose levels closely A Nurse Practitioner who is responsible for administering medications should understand that the goals of the MedWatch program are to (Select all that apply.) - provide regular feedback

about product safety issues. facilitate the reporting of adverse reactions of drugs. increase awareness of serious reactions caused by drugs or medical devices. A patient is bothered with nighttime episodes of bronchoconstriction related to asthma. Which of the following medications can be administered to decrease the nighttime episodes and prevent asthma attacks? - Leukotriene modifiers Mr. Lacuna is an 83-year-old resident of a long-term care facility who has a diagnosis of moderate Alzheimer disease. Mr. Lacuna's physician recently prescribed oral rivastigmine, but he was unable to tolerate the drug due to its gastrointestinal effects. As a result, he has been ordered the transdermal patch form of the medication. When administering this form of rivastigmine, the nurse should - apply the patch to Mr. Lacuna's back to reduce the chance that he will remove it. After a recent history of shortness of breath that has become increasingly severe, a woman has been prescribed ipratropium by MDI while she undergoes a diagnostic workup. What patient teaching should the nurse provide to this patient? - "It's important that you perform deep breathing exercises before and after taking ipratropium." During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse's assessment reveals that the patient has been taking over-the- counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives - may cause nutrient deficiencies. A Nurse Practitioner is instructing a patient who was recently diagnosed with multiple sclerosis about dantrolene (Dantrium). The patient is a 38-year-old-male and the foreman for a construction company. In order to minimize one important adverse effect of the drug, the nurse will give the patient which of the following instructions? - Wear appropriate clothing and sunscreen whenever he is in direct sunlight A 62-year-old man is admitted to the hospital with a diagnosis of chest pain. He has an order for 0.3 mg of sublingual nitroglycerin prn for chest pain. Which of the following actions should the nurse do first when he complains of chest pain? - Administer a tablet under his tongue and repeat the action in 5 and 10 minutes if the pain has not subsided A 60-year-old African-American man lives with a number of chronic health problems. Genetic factors are likely to influence his etiology and/or treatment of - hypertension. A 22-year-old male college senior has lived with a diagnosis of Crohn's disease for several years and has undergone several courses of treatment with limited benefit. Which of the following targeted therapies has the potential to alleviate the symptoms of Crohn's disease? - Infliximab (Remicade) Following an endoscopy, a 66-year-old man has been diagnosed with a duodenal ulcer resulting from Helicobacter pylori infection. Which of the following medications will likely be used in an attempt to eradicate the patient's H. pylori infection? (Select all that apply.) - Antibiotics A PPI A 70-year-old woman has a complex medical and a current drug regimen that includes calcium and vitamin D supplements for osteoporosis, metformin (Glucophage) for type 2

A 76-year-old woman has a complex medical history that includes emphysema, osteoporosis, malnutrition, and hypothyroidism. Recently, the woman fell outside her home as a result of weakness and suffered a fracture to her femoral head. The woman's subsequent hip- replacement surgery has been scheduled and the care team recognizes that the use of isoflurane will be most significantly influenced by - her history of emphysema.

Psychopharmacology Exam Questions and Answers, Exams of Nursing

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PMHNP Psychopharm Exam 13 2024