Nurs 6630 final exam (2018), nurs 6630 midterm exam (2018): walden


  

                                    NURS6630 Final Exam (2018): Walden University

QUESTION 1 

What get the PMHNP most mitigated adrecognized to a resigned delay psychotic provocation who omissions to direct the top-down cortical administer and the extravagant force from striatal hyperactivity? 

A. Stimulants B. Antidepressants C. Antipsychotics D. SSRIs 

QUESTION 2 

The PMHNP is nobleing a medication adjustment liberty for a resigned who is exhibiting psychotic manners delay thin handleing administer and provocation. Of the succorful adjustments, which can succor differ some of the redundant proceeds or concomitants that are recognizedly accountd by D2 opposition? 

A. First-generation, gregarious antipsychotics B. First-generation, atypical antipsychotics C. Second-generation, gregarious antipsychotics D. Second-generation, atypical antipsychotics 

QUESTION 3 

The PMHNP is examineing dopamine D2 receptor enjoyment and its friendship delay obnoxious manners in resigneds delay the ward. Why does the PMHNP adrecognized a government dose of atypical antipsychotics? 

A. The doses are inveterate on achieving 100% D2 receptor enjoyment. B. The doses are inveterate on achieving a reserve of 80% D2 receptor enjoyment. C. The doses are inveterate on achieving 60% D2 receptor enjoyment. D. None of the balance. 

QUESTION 4 

Why does the PMHNP shirk prescribing clozapine (Clozaril) as a earliest-line adjustment to the resigned delay psychosis and provocation? 

A. Tnear is too eminent a abandon of thoughtful redundant margin proceeds. B. It can magnify the psychotic concomitants. C. Clozapine (Clozaril) should not be used as eminent-dose monotherapy. D. Tnear is no documentation that clozapine (Clozaril) is powerful for resigneds who are furious. 

QUESTION 5 

The PMHNP is caring for a resigned on risperiperformed (Risperdal). Which renewal made by the PMHNP exhibits becoming thrift for this resigned? 

A. Explaining to the resigned that tnear are no abandons of EPS B. Prescribing the resigned 12 mg/dail C. Titrating the dose by increasing it total 5–7 days D. Writing a adrecognized for a eminenter dose of unwritten risperiperformed (Risperdal) to finish eminent D2 receptor enjoyment 

QUESTION 6 

The PMHNP scantinesss to adrecognized Mr. Barber a disposition stabilizer that get target obnoxious and hasty concomitants by decreasing dopaminergic neurotransmission. Which disposition stabilizer get the PMHNP noble? A. Lithium (Lithane) B. Phenytoin (Dilantin) C. Valproate (Depakote) D. Topiramate (Topamax) 

QUESTION 7 

The parents of a 7-year-old resigned delay ADHD are restshort environing the proceeds of affronts on their branch. The parents advance to set-out pharmacological adjustment delay a non-stimulant. Which medication get the PMHNP get most mitigated adjust? 

A. Strattera B. Concerta C. Daytrana D. Adderall 

QUESTION 8

8 The PMHNP discerns that sluggish-dose protracted indemnify affronts are most expend for which resigned delay ADHD? 

A. 8-year-old resigned B. 24-year-old resigned C. 55-year-old resigned D. 82-year-old resigned 

QUESTION 9 

A resigned is adjustd D-methylphenidate, 10-mg protracted-indemnify capsules. What should the PMHNP emsubstantiality when examineing the margin proceeds delay the resigned? 

A. The shapeulation can bear sluggish renewals when enthralled delay subsistence. B. Sedation can be a despicpowerful margin good-natured-natureds of the refuse. C. The medication can affect your lineage constraining. D. This refuse does not accalculate any dependency. 

QUESTION 10 

The PMHNP is instruction parents environing their branch’s new adrecognized for Ritalin. What get the PMHNP emsubstantiality in the instruction? 

A. The succor dose should be enthralled at lunch. B. Tnear are no abandons for insomnia. C. Tnear is merely one daily dose, to be enthralled in the waking. D. Tnear get be abided proceeds into the late. 

QUESTION 11 

A pubescent resigned is adjustd Vyvanse. During the follow-up provision, which dilate made by the resigned moulds the PMHNP gard that the dosing is entity performed improperly? 

A. “I persuade my pill at shatterfast.” B. “I am unfitted to gravitate indifferent,somnolent at ignorance.” C. “I handle okay all day covet.” D. “I am not entrance my pill at lunch.” 

QUESTION 12 

A 14-year-old resigned is adjustd Strattera and asks when the hygienics should be enthralled. What does the PMHNP discern touching the refuse’s dosing profile? 

A. The resigned should persuade the medication at lunch. B. The resigned get bear one or two doses a day. C. The resigned get persuade a pill total 17 hours. D. The dosing should be performed in the waking and at ignorance. 

QUESTION 13 

The PMHNP is examineion delay the parents of an 8-year-old resigned who is receiving an judicious adrecognized for D-amphetamine. The PMHNP reveals expend prescribing manners when she adjusts the behindcited dose: 

A. The branch get be adjustd 2.5 mg. B. The branch get be adjustd a 10-mg tablet. C. The branch’s dose get extension by 2.5 mg total other week. D. The branch get persuade 10–40 mg, daily. 

QUESTION 14 

A resigned is entity adjustd bupropion and is restshort environing the margin proceeds. What get the PMHNP divulge the resigned touching bupropion? 

A. Hurry shape is not worthy. B. Sedation may be despicable. C. It can accalculate cardiac arrhythmias. D. It may unfold jade. 

QUESTION 15 

Which resigned get assent-to a retireior dose of guanfacine? 

A. Resigned who has congestive central-keep-apart scantiness B. Resigned who has cerebrovascular complaint C. Resigned who is replete D. Resigned delay race complaint 

QUESTION 16 

An 18-year-old feminine delay a fact of abundant headaches and a disposition conjecture is adjustd topiramate (Topamax), 25 mg by bunghole daily. The PMHNP discerns that this medication is powerful in negotiateing which say(s) in this resigned? 

A. Migraines B. Bipolar conjecture and degradation C. Pregnancy-induced degradation D. Loftier tail refusal 

QUESTION 17 

The PMHNP is negotiateing a resigned for fibromyalgia and is consequently prescribing milnacipran (Savella). When prescribing this medication, which renewal is the PMHNP mitigated to cull? 

A. Pedagogue liver business-post total 6 months for a year and then per-annum thereafter. B. Pedagogue monthly hurry. C. Split the daily dose into two doses behind the earliest day. D. Pedagogue for latent lineage in the stool. 

QUESTION 18 

The PMHNP is assessing a resigned she has been negotiateing delay the idiosyncrasy of constant refusal. During the tribute, the resigned says that he has of-late been having disaster getting to drowse and staying indifferent,somnolent. Inveterate on this notification, what renewal is the PMHNP most mitigated to persuade? 

A. Adrecognized hydroxyzine (Vistaril), 50 mg PRN or as omissioned B. Adrecognized zolpidem (Ambien), 5mg at bedprotrenjoyment C. Adrecognized melatonin, 5mg at bedprotrenjoyment D. Adrecognized quetiapine (Seroquel), 150 mg at bedtime 

QUESTION 19 

The PMHNP is assessing a feminine resigned who has been entrance lamotrigine (Lamictal) for migraine prophylaxis. Behind discovering that the resigned has reached the utmost dose of this medication, the PMHNP decides to substitute the resigned’s medication to zonisamide (Zonegran). In enumeration to evaluating this resigned’s day-to-day activities, what should the PMHNP secure that this resigned discerns? 

A. Monthly lineage levels must be drawn. B. ECG pedagogueing must be performed uninterruptedly total 3 months. C. White lineage cell calculate must be pedagogueed weekly. D. This medication has unwanted margin proceeds such as sedation, bankruptcy of coordination, and oblivion. 

QUESTION 20 

A resigned recovering from shingles exhibits delay softness and sensitivity to the loftier tail. He says it is twainersome to put a shirt on most days. This resigned has end position renal complaint (ESRD) and is scheduled to bear hemodialysis tomorrow but says that he does not apprehend-aestablish how he can lie in a recliner for 3 hours handleing this forlorn. What get be the PMHNP’s direct? 

A. Adrecognized herpes simplex virus (HSV) antisubstantiality touchstoneing B. Adrecognized a lineage urea nitrogen (BUN) and creatinine STAT C. Adrecognized lidocaine 5% D. Adrecognized hydromorphone (Dilaudid) 2mg 

QUESTION 21 

The PMHNP adjustd a resigned lamotrigine (Lamictal), 25 mg by bunghole daily, for power refusal 6 months ago. The resigned suddenly exhibits to the business-post delay the repining that the medication is no coveter certain and complains of extensiond refusal. What renewal get the PMHNP most mitigated persuade? 

A. Extension the dose of lamotrigine (Lamictal) to 25 mg twice daily. B. Ask if the resigned has been entrance the medication as adjustd. C. Adrecognized gabapentin (Neurontin), 100 mg three protractions a day, beaccalculate lamotrigine (Lamictal) is no coveter certain for this resigned. D. Adrecognized a finished lineage calculate (CBC) to assess for an corruption. 

