NURS 6630 Midterm & Final Exam Study Guides

Question 1

Which of the following is an appropriate strategy for managing treatment-resistant depression?

Question 2

M. M. is 27-year-old female student pharmacist who presents to the ER after experiencing extreme lightheadedness during her fourth-year seminar presentation. Her vitals are as follows: BP (107/65) and HR of 45. What medication below is likely the cause of these symptoms?

Response Feedback:

“The use of beta-blockers may be associated with orthostatic hypotension, lightheadedness, bradycardia, and nausea.”

Question 3

You are currently evaluating a patient with major depressive disorder. One of his major complaints is insomnia. He states that he is awake all night and cannot get any rest. You decide to prescribe an antidepressant that will help his depression and his insomnia. The best option is _______________.

Response Feedback:

The best option for this patient is trazodone. Trazodone is helpful in patients that have depression and insomnia. Trazodone is taken at night to help the patient obtain sleep/rest.

Question 4

What is the therapeutic plasma level of carbamazepine?

Question 5

Which amino acid is involved in the synthesis of both norepinephrine and dopamine?

Question 6

Choose the appropriate pair regarding acetylcholine receptors.

Response Feedback:

“There are two classes of ACh receptors: muscarinic and nicotinic. While muscarinic receptors are G-protein-coupled, nicotinic receptors are ion channels, which allows for rapid influx of NA+ and Ca2+ into the post-synaptic neuron.”

Question 7

When initiating lithium, how long should you wait before checking a lithium level? What is the therapeutic goal level of lithium?

Question 8

Patient is a 59-year-old male with a past medical history significant for bipolar disorder I, hypertension, and COPD. He calls your clinic today complaining of extreme fatigue and a new tremor in his hand. He reports starting lithium 600 mg at bedtime about 5 days ago and thinks that may be the cause. What is the appropriate next step for this patient?

Response Feedback:

“Other bothersome adverse effects” Patient is likely experiencing lithium toxicity and labs should be verified first before continuing with other treatments for the tremor.

Question 9

Of the following medications, which ones are considered first-line in treatment of an acute manic episode of bipolar disorder (assuming monotherapy)?

I. Lithium

II. Fluoxetine

III. Aripiprazole

IV. Risperidone

V. Ziprasidone

VI. Venlafaxine

VII. Quetiapine

VIII. Valproate

Question 10

Glia cells play a supportive role in the neuron. A few of the functions of the glial cells include providing nutrition, maintaining homeostasis, stabilizing synapses, and myelinating axons. The glial cells are categorized as microglia or macroglia. Of the macroglia cells, which one plays a role in myelinating axons, which may contribute to mood disorders if altered?

Question 11

A 25-year-old female comes into your clinic today informing you she is ready to have a baby and wishes to discontinue her birth control at this time. After reviewing her chart, you notice she has a history of bipolar disorder and was previously prescribed valproic acid by another doctor. What is your concern with this medication in this specific patient?

Response Feedback:

“Valproic acid may produce teratogenic effects.”

Question 12

Scott is a 70-year-old man that is taking citalopram 40 mg daily. You discuss changing citalopram to another medication or decreasing the dose. He is hesitant to change medications since citalopram works for him. You end up decreasing his dose to 20 mg/day. He asks why you are wanting to change his medication or lower his dose. Which of the following reasons is the main reason you made the decision to decrease his dose.

Response Feedback:

A maximum daily dose of 20 mg/day is recommended in patients greater than 60 years of age due to the increased risk of QT prolongation.

Question 13

Which medication has been studied and recommended in patients with a social anxiety disorder who also suffer from an alcohol use disorder?

Response Feedback:

“Suggested that treatment with the SSRI paroxetine decreased the anxiety and may have reduced the alcohol use as well”

Question 14

Choose the correct option regarding the major classes of GABA receptors and the ions involved in inhibition of the neurotransmitter pathway

Response Feedback:

“GABAB receptors, akin to the metabotropic glutamate receptors, are G-protein-coupled receptors rather than ion channels. Activation of GABAB causes downstream changes in potassium (K+) and Ca+2 channels, largely via G-protein-mediated inhiation of cAMP.”