QUESTION 22 

An senile woman delay a fact of Alzheimer’s complaint, coronary artery complaint, and myocardial infarction had a gravitate at abode 3 months ago that promiseinationed in her receiving an unconcealed abatement inner fixation. Opportunity assessing this resigned, the PMHNP is made conscious that the resigned abides to touchstone meek to sparing refusal. What is the PMHNP most mitigated to do? 

A. Adrecognized an X-ray beaccalculate it is undeveloped that she dislocated her hip. B. Adrecognized ibuprofen (Motrin) beaccalculate she may omission covet-tidings adjustment and constant refusal is not singular. C. Adrecognized naproxen (Naprosyn) beaccalculate she may bear arthritis and constant refusal is not singular. D. Adrecognized Morphine and substantial therapy. 

QUESTION 23 

The PMHNP is assessing a 49-year-old courageous delay a fact of degradation, post-traumatic importance conjecture (PTSD), alcoholism delay malnutrition, diabetes mellitus mark 2, and hypertension. His substantial tribute is undistinguished delay the exclusion of peripheral edema bilaterally to his retireior extremities and a pre-eminent repining of refusal delay insensibility and tingling to each leg 5/10. The PMHNP set-outs this resigned on a low dose of doxepin (Sinequan). What is the contiguous renewal that must be enthralled by the PMHNP? 

A. Orders liver business-post touchstones. B. Educate the resigned on shirking grapefruits when entrance this medication. C. Encourage this resigned to observe fluids to 1500 ml/day until the swelling subsides. D. Adrecognized a BUN/Creatinine touchstone. 

QUESTION 24 

The PMHNP is evaluating a 30-year-old feminine resigned who says that she notices refusal and a drastic substitute in disposition anteriorly the set-out of her menstrual cycle. The resigned says that she has tried sustenance and lifestyle substitutes but rush has completemented. What get the PMHNP most mitigated do? A. Adrecognized Estrin FE 24 extrresuscitation administer B. Adrecognized ibuprofen (Motrin), 800 mg total 8 hours as omissioned for refusal C. Adrecognized desvenlafaxine (Pristiq), 50 mg daily D. Adrecognized risperiperformed (Risperdal), 2 mg TID 

QUESTION 25 

A resigned delay constant tail refusal has been adjustd a serotonin-norepinephrine reuppersuade debaror (SNRI). How does the PMHNP relate the renewal of SNRIs on the discountenance of refusal to the resigned? 

A. “The SNRI can extension noradrenergic neurotransmission in the descending spinal track to the dorsal horn.” B. “The SNRI can diminish noradrenergic neurotransmission in the descending spinal track to the dorsal horn.” C. “The SNRI can curtail brain atrophy by sluggishing the white subject waste in the dorsolateral prefrontal cortex.” D. “The SNRI can extension neurotransmission to descending neurons.” 

QUESTION 26 

A resigned delay fibromyalgia and main degradation omissions to be negotiateed for concomitants of refusal. Which is the PMHNP most mitigated to adrecognized for this resigned? 

Venlafaxine (Effexor) 

Duloxetine (Cymbalta) 

Clozapine (Clozaril) 

Phenytoin (Dilantin) 

QUESTION 27 

The PMHNP adjusts gabapentin (Neurontin) for a resigned’s constant refusal. How does the PMHNP foretaste the refuse to completement? 

A. It get restrain to the alpha-2-delta ligand subindividual of voltage-sensitive calcium mediums. B. It get abandon synaptic substitutes, including sprouting. C. It get act on the presynaptic neuron to trigger sodium augmentation. D. It get debar breath of dorsal horn neurons to extinguish substantiality input from reaching the brain. 

QUESTION 28 

Mrs. Rosen is a 49-year-old resigned who is experiencing fibro-fog. What does the PMHNP adrecognized for Mrs. Rosen to emend this say? A. Venlafaxine (Effexor) B. Armodafinil (Nuvigil) C. Bupropion (Wellbutrin) D. All of the balance 

QUESTION 29 

The PMHNP is caring for a resigned delay fibromyalgia. Which succor-line adjustment does the PMHNP noble that may be powerful for managing this resigned’s refusal?

A. Methylphenidate (Ritalin) B. Viloxazine (Vivalan) C. Imipramine (Tofranil) D. Bupropion (Wellbutrin 

QUESTION 30 

The PMHNP is striveing to negotiate a resigned’s constant refusal by having the principal restrain the unconcealed medium conformation of VSCCs to seal those mediums delay a “use-dependent” shape of discountenance. Which principal get the PMHNP most mitigated noble? 

A. Pregabalin (Lyrica) B. Duloxetine (Cymbalta) C. Modafinil (Provigil) D. Atomoxetine (Strattera) 

QUESTION 31 

A resigned delay touchy bowel syndrome narrations constant stomach refusal. The PMHNP scantinesss to adrecognized the resigned an principal that get accalculate inwithhold nociceptive inputs from the refusal to be ignored and no coveter perceived as refusalful. Which refuse get the PMHNP adjust? 

A. Pregabalin (Lyrica) B. Gabapentin (Neurontin) C. Duloxetine (Cymbalta) D. B and C 

QUESTION 32 

The PMHNP scantinesss to use a concomitant-inveterate admittance to negotiateing a resigned delay fibromyalgia. How does the PMHNP go environing negotiateing this resigned? 

A. Prescribing the resigned an principal that ignores the refusalful concomitants by initiating a rerenewal apprehend-againn as “fibro-fog” B. Targeting the resigned’s concomitants delay anticonvulsants that debar white subject waste in the dorsolateral prefrontal cortex C. Matching the resigned’s concomitants delay the malfunctioning brain circuits and neurotransmitters that capacity convenient those concomitants D. None of the balance 

QUESTION 33 

The PMHNP is certain delay the ward to thrift for a resigned delay diabetic peripheral neuropathic refusal. The ward asks the PMHNP why SSRIs are not conformably servicepowerful in negotiateing this feature resigned’s refusal. What is the best exculpation by the PMHNP? 

A. “SSRIs merely extension norepinephrine levels.” B. “SSRIs merely extension serotonin levels.” C. “SSRIs extension serotonin and norepinephrine levels.” D. “SSRIs do not extension serotonin or norepinephrine levels.” 

QUESTION 34 

A resigned delay gambling conjecture and no other psychiatric comorbidities is entity negotiateed delay pharmacological principals. Which refuse is the PMHNP most mitigated to adjust? 

A. Antipsychotics B. Lithium C. SSRI D. Naltrexone 

QUESTION 35 

Kevin is an boyish who has been diagnosed delay kleptomania. His parents are animated in seeking pharmacological adjustment. What does the PMHNP divulge the parents touching his adjustment libertys? 

A. “Naltrexone may be an expend liberty to examine.” B. “Tnear are abundant hygienics libertys that negotiate kleptomania.” C. “Kevin may omission to be adjustd antipsychotics to negotiate this complaint.” D. “Lithium has proven powerful for negotiateing kleptomania.” 

QUESTION 36 

Which proposition best relates a pharmacological admittance to negotiateing resigneds for hasty provocation? 

A. Anticonvulsant disposition stabilizers can uproot limbic impressibility. B. Atypical antipsychotics can extension subcortical dopaminergic stimulation. C. Stimulants can be used to diminish frontal discountenance. D. Opioid rivals can be used to curtail force. 

QUESTION 37 

A resigned delay hypersexual conjecture is entity assessed for undeveloped pharmacologic adjustment. Why does the PMHNP adrecognized an antiandrogen for this resigned? 

A. It get frustrate handleings of euphoria. B. It get unfold handleing administer. C. It get seal touchstoneosterone. D. It get redirect the resigned to gard environing other arts. 

QUESTION 38 

Mrs. Kenner is restshort that her teenage daughter spends too abundantly protrenjoyment on the Internet. She inquires environing undeveloped adjustments for her daughter’s addiction. Which exculpation by the PMHNP reveals discerning of pharmacologic admittancees for compulsive conjectures? 

A. “Compulsive Internet use can be negotiateed harmoniously to how we negotiate mob delay gist use conjectures.” B. “Internet addiction is negotiateed delay refuses that succor seal the tension/arousal say your daughter touchstones.” C. “When it comes to Internet addiction, we advance to negotiate resigneds delay pharmaceuticals rather than psychogregarious methods.” D. “Tnear are no evidence-inveterate adjustments for Internet addiction, but tnear are behaviunwritten therapies your daughter can try.” 

QUESTION 39 

Mr. Peterson is examineion delay the PMHNP to examine vigorier sustenanceary persuade. Delay a BMI of 33, Mr. Peterson is stout and omissions to differ his subsistence intake. “Sometimes I gard I’m addicted to subsistence the way some mob are addicted to refuses,” he says. Which proposition best relates the neurobiological parallels inchoate subsistence and refuse addiction? 

A. Tnear is diminishd activation of the prefrontal cortex. B. Tnear is extensiond affection of the reactive honor government. C. Tnear is curtaild activation of territorys that way palatability. D. Tnear are amplified honor circuits that activate upon waste. 

QUESTION 40 

The PMHNP is caring for a resigned who narrations extravagant arousal at ignorancetime. What could the PMHNP use for a protraction-scant protrenjoyment to displace the resigned’s brain from a hyperactive say to a drowse say? 

A. Histamine 2 receptor rival B. Benzodiazepines C. Stimulants D. Caffeine 

QUESTION 41 

The PMHNP is caring for a resigned who touchstones too abundantly balancestimulation and solicitude during dayprotrenjoyment hours. The resigned agrees to a pharmacological adjustment but says, “I don’t scantiness to handle sedated or stupid from the hygienics.” Which sentence made by the PMHNP reveals becoming apprehend-againledge of this resigned’s concomitants and expend adjustment libertys? 

A. Avoiding prescribing the resigned a refuse that seals H1 receptors B. Prescribing the resigned a refuse that acts on H2 receptors C. Intermission the resigned from entrance hygienics that unblocks H1 receptors D.None of the balance 

QUESTION 42 

The PMHNP is performing a power self-confidence compatriot resurvey of the chart of another PMHNP. Upon resurvey, the PMHNP resurveys the chart of an older adult resigned in covet-tidings thrift ease who has constant insomnia. The chart designates that the resigned has been receiving hypnotics on a ignorancely foundation. What does the PMHNP asinfallible problematic environing this documentation? 

A. Older adult resigneds are contraindicated to persuade hypnotics. B. Hypnotics bear prolonged half-lives that can accalculate refuse hoard in the senile. C. Hypnotics bear condensed half-lives that bestow-up-apportion themselves inpowerful for older adults. D. Hypnotics are not powerful for “symptomatically masking” constant insomnia in the senile. 

QUESTION 43 

The PMHNP is caring for a resigned delay constant insomnia who is worried environing pharmacological adjustment beaccalculate the resigned does not scantiness to touchstone assurance. Which pharmacological adjustment admittance get the PMHNP mitigated noble for this resigned for a scant protraction, opportunity minute and punishing the underlying pathology associated delay the insomnia? 

A. Serotonergic hypnotics B. Antihistamines C. Benzodiazepine hypnotics D. Non-benzodiazepine hypnotics 

QUESTION 44 

The PMHNP is caring for a resigned delay constant insomnia who would service from entrance hypnotics. The PMHNP scantinesss to adrecognized the resigned a refuse delay an ultra-condensed half-life (1–3 hours). Which refuse get the PMHNP adjust? 

A. Flurazepam (Dalmane) B. Estazolam (ProSom) C. Triazolam (Halcion) D. Zolpidem CR (Ambien) 

QUESTION 45 

The PMHNP is striveing to negotiate a resigned’s constant insomnia and wishes to set-out delay an judicious adrecognized that has a half-life of approximately 1–2 hours. What is the most expend adrecognized for the PMHNP to mould? 

A. Triazolam (Halcion) B. Quazepam (Doral) C. Temazepam (Restoril) D. Flurazepam (Dalmane) 

QUESTION 46 

A resigned delay constant insomnia asks the PMHNP if they can earliest try an balance-the-contrary (OTC) medication anteriorly one that omissions to be adjustd to succor the resigned drowse. Which is the best exculpation by the PMHNP? 

A. “Tnear are no balance-the-contrary medications that get succor you drowse.” B. “You can cull from one of the five benzo hypnotics that are affectd in the United States.” C. “You get omission to ask the pharmacist for a non-benzodiazepine hygienics.” D. “You can get melatonin balance the calculateer, which get succor delay drowse aggression.” 

QUESTION 47 

A resigned delay constant insomnia and degradation is entrance trazoperformed (Oleptro) but complains of handleing stupid during the day. What can the PMHNP do to curtail the refuse’s dayprotrenjoyment sedating proceeds? 

A. Adrecognized the resigned an antihistamine to contrariety the sedating proceeds B. Increasing the resigned’s dose and administer it earliest art in the waking C. Bestow the hygienics at ignorance and retireior the dose D. None of the balance 

QUESTION 48 

The PMHNP is instruction a resigned delay a drowse conjecture environing entrance diphenhydramine (Benadryl). The resigned is restshort environing the margin proceeds of the refuse. What can the PMHNP direct the resigned environing this adjustment admittance? 

A. “It can accalculate diarrhea.” B. “It can accalculate blurred desire.” C. “It can accalculate extensiond salivation.” D. “It can accalculate heightened apprehensive proceeds.” 

QUESTION 49 

Parents of a 12-year-old boy scantiness to reflect observeation failure hyperbreath conjecture (ADHD) medication for their son. Which medication would the PMHNP set-out? 

Methylphenidate Amphetamine salts Atomoxetine All of the balance could hypothetically negotiate their son’s concomitants. 

QUESTION 50

An adult resigned exhibits delay a fact of alcohol addiction and observeation failure hyperbreath conjecture (ADHD). Absorbed these comorbidities, the PMHNP determines which of the behindcited medications may be the best adjustment liberty? 

A. Methylphenidate (Ritalin, Concerta) B. Amphetamine C. Atomoxetine (Strattera) D. Fluoxetine (Prozac) 

QUESTION 51 

An 8-year-old resigned exhibits delay harsh hyperactivity, barkred as “ants in his pants.” Inveterate on self-narration from the resigned, his parents, and his directer; observeation failure hyperbreath conjecture (ADHD) is reputed. What medication is the PMNHP most mitigated to adjust? 

A. Methylphenidate (Ritalin, Concerta) B. Clonidine (Catapres) C. Bupropion (Wellbutrin) D. Desipramine (Norpramin) 

QUESTION 52 

A 9-year-old feminine resigned exhibits delay concomitants of twain observeation failure hyperbreath conjecture (ADHD) and oppositional rebellious conjecture. In evaluating her concomitants, the PMHNP determines that which of the behindcited medications may be advantageous in augmenting affront medication? 

A. Bupropion (Wellbutrin) B. Methylphenidate (Ritalin, Concerta) C. Guanfacine ER (Intuniv) D. Atomoxetine (Strattera) 

QUESTION 53 

A PMHNP supervisor is examineing delay a nursing ward how affronts and noradrenergic principals support delay ADHD concomitants. What is the expend exculpation? 

A. They twain extension distinguished power output dopamine (DA) and norepinephrine (NE). B. Dopamine (DA) and norepinephrine (NE) are extensiond in the prefrontal cortex. C. Noradrenergic principals punish abatements in dopamine (DA) in the honor track inherent to extensiond power to conceal observeation to repetitive or boring tasks and hinder distractions. D. All of the balance. 

QUESTION 54 

A 43-year-old courageous resigned is seeking percolation environing negotiateing observeation failure hyperbreath conjecture (ADHD) in adults and how it differs from negotiateing branchren, gone his son is on medication to negotiate ADHD. The PMHNP removes a main contrariety is which of the behindcited? 

A. Affront adrecognized is past despicpowerful in adults. B. Comorbid says are past despicpowerful in branchren, collisioning the use of affronts in branchren. C. Atomoxetine (Strattera) use is not instructd in branchren. D. Comorbidities are past despicpowerful in adults, collisioning the adrecognized of enumesound principals. 

QUESTION 55 

A 26-year-old feminine resigned delay nicotine assurance and a fact of solicitude exhibits delay concomitants of observeation failure hyperbreath conjecture (ADHD). Inveterate on the tribute, what does the PMHNP reflect? 

A. ADHD is numerously not the rendezvous of adjustment in adults delay comorbid says. B. ADHD should numerously be negotiateed earliest when comorbid says pause. C. Nicotine has no narrationed collision on ADHD concomitants. D. Symptoms are numerously quiet to negotiate delay affronts, absorbed the bankruptcy of comorbidity delay other says. 

QUESTION 56 

Which of the behindcited is a penny proposition touching the use of affronts to negotiate observeation failure hyperbreath conjecture (ADHD)? 

A. In adults delay twain ADHD and solicitude, negotiateing the solicitude delay nobleive serotonin reuppersuade debarors (SSRIs), serotonin-norepinephrine reuppersuade debarors (SNRIs), or benzodiazepines and the ADHD delay affronts is most powerful in negotiateing twain says. B. Distinguished power output is extensiond by dialing up the indemnify of dopamine (DA) and norepinephrine (NE). C. In says wnear extravagant DA activation is exhibit, such as psychosis or madness, comorbid ADHD should nforcontinually be negotiateed delay affronts. D. Eminent dose and pulsatile delivery of affronts that are condensed acting are advancered to negotiate ADHD. 

QUESTION 57 

The PMHNP is providing a completementshop for pediatric fosters, and a inquiry is posed environing noradrenergic principals to negotiate ADHD. Which of the behindcited noradrenergic principals bear norepinephrine reuppersuade debaror (NRI) becomingties that can negotiate ADHD? 

A. Desipramine (Norpramin) B. Methylphenidate (Ritalin, Concerta) C. Atomoxetine (Strattera) D. Twain “A” & “C” E. “C” merely 

QUESTION 58 

A 71-year-old courageous resigned comes to an prodesire delay his 65-year-old accelerationmate. They are twain having matters barkred to her remembrance and power to apprehend-aestablish faces. The PMNHP is consequently prescribing memantine (Namenda) inveterate on the behindcited concomitants: 

A. Amnesia, aphasia, apnea B. Aphasia, apraxia, diplopia C. Amnesia, apraxia, agnosia D. Aphasia, agnosia, arthralgia 

QUESTION 59 

The PMHNP evaluates a resigned exhibiting delay concomitants of dementia. Anteriorly the PMHNP reflects adjustment libertys, the resigned must be assessed for other undeveloped accounts of dementia. Which of the behindcited exculpations addresses twain undeveloped other accounts of dementia and a sound adjustment liberty for Dementia? 