Question 15

A 32-year-old males calls you complaining of decreased libido since starting Paroxetine 20 mg 2 weeks ago. He reported stopping the medication 1 day ago and is now experiencing extreme irritability and nervousness. He wishes to stop this medication due to side effects. What do you recommend?

Response Feedback:

under selective serotonin re-uptake inhibitors discontinuation syndrome subtitle: “The risk of such adverse events occurring seems to be inversely related to the half-life of the SSRI, with fluoxetine reported as having a significantly lower risk than paroxetine in two studies. For more severe discontinuation-related adverse events, re-institution of the SSRI and slow taper may be necessary to alleviate these symptoms.”

Question 16

Close-ended questions will help identify when patients are taking medications incorrectly.

Question 17

Which of the following medications used for treatment of bipolar disorder may increase stroke risk among older patients, particularly those with dementia?

Response Feedback:

“Notably, pharmacovigilance studies suggest that atypical antipsychotics may increase stroke risk among older patients, particularly those with dementia, so use of SGA requires more caution in this group.”

Question 18

Of the following medications used in the treatment of social anxiety disorder, which one would you AVOID in a patient who has uncontrolled hypertension?

Response Feedback:

Phenelzine reported to have hypertensive reactions as a limitation/primary side effect

Question 19

A patient presents to your clinic with generalized anxiety disorder. Her past medical history is significant for type II diabetes and uncontrolled hypertension. Which of the following agents would be least appropriate to start her on?

Response Feedback:

Venlafaxine has been associated with increased hypertension and should not be used as an initial treatment option.

Question 20

Alprazolam, phenobarbital, and alcohol all bind allosterically to GABA_A receptors. What occurs to the GABA_A receptor when these substances bind to the receptor?

Response Feedback:

The receptor becomes more sensitive to GABA. GABA is the major inhibitory neurotransmitter within the CNS.

Question 21

Which of the following syndromes is characterized by disorientation + confusion, agitation, fever, diarrhea, and ataxia? This syndrome can occur when an MAOI is given with an SSRI

Response Feedback:

The serotonin syndrome is characterized by alterations in cognition (e.g., disorientation and confusion), behavior (e.g., agitation and restlessness), autonomic nervous system function (e.g., fever, shivering, diaphoresis, and diarrhea), and neuromuscular activity (e.g., ataxia, hyperreflexia, and myoclonus). Since MAO enzymatic activity requires approximately 14 days to be restored, such food or medications should be avoided for 2 weeks after the discontinuation of an irreversible MAOI (“MAOI washout period”). Serotonergic and dopaminergic antidepressants are typically discontinued 2 weeks before the initiation of an MAOI, with the exception of fluoxetine, which needs to be discontinued 5 weeks in advance due to its relatively longer half-life.

Question 22

Jamie has major depressive disorder and you decide to prescribe an SSRI. Jamie wants to make sure her medication is covered by her insurance plan. You review a list of SSRIs and notice that one medication listed on the list is not FDA-approved for the treatment of depression. Which of the following medications do you decide to NOT prescribe for Jamie’s depression?

Response Feedback:

Only one of the SSRIs, fluvoxamine, is not approved for the treatment of depression in the United States, as it is approved only for the treatment of obsessive-compulsive disorder (OCD).

Question 23

K. B. is a 28-year-old male who was started on Venlafaxine 75 mg about 2 weeks ago and is now calling you asking how long it should take for this medication to begin to work. He is concerned his girlfriend will leave him if he doesn’t get better quickly. What is the appropriate amount of time to allot to see a therapeutic response?

Response Feedback:

“It has been consistently observed and reported that remission of depression often requires 4 weeks of treatment or more;” Page 33: “Use of antidepressant for at least 6–12 weeks to determine whether it is helping or not”

Question 24

The serotonin system is involved in many processes in psychiatry, including, most prominently, mood, sleep, and psychosis. Of the following neurons listed, from where is serotonin synthesized?