A. Undeveloped other accounts: hypothyroidism, Cushing’s syndrome, multiple sclerosis Undeveloped adjustment liberty: memantine B. Undeveloped other accounts: hypothyroidism, adrenal omission, hyperparathyroidism Undeveloped adjustment liberty: performedpezil C. Undeveloped other accounts: hypothyroidism, adrenal omission, niacin noncommunication Undeveloped adjustment liberty: risperiperformed D. Undeveloped other accounts: hypothyroidism, Cushing’s syndrome, lupus erythematosus Undeveloped adjustment liberty: performedpezil 

QUESTION 60 

A adrecognized of nursing wards seeks advance percolation from the PMHNP on how cholinesterase debarors are advantageous for Alzheimer’s complaint resigneds. What is the expend exculpation? 

A. Acetylcholine (ACh) perdition is debared by sealing the enzyme acetylcholinesterase. B. Effectiveness of these principals supervenes in all positions of Alzheimer’s complaint. C. By increasing acetylcholine, the extricate in some resigneds may be short accelerated. D. Twain “A” & “C.” 

QUESTION 61 

The PMHNP is assessing a resigned who exhibits delay rich levels of brain amyloid as notpowerful by positron emission tomography (PET). What other elements get the PMHNP reflect anteriorly prescribing medication for this resigned, and what medication would the PMHNP scantiness to shirk absorbed these other elements? 

A. ApoE4 genomark and shirk antihistamines if undeveloped B. Mark 2 diabetes and shirk olanzapine C. Solicitude and shirk methylphenidate D. Twain “A” & “B” 

QUESTION 62 

A 72-year-old courageous resigned is in the forthcoming positions of Alzheimer’s complaint. The PMHNP determines that special remembrance is a key reflectation in nobleing a medication. Which of the behindcited would be an expend precious? 

A. Rivastigmine (Exelon) B. Donepezil (Aricept) C. Galantamine (Razadyne) D. All of the balance 

QUESTION 63 

A 63-year-old resigned exhibits delay the behindcited concomitants. The PMHNP determines which set of concomitants secure prescribing a medication? Noble the exculpation that is matched delay an expend adjustment. 

A. Frugal power to recall names is most problematic, and an expend adjustment liberty is memantine. B. Infirmity in the power to discern and keep new notification is most problematic, and an expend adjustment liberty would be performedpezil. C. Frugal power to asinfallible the punish account is most problematic, and an expend adjustment liberty would be memantine. D. Frugal power to recall wnear objects are most problematic, and an expend adjustment liberty would be performedpezil. 

QUESTION 64 

A 75-year-old courageous resigned diagnosed delay Alzheimer’s complaint exhibits delay noise and obnoxious manner. The PMHNP determines which of the behindcited to be the best adjustment liberty? 

A. Immunotherapy B. Donepezil (Aricept) C. Haloperidol (Haldol) D. Citalopram (Celexa) or Escitalopram (Lexapro) 

QUESTION 65 

The PMHNP has been asked to collect an in-service luxuriance to emsubstantiality observeation to the use of antipsychotics to negotiate Alzheimer’s. What does the PMHNP remove to staff? 

A. The use of antipsychotics may accalculate extensiond cardiovascular equablets and portraiture. B. A good-natured-natured-natured liberty in negotiateing noise and psychosis in Alzheimer’s resigneds is haloperidol (Haldol). C. Antipsychotics are numerously used as “chemical straightjackets” to balance-tranquilize resigneds. D. Twain “A” & “C.” 

QUESTION 66 

An 80-year-old feminine resigned diagnosed delay Position II Alzheimer’s has a fact of touchy bowel syndrome. Which cholinergic refuse may be the best precious for adjustment absorbed the resigned’s gastrointestinal problems? 

A. Donepezil (Aricept) B. Rivastigmine (Exelon) C. Memantine (Namenda) D. All of the balance 

QUESTION 67 

The PMHNP discerns that bupropion (Wellbutrin) is an powerful way to support resigneds delay smoking intermission. Why is this medication powerful for these resigneds? 

A. Bupropion (Wellbutrin) indemnifys the dopamine that the resigned would recognizedly assent-to through smoking. B. Bupropion (Wellbutrin) supports resigneds delay their cravings by changing the way that tobacco tastes. C. Bupropion (Wellbutrin) seals dopamine reuptake, enabling past availpower of dopamine. D. Bupropion (Wellbutrin) completements on the mesolimbic neurons to extension the availpower of dopamine. 

QUESTION 68 

Naltrexone (Revia), an opioid rival, is a medication that is used for which of the behindcited says? 

A. Alcoholism B. Constant refusal C. Affront of inhalants D. Meek to sparing heroin delaydrawal 

QUESTION 69 

A resigned addicted to heroin is receiving adjustment for detoxification. He starts to touchstone tachycardia, tremors, and diaphoresis. What medication get the PMHNP adrecognized for this resigned? 

A. Phenobarbital (Luminal) B. Methaperformed (Dolophine) C. Naloxone (Narcan) D. Clonidine (Catapres) 

QUESTION 70 

A resigned diagnosed delay obsessive compulsive conjecture has been entrance a eminent-dose SSRI and is keep-aparticipating in therapy twice a week. He narrations an inpower to heave out responsibilities due to harmonious clashnces of his obsessions and compulsions. The PMHNP apprehend-agains that the contiguous tread would be which of the behindcited? 

A. Diminish his SSRI and add buspirone (Buspar). B. Diminish his SSRI and add an MAOI. C. Diminish his SSRI steadily until it can be canceld then try an antipsychotic to direct his concomitants. D. Observe his SSRI dosage the harmonious and add a low-dose TCA. 

QUESTION 71 

The PMHNP is assessing a resigned who get be receiving phentermine (Adipex-P)/topiramate (Topamax) (Qsymia). Which of the behindcited says/diseases get demand advance evaluation anteriorly this medication can be adjustd? 

A. Race complaint position II B. Obesity C. Cardiovascular complaint D. Diabetes mark II 

QUESTION 72 

The PMHNP adjusts an stout resigned phentermine (Adipex-p)/topiramate ER (Topamax) (Qsymia), Why is topiramate (Topamax) numerously adjustd delay phentermine (Adipex-P)? 

A. Phentermine (Adipex-P) dose can be extensiond safely when enthralled delay an anticonvulsant. B. Phentermine (Adipex-P) completements by extinguishing inclination opportunity topiramate (Topamax) acts by debaring inclination. C. Topiramate (Topamax) powerfuliates inclination extinguishion finishd by phentermine (Adipex-P). D. Topiramate (Topamax) succors frustrate the unwanted margin proceeds of phentermine (Adipex-P). 

QUESTION 73 

The PMHNP is assessing a resigned who has exposed suicidal fixed and is now stating that he is hearing voices and sees mob chasing him. The PMHNP identifies these concomitants to be associated delay which of the behindcited? 

A. Barbiturate venom B. Marijuana venom C. “Bath salt” venom D. Cocaine venom 

QUESTION 74 

The PMHNP is caring for a resigned who unconcealedly admitted to imbinature a quart of vodka daily. Anterior to prescribing this resigned disulfiram (Antabuse), it is influential for the PMHNP to: 

A. Evaluate the resigned’s getingness to leave-off from alcohol B. Counsel the resigned on sustenanceary restrictions C. Obtain liver business-post touchstones D. Assess for addiction to opioids 

QUESTION 75 An opioid-naive resigned is entrance MS Contin (morphine sulfate) to negotiate his refusal that is succorary to cancer. Under what requisite would the PMHNP adrecognized naloxone (Narcan) IM/SQ? 

A. The resigned’s oration is slurred, and he is in and out of drowse. B. The resigned’s inclination has diminishd from eating 100% of his asceticism to 50% of his asceticism. C. The resigned complains of not having a bowel move for 4 days. D. The resigned’s life-supporting signs are 98.4F temp, 88 pulse, 104/62 lineage constraining, and 8 respirations. 

QUESTION 76 

When completing this exam, did you accede delay Walden University’s Code of Persuade including the expectations for academic rectitude? 

Yes No

  

                         NURS 6630 Midtidings Exam (2018): Walden University

QUESTION 1

1.      A noncompliant resigned says, "Why do you scantiness me to put this vitiate in my substantiality?" Confirm the best exculpation made by the psychiatric-mental vigor foster practitioner (PMHNP).

A.

"You bear to persuade your medication to befit firmly-fixed."

B.

"Most medications get extension the estimate of neurotransmitters that you already bear in the brain."

C.

"Most medications used in adjustment are either increasing or decreasing neurotransmitters that your substantiality already has."

D.

"Why do you revere that your medication is vitiate?" 

QUESTION 2

1.      Which proposition environing neurotransmitters and medications is penny?

A.

Natural neurotransmitters such as endorphins bear been discovered behind the harvest of medications.

B.

Some medications were exposed behind the evidence and apprehend-againn renewal of the neurotransmitters in the brain.

C.

Neurotransmitters assent-to messages from most medications.

D.

The neurotransmitter serotonin is at-unintermittently concatenateed to degradation. Aftercited this evidence, the antidepressant Prozac was exposed.

1 points  

QUESTION 3

1.      When an unfirmly-fixed resigned asks why it is compulsory to add medications to his running influence, the PMHNP's best exculpation would be:

A.

"In an most-outrageous plight such as yours, past than one medication is numerously omissioned."

B.

"Due to the undignifiedness of your running medication, we omission to try someart else that can haply powerfuliate its proceeds.

C.

"Medications are numerously peculiar to the neurotransmitter(s) they are affecting and, due to past than one neurotransmitter involvement, it is numerously compulsory to use past than one medication to emend concomitants."

D.

"I discern your matter. We can cancel your running medication and switch to a incongruous one that may amend direct your concomitants."

1 points  

QUESTION 4 ?

1.      During gene evidence, what must supervene anterior to a gene entity exposed?

A.

Transcription element must restrain to the regulatory territory delayin the cell's central-part.

B.

RNA must be converted to mRNA.

C.

The coding territory must disjoined from the regulatory territory. This is wickedness

D.

RNA polymerase must debar the way of changing RNA to mRNA.

1 points  

QUESTION 5

1.      While genes bear undeveloped to differ manner, manner can to-boot differ genes. How do genes collision this way?

A.

Genes collision neuron business-posting at-once.

B.

Changes made to proteins administer to substitutes in manner.

C.

Neurons are powerful to collision protein structure.

D.

Genes collision the DNA of a cell, inherent to substitutes in manner.

1 points  

QUESTION 6

1.      Though medications bear the power to target neurotransmitters in the synapse, it is not numerously compulsory. The PMHNP discerns that this is consequently:

A.

Neurotransmission that supervenes via the axon recognizes for enravishment of a neurotransmitter.

B.

Active enravishment is a incongruous mark of vital-force that recognizes the enravishment of infallible neurotransmitters.

C.

Neurotransmitters can distribute by diffusion.

D.

The postsynaptic neuron can indemnify the neurotransmitter.

1 points  

QUESTION 7

1.      Why is the cytochrome P450 enzyme government of appreciation to the PMHNP?

A.

The races peculiarate a role delay perspiration of the medication, and if a resigned has race infirmity, the dose must be extensiond to be powerful.

B.

The bioavailpower of the medication behind it passes through the stomach and liver can be altered. Punish exculpation

C.

The medication's chemical adjustment substitutes when it comes in touch delay the pointed in the stomach.

D.

The CYP enzyme government is a undeviating and predictpowerful way that adjustrs must discern to negotiate says powerfully.

1 points  

QUESTION 8

1.      It is influential for the PMHNP to apprehend-aestablish contrarietys in pharmacokinetics to safely adrecognized and pedagogue medications. Which of the behindcited propositions does the copent PMHNP confirm as penny?

A.

About 1 out of 5 Asians demands retireior-than-recognized doses of some antidepressants and antipsychotics.

B.

The tidings polymorphic refers to the substantiality's power to shatter a medication down divers ways, and this resigned may demand eminenter doses of infallible antidepressants and antipsychotics.

C.

About 1 out of 30 Caucasians demands retireior doses of some antidepressants and antipsychotics.

D.

Most enzyme tracks do not bear interactions inchoate the newer medications.

1 points  

QUESTION 9

1.      As it relates to G-protein concatenateed receptors, what does the PMHNP discern environing medications that are used in manner?

A.

Most medications that act on G-protein concatenateed receptors bear rivalic traits.

B.

The mainity of medications used in manner are generous agonists and are used to aggravate the substantiality's original neurotransmitters.

C.

Most medications act as inequitpotent agonists beaccalculate they recognize the substantiality to use merely what is omissioned.

D.

Medications used in manner may act as inverse agonists if the dosage is too eminent.

1 points  

QUESTION 10

1.      The PMHNP is consequently prescribing a 49-year-old courageous clozapine (Clozaril) to negotiate his schizophrenia and suicidal ideations. The PMHNP is conscious that which element may collision the dose omissioned to powerfully negotiate his say:

A.

The resigned smokes cigarettes. 

B.

The resigned has hypertension.

C.

The resigned has constant race complaint, position 2.

D.

The resigned imbibes a cup of coffee a day.

1 points  

QUESTION 11

1.      A resigned is diagnosed delay bipolar conjecture and is runningly entrance carbamazepine (Tegretol), aripiprazole (Abilify), and melatonin. The PMHNP has recognized written an adrecognized to cancel the carbamazepine (Tegretol) for refuse-induced thrombocytopenia. The PMHNP is conscious that his contiguous best renewal is to:

A.

Alert staff to undeveloped seizures

B.

Write an adrecognized for a incongruous dispositionstabilizer 

C.

Decrease the aggregate adjustd for aripiprazole (Abilify)

D.

Explain to the resigned that it get be past involved to administer his differ

1 points  

QUESTION 12

1.      A resigned of-late transmitted behindcited a suicide strive has a fact of schizophrenia, degradation, and fibromyalgia. He is runningly entrance Amitriptyline (Elavil), Lisinopril, aspirin, and fluoxetine (Prozac). Which is the best renewal for the PMHNP to persuade for this resigned?

A.

Review Amitriptyline (Elavil) level 

B.

Order a liver business-post touchstone

C.

Check the resigned's lineage consluxuriance and pulse

D.

Order a stat platelet calculate

1 points  

QUESTION 13

1.      A resigned delay schizophrenia is absorbed an inverse agonist that acts on the receptor 5HT and neurotransmitter serotonin. What is the sounde for prescribing a medication such as this?

A.

To exalt the availpower of serotonin

B.

To diminish serotonin

C.

To inat-unintermittently extension the aggregate of dopamine in the substantiality

D.

To succor diminish the aggregate of serotonin and dopamine

1 points  

QUESTION 14

1.      The PMHNP is caring for filthy resigneds. Which resigned proposition designates that benzodiazepines would be advantageous?

A.

"I bear disaster staying indifferent,somnolent in the average of the ignorance."

B.

"My associate told me that I look to bear disaster recalling arts casually."

C.

"I unquestionably scantiness to seal smoking, but the cravings are too tenacious."

D.

"I handle pregnant to go outmargin and be in wide crowds."

1 points  

QUESTION 15

1.      Ms. Harlow is a 42-year-old resigned who is adjustd a refuse that acts on ionotropic receptors. She is recondite environing the proceeds of the refuse and how it get act on her concomitants. Which proposition made by the PMHNP reveals becoming discerning of Ms. Harlow's adjust?

A.

"The refuse get bear an approximately imconvenient good-natured-natureds."

B.

"The refuse can persuade a opportunity to plant up in your government." 

C.

"The refuse is sluggish to indemnify but decisives for a covet protraction."  

D.

"The refuse get mould a cunning contrariety in your concomitants." 

1 points  

QUESTION 16

1.      A resigned is seeking pharmacological adjustment for smoking intermission. Which refuse class does the PMHNP adrecognized to the resigned?

A.

Benzodiazepine

B.

Mirtazapine (Remeron)

C.

Ketamine

D.

Varenicline (Chantix)

1 points  

QUESTION 17

1.      The PMHNP is caring for a new resigned who has been transmitted from another business-post. When examineion delay the new resigned, the resigned narrations, "I handle affect I am special delay the stabilizers." The PMHNP offerly apprehend-agains that the resigned is describing which bark of refuse?

A.

Full agonists

B.

Antagonists

C.

Partial agonists

D.

Inverse agonists

1 points  

QUESTION 18

1.      A resigned exhibits delay abundant episodes of madness. Which proposition relates an expend adjustment admittance for this resigned?

A.

"The resigned omissions to bear an inverse agonist."

B.

"The resigned could service from an anticonvulsant."  

C.

"The resigned's calcium, sodium, chloride, and potassium levels must be regulated." 

D.

"The resigned should bear a refuse that acts on ligand-gated ion mediums."

1 points  

QUESTION 19

1.      The PHMNP is caring for a resigned who would service from nicotine cholinergic, serotonin 3, or glycine receptors. What bark of principal does the PHMNP scantiness to adrecognized for this resigned?

A.

Ligand-gated ion mediums delay a pentameric structure

B.

Ligand-gated ion mediums delay a tetrameric structure

C.

Voltage-sensitive ion mediums

D.

Anticonvulsants

1 points  

QUESTION 20 ?

1.      Which proposition made by the resigned suggests the resigned get omission to be negotiateed delay antipsychotics that target paranoid psychosis?

A.

"It's my failure that all of this is happening. I don't gard I could forforcontinually forbestow myself." 

B.

"I bear to confabulation to the President beaccalculate I'm the merely one who can succor him."

C.

"I'm not believing why that lady is wearing a red jacket gone it's the dogs who omission subsistence."

D.

"I don't apprehend-aestablish that I equpotent scantiness to go to that examineion. It doesn't look merit it anymore."

1 points  

QUESTION 21

1.      A resigned has been negotiateed delay a estimate of strange psychotropic refuses. How is it theoretically undeveloped to confirm apprehensive emendment in the resigned using neuropsychological tribute batteries behind the pharmacologic therapy? I did not bear this inquiry

A.

Obtaining raw normative metrics and using them to assess business-postality

B.

Having the resigned narration on apprehensive business-post inveterate on special touchstones

C.