Response Feedback:

under serotonin subheading and figure 1-18 on page 16:

Locus Coeruleus: Norepinephrine

Nucleus basalis: cholinergic neurons

Substantia Nigra: dopamine Ventral

Tegmental area: dopamine

Question 25

A 23-year-old female was just diagnosed with major depressive disorder and is being started on escitalopram 10 mg daily. The patient should be counseled about which Black Box warning?

Response Feedback:

“In 2004, the FDA asked manufacturers of almost all the new antidepressant drugs to include in their labeling a warning statement that recommends close observation of adult and pediatric patients treated with these drugs for worsening depression or the emergence of suicidality.”

Question 26

Which of the following disease states contributes to a greater risk for substance use, violence, and victimization as well as worse overall quality of life?

Response Feedback:

“Moreover, non-adherent patients with schizophrenia are at greater risk for substance use, violence, and victimization as well as worse overall quality of life.”

Question 27

Which anticonvulsant below induces its own metabolism over time?

Question 28

Which of the following statements below is NOT considered an appropriate treatment strategy for treatment-resistant depression?

Response Feedback:

“Combination of an SSRI OR an SNRI with a norepinephrine-dopamine re-uptake inhibitor (bupropion) or a serotonin-norepinephrine antagonist (mirtazapine or mianserin) is a commonly used combination”

Question 29

Which neurotransmitter is considered the major inhibitory neurotransmitter?

Question 30

Which statement is TRUE regarding the use of selective serotonin reuptake inhibitors (SSRI)/serotonin-norepinephrine reuptake inhibitors (SNRI) in patients with Generalized Anxiety Disorder?

Response Feedback:

“Because the SSRI/SNRIs have the potential to cause initial restlessness, insomnia, and increased anxiety, and because the patients are commonly sensitive to somatic sensations, the starting doses should be low, typically half (or less) of the usual starting dose….”

Question 31

K. T. is a 35-year-old woman who was diagnosed with Generalized Anxiety Disorder about 4 weeks ago. She was prescribed Clonazepam 2 mg at bedtime but was referred to you to determine chronic treatment. K. T. states the new medication has been helping a lot but worries about all the side effects that come with it. She wants to discontinue the medication. What is the appropriate next step to help K. T.?

Response Feedback:

“The regular use of benzodiazepines for more than 2 to 3 weeks may be associated with physiological dependence and the potential for significant withdrawal symptoms with discontinuation. Discontinuation of benzodiazepines is best done with a gradual taper to minimize withdrawal symptoms.”

– Answer choice A: Honor the patient’s request of discontinuing the medication.

– Answer Choice C: An abrupt stop of a benzodiazepine will likely send the patient into having withdrawal symptoms.

– Answer D: Patient will likely experience withdrawal symptoms due to how often the patient uses it OR patient will experience withdrawal symptoms after missing one dose, thus the therapy wouldn’t have changed at all from how she has been taking it.

Question 32

Which answer choice includes all the components of patient-focused interventions to enhance adherence?

I. Education

II. Motivation

III. Skills

IV. Logistics

Question 33

Which of the following medications are known as selective serotonin re-uptake inhibitors (SSRIs)?

i. Nortriptyline

ii. Citalopram

iii. Duloxetine

iv. Fluoxetine

v. Venlafaxine

Question 34

In order for the NMDA receptor to fully open and allow an influx of calcium, both glutamate and glycine must bind to cause a depolarization of the cell that will ultimately displace which ion? Is the NMDA receptor an ionotropic or metabotropic receptor?

Question 35

Is this a TRUE or FALSE statement? The following patient case is considered an example of treatment-resistant depression.

B. B. is a 26-year old-female at your clinic today with the diagnosis, “treatment-resistant depression.” She is currently on Bupropion 300 mg daily and has been at this dose for 6 weeks with no alleviation in depressive symptoms.

She has trialed the following medications in the past with treatment duration listed:

– Paroxetine 40 mg daily for 6 weeks

– Citalopram 20 mg daily for 2 weeks

Response Feedback:

“At least one trial with an antidepressant with established efficacy in MDD (with sufficient duration and doses) is considered to be adequate antidepressant treatment.”