Monitoring the resigned in a administerled setting 

D.

Measuring concomitants of psychosis

1 points  

QUESTION 22

1.      Mr. McCullin is 64 years old delay Parkinson's complaint. The PMHNP caring for Mr. McCullin scantinesss to set-out him on a dopamine agonist to succor direct and negotiate his say. The PHMNP nobles this principal beaccalculate of which renewal it has on resigneds affect Mr. McCullin?

A.

Dopamine is tidingsinated through multiple agencys.

B.

The D2 autoreceptor regulates indemnify of dopamine from the presynaptic neuron.

C.

MAO-B exhibits in the mitochondria delayin the presynaptic neuron.

D.

D2 receptors are the earliest resluxuriance site for dopamine agonists. 

1 points  

QUESTION 23

1.      Mrs. Trevor is a 44-year-old resigned who does not bear a idiosyncrasy of schizophrenia but sometimes narrations concomitants of psychosis, followed by harsh jade. Mrs. Trevor inquires environing the use of amphetamines to succor delay her vital-force levels. Which exculpation made by the PMHNP is most expend?

A.

"Amphetamines may succor you, as they can lighten psychotic says."

B.

"Amphetamines can debar privative concomitants of schizophrenia, so this capacity be a good-natured-natured-natured precious for you."

C.

"Amphetamines can accalculate hallucinations, so I would instruct resisting this mark of adjust."

D.

"Amphetamines can administer to a dopamine noncommunication, so I get not adrecognized this for you."

1 points  

QUESTION 24

1.      The PMHNP is caring for a resigned delay schizophrenia and is consequently a medley of adjustment admittancees. The PHMNP nobles a vipowerful adjustment that is harmonious delay the "dopamine theory of schizophrenia." What renewal does the PMHNP foretaste this adjustment having on the resigned?

A.

Blocking the indemnify of dopamine facilitates the aggression of unequivocal schizophrenia concomitants.

B.

Hyperbreath in the mesolimbic dopamine track convenients the unequivocal concomitants of schizophrenia.

C.

Antipsychotic refuses that unconcealed D2 receptor tracks can negotiate schizophrenia.

D.

The neuroanatomy of dopamine neuronal tracks can clear-up concomitants of schizophrenia.

1 points  

QUESTION 25

1.      A resigned is diagnosed delay schizophrenia. What extensions the resigned's undeveloped to convenient the apprehensive concomitants of the complaint?

A.

Achieving underbreath of the mesocorticol projections to the prefrontal cortex

B.

Achieving balancebreath of the mesocorticol projections to the ventromedial prefrontal cortex

C.

Achieving underbreath of the mesocortical projections to the ventromedial prefrontal cortex

D.

Achieving balancebreath of the mesocorticol projections to the prefrontal cortex

1 points  

QUESTION 26

1.      The PMNHP is assessing a 29-year-old resigned who persuades antipsychotics that seal D2 receptors. What resigned instruction should the PMHNP emsubstantiality barkred to the undeveloped margin proceeds of this mark of refuse?

A.

Hypersexuality

B.

Amenorrhea

C.

Dystonia

D.

Tardive dyskinesia 

A.

1 points  

QUESTION 27

1.      The PMHNP is caring for a resigned who is entrance antipsychotics heard the psychiatrist divulge the resigned that the resigned would be placed on a incongruous antipsychotic principal. Which of the behindcited demands the covetouchstone transition protrenjoyment for hygienic service?

Olanzapine to clozapine

B.

Asenapine to Risperidone

C.

Aripripazole to ziprasidone

D.

Aripripazole to clozapine

1 points  

QUESTION 28

1.      The PMHNP is assessing a resigned who has cirrhosis of the liver and foretastes that the resigned get be adjustd an antipsychotic. Which medication does the PMHNP doubt get be adjusted for this resigned?

A.

Quetiapine

B.

Paliperidone

C.

Lurasidone

D.

Clozapine

1 points  

QUESTION 29

1.      Which proposition made by the PMHNP exemplifies punish instruction of physiological proceeds in the substantiality?

A.

Muscarinic rivals are past mitigated to accalculate diminishd prolactin levels.

B.

D2 rivals diminish the affectlihood of EPS concomitants.

C.

D2 opposition is concatenateed to antidepressant becomingties.

D.

D2 inequitpotent agonists are associated delay extensiond agency in negotiateing unequivocal concomitants of schizophrenia.

1 points  

QUESTION 30

1.      Mrs. Schwartzman is a 52-year-old resigned delay schizophrenia and no certain fact of degradation. When examineion delay the PMHNP, she exhibits delay indifference and delaydrawn gregarious manner, and she narrations a waste of joy from enjoypowerful activities. What does the PMHNP retire from this encontrary delay the resigned?

A.

An underlying depressive conjecture

B.

The late substitute of a 2nd age antipsychotic to a gregarious one 

C.

The late substitute of a 1st age antipsychotic to a 2nd age antipsychotic

D.

All of the balance

1 points  

QUESTION 31

1.      The PMHNP is entrance a fact on a resigned who has been on antipsychotics for abundant years. Which abandon elements are most mitigated to tend to a peculiar unfolding tardive dyskinesia (TD)?

A.

Long-tidings use of antipsychotics

B.

Genetic disposition

C.

Age

D.

A and C

E.

All of the balance

1 points  

QUESTION 32

1.      The ward inquires environing antipsychotic medications. Which exculpation by the PMHNP relates nthe elements that tend to curtaild abandon of extrapyramidal concomitants (EPS) for resigneds who persuade antipsychotics?

A.

Those that are powerful D2 rivals

B.

Those that are powerful D2 rivals delay 5HT2A opposition becomingties

C.

D2 receptors that are sealed in the nigrostriatal track

D.

Potent D2 rivals that seal the muscarinic anti-M1 cholinergic receptors

1 points  

QUESTION 33

1.      Mr. Gordon is a average-patriarchal resigned who is entrance antipsychotics. When examineion delay the PMHNP, he narrations unequivocal exculpations to the medication, stating, "I unquestionably handle as though the proceeds of my degradation are going separate." Which receptor renewal in antipsychotic medications is revered to be the most advantageous in pliant the proceeds barkred by Mr. Gordon?

A.

5HT2 opposition

B.

D2 opposition

C.

Alpha-2 opposition

D.

D2 inequitpotent agonist

1 points  

QUESTION 34

1.      A resigned who was of-late admitted to the psychiatric nursing individual is entity negotiateed for bipolar conjecture. Which neurotransmitter is the PMHNP most mitigated to target delay pharmaceuticals?

A.

Norepinephrine

B.

Dopamine

C.

Serotonin

D.

A and C

E.

All of the balance

1 points  

QUESTION 35

1.      Ms. Ryerson is a 28-year-old resigned delay a disposition conjecture. She of-late requested to exchange to a new PMHNP, behind not getting acovet courteous delay her anterior collectr. The new PHMNP is resurveying Ms. Ryerson's medical chart anterior to their earliest provision. Upon resurvey, the PMHNP sees that the shacompatriot collectr decisive documented "resigned had accelerated poop out." What does the PMHNP retire environing the resigned's adrecognized inveterate on this documentation?

A.

The resigned has an unsustained exculpation to antidepressants.

B.

The resigned has antidepressant-induced hypomania. 

C.

The resigned has a depletion of monoamine neurotransmitters.

D.

The resigned has an redundant good-natured-natureds to atypical antipsychotics.

1 points  

QUESTION 36

1.      The PMHNP apprehend-agains that which resigned would be contraindicated for antidepressant monotherapy?

A.

Patient delay a bipolar I designation

B.

Patient delay a bipolar II designation

C.

Patient delay a bipolar III designation

D.

None of the balance

1 points  

QUESTION 37

1.      Why does the PMHNP shirk negotiateing a resigned delay cyclothymia, and has main depressive episodes, delay antidepressant monotherapy?

A.

The resigned may touchstone paranoid shirkant manner.

B.

The resigned may touchstone harsh degradation.

C.

The resigned may touchstone auditory hallucinations.

D.

The resigned may touchstone extensiond disposition cycling.

1 points  

QUESTION 38

1.      The PMHNP is caring for a resigned delay the s genomark of SERT. What does the PMHNP discern touching this resigned's exculpation to nobleive serotonin reuppersuade debaror (SSRI)/SNRI adjustment?

A.

The resigned has a eminenter accident of tolerating SSRI/SNRI adjustment.

B.

The resigned get bear a unequivocal exculpation to SSRI/SNRI adjustment.

C.

The resigned get unfold harsh disposition cycling in exculpation to adjustment.

D.

The resigned may be short correspondent or indulgent to the adjustment.

1 points  

QUESTION 39

1.      Ms. Boeckh is a 42-year-old resigned delay main degradation. The PMHNP discerns that which renewal of norepinephrine get affect Ms. Boeckh's serotonin levels?

A.

Norepinephrine powerfuliates 5HT indemnify through a2 postsynaptic receptors.

B.

Norepinephrine debars 5HT indemnify through a2 receptors.

C.

Norepinephrine debars α2 receptors on axon tidingsinals.

D.

Norepinephrine powerfuliates 5HT indemnify through a1 and a2 receptors.