Question 36

Choose the appropriate statement regarding lamotrigine dosing.

Response Feedback:

Carbamazepine induced metabolism of lamotrigine – increase dose of lamotrigine; Valproate may inhibit clearance of lamotrigine, so dose reduction of lamotrigine is needed

Question 37

You have been consulted to evaluate a 72-year-old male with a past medical history significant for atrial fibrillation and COPD with a new diagnosis of major depression disorder. Based on his comorbid conditions, what antidepressant would you recommend as first-line?

Response Feedback:

(Options C & D are both TCA antidepressants and, based on the patient’s age and comorbid conditions, a TCA would likely result in more side effects, such as increased fall risk due to potential for orthostatic hypotension and anticholinergic-related side effects. In addition, patient has a history for cardiac abnormalities due to A. fib diagnosis – TCAs result in electrocardiographic changes in susceptible individuals, therefore, would likely avoid. Choice B is used more for ADHD purposes than as an antidepressant)

Page numbers used: Page 39 for TCA side-effect profile

Question 38

An 81-year-old male comes to your clinic today complaining of dry mouth, blurred vision, and constipation. He has a past medical history significant for hypertension, heart failure, and depression. Of the following medications, which one is likely contributing to these side effects?

Response Feedback:

Only TCA is listed with most anticholinergic effects; Page 39 for TCA side effect profile: “dry mouth, blurred vision, constipation, urinary hesitancy, tachycardia, memory difficulties, and ejaculatory difficulties”

Question 39

Austin is one of your clients and he asks you why exercise makes him feel better and lifts his mood. You tell him that his body is releasing _____________ which you know is a naturally occurring _______________.

Response Feedback:

The client is releasing a naturally occurring opioid (endorphins) that are considered peptides. The other neurotransmitters mentioned are not released during exercise and do not match the correct classification

Question 40

John presents with both autonomic symptoms and physical hyperarousal after abruptly stopping his chronic opioid therapy. He claims that he is afraid of taking his medication because of what he is seeing on the news regarding opioid-related deaths. You know that John is experiencing symptoms due to an increase in norepinephrine. You decide to treat John with a medication to dampen the symptoms of opioid withdrawal. Which medication do you prescribe John?

Response Feedback:

Clonidine dampens the symptoms associated with opioid withdrawal. The stimulation of the alpha-2 adrenoreceptors activate an inhibitory neuron.

Question 41

A 27-year-old female presents to your emergency room today with a rash that started about 1 week ago and has now spread to covering her whole body. She has a past medical history significant for type 2 diabetes, hypertension, and bipolar disorder. The patient reports, “The only thing that is different is that I’ve been on this new medication for my bipolar for a few weeks.” Of the following medications, which one is likely to be causing this severe rash?

Response Feedback:

Lamotrigine can cause a severe rash than can be life threatening

Question 42

Which of the following symptoms is NOT part of the diagnostic features for bipolar disorder?

Response Feedback:

“Psychosis is not represented in the diagnostic features for BPD.”

– “Psychosis typically resolves along with the mood symptoms, though diagnostic criteria acknowledge that psychotic symptoms may linger beyond the end of the episode.”

Question 43

It is appropriate to start lamotrigine in combination with another atypical antipsychotic in treatment of an acute manic episode in bipolar disorder.

Response Feedback:

“Lamotrigine has also been extensively studied in bipolar depression as well….”

Question 44

R.J. never felt relief from his depressive symptoms, even after appropriate time and dose titration of Venlafaxine. He was switched to Bupropion 150 mg about 2 months ago and is following up with you today. He reported feeling “great” and that his relationship with his girlfriend is “better than ever now.” Because he is feeling so well at this time, he is wondering when he can stop taking Bupropion. How long must the patient be symptom-free before he may begin a trial to taper off the antidepressant therapy?

Response Feedback:

“Therefore, in treatment-responders, most experts favor a continuation of antidepressant therapy for a minimum of 6 months following the achievement of remission.”

Question 45

Choose the correct statement(s) regarding lithium levels. SELECT ALL THAT APPLY.