1 points  

QUESTION 40

1.      Which proposition made by the PMHNP punishly relates the interdependence inchoate NE neurons and pharmaceutical adjustment?

A.

"Drugs debar the indemnify of NE."

B.

"Drugs can ape the original business-posting of the NE neuron."

C.

"Drugs are unfitted to feign the proceeds of NE neurons."

D.

"Drugs frustrate the original business-posting of the NE neuron by sealping the presynaptic a2 neuron."

1 points  

QUESTION 41

1.      The PMHNP is assessing a resigned in the psychiatric exigency admittance. The resigned divulges the PMHNP that he does not discern why his degradation has not lifted behind entity on filthy incongruous antidepressants balance the route of a year. Which of the behindcited concomitants can be residual concomitants for resigneds who do not finish absolution delay main depressive conjecture?

A.

Insomnia

B.

Suicidal ideation

C.

Problems concentrating

D.

A and C

1 points  

QUESTION 42

1.      Fluoxetine (Prozac) has been adjustd for a resigned. Which of the behindcited propositions is penny touching the renewal of this medication?

A.

Neuronal firing rates are not dysregulated in degradation.

B.

Blocking the presynaptic SERT get offerly administer to a wide communicate of serotonin in abundant synapses.

C.

Upon the sharp government of a SSRI, 5HT diminishs. 

D.

The renewal at the somatodendritic end of the serotonin neuron may best clear-up the hygienic renewal of SSRIs. 

1 points  

QUESTION 43

1.      The foster educationist apprehend-agains that instruction was powerful when one of the wards compares fluvoxamine to sertraline and notes which of the behindcited harmoniousities?

A.

Both bear a sedative-like, calming good-natured-natureds. 

B.

Both tend to antipsychotic renewals.

C.

Both reveal favorpowerful ascertainings in negotiateing degradation in the senile.

D.

Both are apprehend-againn for causing harsh delaydrawal concomitants such as dizziness, impatience, and akathisia.

1 points  

QUESTION 44

1.      A 45-year-old feminine resigned delay allergic rhinitis and recognized lineage consluxuriance has had no abatement in depressive concomitants behind perplexing bupropion, paroxetine, and venlafaxine. What prefrugal are omissioned in consequently monoamine oxidase debarors (MAOI) in negotiateing her degradation?

A.

Since all MAOIs demand sustenanceary restrictions, the resigned get omission to shirk all cheeses and patriarchal, smoked, or fermented meats.

B.

The resigned cannot persuade any antihistamines. 

C.

The resigned cannot bear two attainment teeth extracted opportunity on a MAnOI.

D.

The resigned get omission to minimize sustenanceary inpersuade of subsistences such as tap and unpasteurized beer, patriarchal cheeses, and soy products/tofu. 

1 points  

QUESTION 45

1.      After sitting in on an interdisciplinary adjustment team examineion, the ward foster asks the pedagogue to clear-up a government-inveterate admittance to the adjustment of degradation. What is the expend exculpation?

A.

Symptoms succor invent a idiosyncrasy, then concomitants are deconstructed into a register of peculiar concomitants touchstoned by a resigned. 

B.

Symptoms are matched earliest delay the brain circuits that hypothetically convenient them and then delay the apprehend-againn neuropharmacological prescribe of these circuits by neurotransmitters.

C.

Treatment libertys that target neuropharmacological agencys are fiomission to elucidate concomitants one by one.

D.

All of the balance.

1 points  

QUESTION 46

1.      A 51-year-old feminine resigned exhibits delay concomitants of degradation, including bankruptcy of motivation and involvedy drowseing. What abandon elements would extension her vulnerpower for a idiosyncrasy of degradation?

A.

First aggression in puberty or forthcoming adulthood

B.

Late aggression of menses  

C.

Premenstrual syndrome

D.

A and C

1 points  

QUESTION 47

1.      A foster balancehears that a resigned has failed merely therapy delay an SSRI and SNRI. She to-boot discerns that the resigned has been on dual SSRI/SNRI therapy delayout protracted concomitant administer. She admittancees the PMHNP and asks what the contiguous adjustment liberty could be in this lookingly adjustment-resistant resigned. The PMHNP divulges the foster she get negotiate the resigned delay the behindcited influence:

A.

MAOI plus SNRI

B.

SSRI/SNRI plus NDRI 

C.

NDRI/SNRI plus mirtazapine

D.

NDRI plus modafinil

1 points  

*Q/UESTION 48

1.      Mrs. Radcliff is a 42-year-old resigned who is consequently sealping paroxetine. Why does her PMHNP instruct resisting this rash discontinuation of the hygienics?

A.

She may touchstone delaydrawal concomitants.

B.

She may touchstone extensiond trauma.

C.

Effects of rash intermission are hidden.

D.

It can administer to involvedies delay tension.

1 points  

QUESTION 49

1.      A resigned is adjustd fluoxetine but is restshort environing the margin proceeds. Which proposition reveals servile resigned instruction when examineing the margin proceeds associated delay fluoxetine?

A.

Weight shape can be problematic.

B.

Sedation is very despicable.

C.

Induction of madness is worthy.

D.

Seizures are not worthy.

1 points  

QUESTION 50

1.      The PMHNP is caring for a resigned delay solicitude who unfolds meek to sparing hepatic infirmity. Which renewal does the PMHNP persuade touching the use of venlafaxine?

A.

Stop the venlafaxine

B.

Lower the dose of venlafaxine by 50%

C.

Lower the dose of venlafaxine by 25-40%

D.

Increase the dose of venlafaxine by 50%

1 points  

QUESTION 51

1.      A 25-year-old feminine resigned is entity adjustd milnacipran to negotiate fibromyalgia, and expresses matter touching "how she get handle and look" from entrance the hygienics. Which proposition punishly relates the margin proceeds as a promiseination of entrance this medication?

A.

It can affect her menstruation. 

B.

Suicidality can be despicpowerful inchoate pubescent adults.

C.

Sedation may be problematic.

D.

Weight shape is worthy.

1 points  

QUESTION 52

1.      Mr. Ruby is a 33-year-old merely father who is requesting pharmacological clashnce to negotiate his fibromyalgia. The PMHNP sees in the medical chart that he has a late idiosyncrasy of arrhythmia and a BMI of 29. During his tribute, the PMHNP discerns that Mr. Ruby completements 40-50 hours a week as a contractor and "manages his importance" by smoking 3-4 cigarettes a day and having 8-10 imbibes of alcohol each week. Why would duloxetine be contraindicated for Mr. Ruby?

A.

He has fibromyalgia.

B.

He has arrhythmia.

C.

He uses alcohol.

D.

He is balanceweight.

1 points  

QUESTION 53

1.      A resigned is adjustd sertraline to negotiate fright conjecture. Knowing that sertraline can judiciously accalculate solicitude or insomnia, what should the PMHNP do?

A.

Prescribe covet-acting benzodiazepine for 2 weeks, then extension the dose.

B.

Prescribe condensed-acting benzodiazepine for 2 weeks, then cancel.

C.

Prescribe covet-acting benzodiazepine for 2 weeks, then cancel.

D.

Prescribe condensed-acting benzodiazepine for 2 weeks, then extension the dose. 

1 points  

QUESTION 54

1.      A resigned is adjustd 50 mg of desvenlafaxine to persuade total other day for main depressive conjecture. What does the PMHNP discern environing this resigned?

A.

The resigned has hepatic infirmity.

B.

The resigned has sparing renal infirmity.

C.

The resigned has harsh renal infirmity.

D.

The resigned has cardiac infirmity.

1 points  

QUESTION 55

1.      The PMHNP discerns that which agency tends to a worse tolerpower profile for resigneds entrance tricyclic antidepressants (TCAs)?

A.

Histamine H1 receptor sealade can accalculate insomnia.

B.

Muscarinic M1 receptor sealade accounts blurred desire.

C.

Alpha 1 adrenergic receptor sealade accounts hurry shape.

D.

Muscarinic M3 receptor sealade accounts sedation.

1 points  

QUESTION 56

1.      A resigned who was adjustd an MAO debaror is discerning environing sustenanceary modifications. Which proposition made by the PMHNP reveals becoming instruction of the subsistence-refuse interactions for MAO debarors?

A.

"You must shirk soy products, such as tofu."

B.

"You should not decay wayed meats."

C.

"You may decay fermented subsistences, affect sauerkraut."

D.

"You may abide to imbibe beers on tap."

1 points  

QUESTION 57

1.      A resigned who is adjustd MAO debarors asks environing whether he can abide entrance pseudoephedrine to succor his redundancy. Which exculpation by the PMHNP designates becoming discerning of refuse-refuse interactions?  

A.

"Decongestants are noble to abide entrance delay MAO debarors." 

B.

"Decongestants are okay to persuade delay MAO debarors in temperance."

C.

"Decongestants should be shirked due to abandon of serotonin syndrome." 

D.

"Decongestants should be shirked due to abandon of hypertensive crisis."  

1 points  

QUESTION 58

1.      Ms. Skidpast exhibits for a follow-up prodesire behind entity adjustd phenelzine (Nardil), and narrations "I persuade my 45 mg pill, three protractions a day, recognized affect I'm deemed to." What does the PMHNP discern environing this resigned?

A.

Ms. Skidpast is entrance the punish dose of phenelzine (Nardil).