Response Feedback:

under pharmacokinetics and pharmacodynamics subtitle

– “NSAIDs or other COX-2 inhibitors may decrease renal blood flow and thereby increase lithium levels by up to 25%.”

– “Therefore, thiazide diuretics, which act distally, will tend to increase lithium levels by up to 50% while those that act more proximally generally have less of an effect on lithium levels.”

Question 46

What is the strongest established risk factor for bipolar disorder?

Response Feedback:

“The strongest established risk factor for BPD is a family history of BPD.”

Question 47

Which one of the anticonvulsants mentioned below has sufficient data to support its use in bipolar disorder?

Response Feedback:

Carbamazepine has data to support its use in the treatment of bipolar disorder. The other medications listed do not have data to support the use in any phase of bipolar disorder.

Question 48

Ronnie presents to your clinic with tremor, bradykinesia, and rigidity. The symptoms are very similar to what you would see in a patient with Parkinson’s disease. The client was prescribed risperidone several weeks ago. What is the reason for Ronnie’s symptoms?

Response Feedback:

Risperidone is an antipsychotic that works by blocking dopamine receptors in the striatum. Dopamine blockade has been associated with the extrapyramidal symptoms that are seen with antipsychotic usage.

Question 49

M. B. was just diagnosed with Generalized Anxiety Disorder and pharmacotherapy is needed. Which of the following would be a first-line treatment option for M. B.?

. Duloxetine

I. Quetiapine

II. Diazepam

III. Escitalopram

Response Feedback:

“As is true for panic and the other anxiety disorders, the SSRIs and SNRIS are generally considered first-line agents for the treatment of GAD because of their favorable side effect profile….”

Question 50

Which of the following medications is best to AVOID in maintenance treatment of bipolar disorder and why?

Response Feedback:

“As noted previously, antidepressants may contribute to an increase in mood episode frequency.”

Question 51

When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?

Sunday, July 10, 2022 12:10:09 PM EDT

NURS 6630 MIDTERM EXAM STUDY GUIDE

Non-compliant patients
Neurotransmitters
Gene Expression
Cytochrome P450 Enzyme System
Pharmacokinetics
Mechanisms of receptors including:
G-Protein linked receptor

NURS 6630 Midterm & Final Exam Study Guides

o nicotine cholinergic
o serotonin
o dopamine
o norepinephrine
o D2 receptors
o glycine receptors
o ionotropic receptors
· Medications classifications – Full agonists, antagonists, partial agonist, and inverse agonists
· Therapeutics, side effects, dosing, use, and special populations for medications to treat
o Psychosis and schizophrenia
o bipolar disorders
o depression
o mania
o paranoid psychosis
o panic disorders
o fibromyalgia
o smoking cessation
o Parkinson’s disease
o anxiety. 6630 Midterm & Final Exam Study Guides.
o stress
o PTSD
· How to identify improvement in a patient following administration of medication
· System-based approaches to treatment
· MAO inhibitors

Stahl’s Essential Psychopharmacology

Chapter 1 – Chemical Neurotransmission

· Anatomical versus chemical basis of neurotransmission

Signal transduction cascades
· Epigenetics

Chapter 2 – Transporters, receptors, and enzymes as targets of psychopharmacological drug action

· Neurotransmitter transportation as targets of drug action
· G-protein-linked receptors
· Enzymes as targets of psychotropic drugs
· Cytochrome P450 drug metabolizing enzymes as targets of psychotropic drugs

Chapter 3 – Ion channels as targets of psychopharmacological drug action

· Ligand-gated ion channels as targets of psychopharmacological drug action
· Voltage-sensitive ion channels as targets of psychopharmacological drug action
· Ion channels and neurotransmission. NURS 6630 Midterm & Final Exam Study Guides.