B.

Ms. Skidpast is not entrance abundance of the phenelzine (Nardil); she should be entrance three protractions that aggregate. 

C.

Ms. Skidpast is entrance too abundantly of the phenelzine (Nardil); she should be entrance the 45 mg in three doses.

D.

Ms. Skidpast is entrance too abundantly of the phenelzine (Nardil); she is deemed to persuade 45 mg total 24 hours.

1 points  

QUESTION 59

1.      The PMHNP is caring for divers resigneds who exhibit delay fitful concomitants and vigor issues. For which resigned does the PMHNP adrecognized pregabalin (Lyrica)?

A.

Patient delay PTSD

B.

Patient delay inequitpotent seizures

C.

Patient delay galactose fanaticism  

D.

Patient delay Lapp lactase noncommunication

1 points  

QUESTION 60

1.      Mr. Gutier is 72 years old delay solicitude and depressive concomitants. His PMHNP is prescribing lorazepam (Ativan). What does the PMHNP discern touching this adjust?

A.

The PMHNP get adrecognized short than 2-6 mg for Mr. Gutier to persuade daily.

B.

The PMHNP get demand Mr. Gutier to persuade 2-4 doses of lorazepam (Ativan) per day.

C.

The PMHNP get adrecognized past than 2-6 mg for Mr. Gutier to persuade daily.

D.

The PMHNP get bear Mr. Gutier persuade 6 mg of lorazepam (Ativan) as a PRN.

1 points  

QUESTION 61

1.      A resigned is entity adjustd a sedating antidepressant, but is restshort environing hurry shape. Which medication is most mitigated to be adjustd to addresses the resigned's matters? 

A.

mirtazapine (Remeron)

B.

doxepin (Silenor)

C.

alprazolam (Xanax)

D.

trazaperformed (Oleptro)

1 points  

QUESTION 62

1.      A resigned who was diagnosed delay bipolar conjecture delayout madness, asks the PMHNP why he is entity adjustd a disposition stabilizer. What is the expend exculpation?

A.

Mood stabilizers are merely adjustd to negotiate manic phases of bipolar degradation

B.

Mood stabilizers can conformably negotiate twain madness and bipolar degradation

C.

Mood stabilizers can target madness and madness falling-back and to-boot curtail concomitants of bipolar degradation and falling-back of bipolar degradation concomitants but no refuse has been proven to target all filthy hygienic renewals

D.

Certain disposition stabilizers, such as lithium, are powerful to conformably target madness and bipolar degradation

1 points  

QUESTION 63

1.      The PMHNP is assessing a resigned in the exigency admittance. The resigned shares that he has been on lithium (Lithobid) for abundant years. What lineage touchstones does the PMHMP adjust?

A.

Thyroid Stimulating Hormone (TSH)

B.

Complete Lineage Calculate (CBC)

C.

Erythrocyte Sedimentation Rate

D.

Platelet Count

1 points  

QUESTION 64

1.      A 39-year old feminine resigned exhibitly on lithium would affect to try a new medication to negotiate her bipolar conjecture. She has had matters environing margin proceeds from lithium and scantinesss to discern past environing Lamotrigine (Lamictal) as a adjustment liberty. The PMHNP removes some of the matchless aspects of this principal, including which of the behindcited?  I don’t gard I had this inquiry

A.

Tnear is some evidence lamotrigine can frustrate gradation from meek apprehensive infirmity to Alzheimer's complaint

B.

Lamotrigine may accalculate rashes, including the life-threatening Stevens-Johnson syndrome

C.

It was one of the earliest anticonvulsants affectd by the FDA to negotiate bipolar degradation

D.

Tnear is a abandon for amenorrhea and polycystic ovarian complaint in women of branchbearing age

1 points  

QUESTION 65

1.      A nursing ward is seeking percolation on the use of anticonvulsants to negotiate degradation and is unclear environing most powerful outcomes. Which of the behindcited principals does the PMHNP remove as having uninfallible outcomes?

A.

Carbamazepine (Tegretol)

B.

Gabapentin (Neurontin)

C.

Valporoic Pointed (Depakene)

D.

All of the balance

1 points  

QUESTION 66

1.      A 46-year old courageous resigned mentions divers opinion adjustments to Carbamazepine (Tegretol) as a way to direct concomitants of his bipolar degradation. Which of the behindcited does the PMHNP designate would not be an principal to negotiate bipolar degradation?

A.

Omega-3-fatty-acids

B.

Soybean lecithin

C.

Inositol

D.

L-methylfolate

1 points  

QUESTION 67

1.      The PMHNP is examineion delay a new dowager who would affect to start entrance medication ashape to negotiate her bipolar degradation; she is breastfeeding her 2-month old daughter. The PMHNP apprehend-agains that which of the behindcited medications is contraindicated for this resigned?

A.

Valporic Pointed (Depakene)

B.

Carbamazepine (Tegretol)

C.

Lithium (Lithobid)

D.

Lamotrigine (Lamictal)

1 points  

QUESTION 68

1.      The PMHNP assesses a 10-year old courageous branch in the ER and doubts madness. Which of the behindcited concomitants and recommendations for follow-up evaluation are expend?

A.

Irritability, euphoria, anger; the branch should be evaluated advance for persuade conjecture. 

B.

Irritability, furious outbursts, hyperactivity; the branch should to-boot be evaluated advance for ADHD

C.

Irritability, stupor, anger; the branch should be evaluated advance for ADHD.  

D.

Irritability, sharp madness, hyperactivity; the branch should be evaluated advance for persuade conjecture. 

1 points  

QUESTION 69

1.      A resigned was diagnosed delay GAD 4 weeks ago and was placed on Clonazepam (klonopin) twice a day and citalopram (citalopram (celexa)) uninterruptedly daily. When he asks the PMHNP why it is compulsory to abalienate him off of the Clonazepam (klonopin) the best exculpation is:

A.

Clonazepam (klonopin) may clash delay citalopram (celexa)s targeted areas in the brain

B.

Clonazepam (klonopin) is not recommended for covet tidings use due to undeveloped sedation

C.

Clonazepam (klonopin) was used as an aid to negotiate your say opportunity you were adjusting to citalopram (celexa)

D.

Clonazepam (klonopin) and citalopram (celexa) target the harmonious area in the brain and behind covet-tidings use they get start to cope making one past or short powerful than the other

1 points  

QUESTION 70

1.      During tribute a resigned says "Why are you asking me environing my central-part, I am near for my head", the PMHNP's best exculpation is:

A.

"Some medications can accalculate central-keep-apart issues so it is compulsory to government those out anteriorly you start medication."

B.

"This is a keep-akeep-apart of our stereopattern admittance and it is influential that you bestow me veracious exculpations."

C.

"Chronic says such as Lupus can accalculate an area in your brain to malfunction, peculiarally your hippocampus."

D.

"Anxiety can accalculate cortisol levels to extension and when this happens abundantly it puts you at abandon for comorbidities such as mark 2 diabetes."

1 points  

QUESTION 71

1.      The PMHNP discerns that the undeveloped of alcohol affront in the watchful resigned is eminenter for the behindcited reason: A.

Alcohol is lawful and is a despicpowerful way that most mob communicate delay their problems.

B.

Alcohol completements harmonious to benzodiazepines

C.

Up to 30% of mob delay solicitude use alcohol to self-medicate

D.

Alcohol extensions serotonin at the synapse and the resigned may temporarily handle happy

1 points  

QUESTION 72

1.      After adjusting flumazenil (Rumazicon) the PMHNP frugal the staff to pedagogue for which undeveloped good-natured-natureds?

a.

Respiratory degradation

b.

Sedation and impatience

c.

Sweating and qualm (This inquiry was notable wickedness but I gard the exculpations are incongruous too)

d.

Bradycardia and tachypnea

1 points  

QUESTION 73

1.      A resigned  is adjustd escitalopram (Lexapro) for his solicitude. When he asks why he was absorbed an antidepressant the PMHNP's best exculpation is:

A.

"SSRIs are used to negotiate solicitude beaccalculate serotonin has been proven to succor delay handleings of misgiving and molest."

B.

"Even though you were diagnosed delay solicitude tnear is a very eminent accident that you to-boot bear degradation due to the harmoniousities of twain complaints."

C.

"Antidepressants are adjustd prophylactically to frustrate concomitants of degradation."

D.

"Escitalopram (Lexapro) is very powerful delay negotiateing the fright attacks that can supervene delay solicitude."

1 points  

QUESTION 74 ?

1.      The PMHNP evaluates the resigned for "misgiving saying" when he asks:

A.

Have you forforcontinually touchstoned any mark of trauma?

B.

What do you do when you handle misgiving?

C.

Does your dowager or father bear a fact of misgiving and/or molesting?

D.

What moulds your misgiving amend?

1 points  

QUESTION 75

1.      A resigned diagnosed delay PTSD is adjustd propranolol (Inderal) and the PMHNP discerns that he was adjustd this medication for what purpose:

A.

He has tempestuous eminent lineage consluxuriance and this must be negotiateed anteriorly rendezvousing on his PTSD.

B.

Beta sealers are concatenateed to reconsolidation.

C.

This medication get recognize the resigned to drowse throughout the ignorance.

D.

This medication is concatenateed to the extension of serotonin in the brain.

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