Chapter 4 – Psychosis and schizophrenia

· Symptom dimensions in schizophrenia
· Neurotransmitters and circuits in schizophrenia
· Neurodevelopment and genetics in schizophrenia
· Neuroimaging circuits in schizophrenia

Chapter 5 – Antipsychotic agents

· Conventional antipsychotics
· Atypical antipsychotics
· Links between antipsychotic binding properties and chemical actions
· Pharmacologic properties of individual antipsychotics: the pines, the dones, two pips and a rip plus more
· Antipsychotics in clinical practice. NURS 6630 Midterm & Final Exam Study Guides.
· Future treatments for schizophrenia

Chapter 6 – Mood disorders

· Description of mood disorders
· The bipolar spectrum
· Can unipolar depression be distinguished from bipolar depression?
· Are mood disorders progressive?
· Neurotransmitters and circuits in mood disorders
· Stress and depression
· Symptoms and circuits in depression
· Symptoms and circuits in mania. NURS 6630 Midterm & Final Exam Study Guides.
· Neuroimaging and mood disorders

Chapter 7 – Antidepressants

· General principles of antidepressant action
· Antidepressant classes
· Augmenting antidepressants
· How to choose an antidepressant
· Future treatments for mood disorders

Stahl’s Illustrated Guide – Anxiety, Stress, and PTSD

Chapter 4 – First line medications for PTSD

· Pharmacological Treatments
· SSRIs
Chapter 5 – Second-line, adjunct, and investigational medications for PTSD
· Second-line Medications
· Adjunct Medications. NURS 6630 Midterm & Final Exam Study Guides.
· Investigational Medications

NURS 6630 FINAL EXAM STUDY GUIDE

Therapeutics, side effects, dosing, use, and special populations for medications to treat
o psychotic aggression
o psychotic behaviors
o psychosis and aggression
o impulsive symptoms
o ADHD
o mood disorders
o fibromyalgia
o chronic pain
o migraines
o shingles
o Alzheimer’s disease
o dementia
o PTSD
o Premenstrual dysphoric disorder (PDD)
o Irritable bowel syndrome
o diabetic peripheral neuropathic pain
o addictions
o smoking cessation
o Kleptomania. NURS 6630 Midterm & Final Exam Study Guides.
o Impulsive aggression
o Insomnia and sleep disorders
o

Stahl’s Essential Psychopharmacology

Chapter 10 – Chronic pain and its treatment

· What is pain?
· Neuropathic pain
· Descending spinal synapses in the dorsal horn and the treatment of chronic pain
· Targeting sensitized circuits in chronic pain conditions
· Targeting ancillary symptoms in fibromyalgia

Chapter 11 – Disorders of sleep and wakefulness and their treatment

· Neurobiology of sleep and wakefulness
· Insomnia and hypnotics. NURS 6630 Midterm & Final Exam Study Guides.
· Excessive daytime sleepiness (hypersomnia) and wake-promoting agents

Chapter 12 – Attention deficit hyperactivity disorder and its treatment

· Symptoms and circuits: ADHD as a disorder of the prefrontal cortex
· ADHD as a disorder of inefficient “tuning” of the prefrontal cortex by dopamine and norepinephrine
· Neurodevelopment and ADHA
· Treatment

Chapter 13 – Dementia and its treatment

· Causes, pathology, and clinical features of dementia
· Three stages of Alzheimer’s disease. NURS 6630 Midterm & Final Exam Study Guides.
· Targeting amyloid as a future disease-modifying treatment of Alzheimer’s disease
· Targeting glutamate
· Treatments for psychiatric and behavioral symptoms in dementia
· Other proposed targets for dementia

Chapter 14 – Impulsivity, compulsivity, and addiction

· Overview of impulsive-compulsive disorders
· Neurocircuitry and the impulsive-compulsive disorders
· Substance addictions
· Obesity as an impulsive-compulsive disorder

Stahl’s Illustrated Guide – Chronic Pain and Fibromyalgia

Chapter 5 – Pain drugs. NURS 6630 Midterm & Final Exam Study Guides.

Stahl’s Illustrated Guide – ADHA

Chapter 4 – ADHD treatments

Stahl’s Illustrated Guide – Substance Use and Impulsive Disorders

Chapter 10 – Disorders of impulsivity and compulsivity

Stahl’s Illustrated Guide – Violence

Chapter 3 – Treatment of violence and aggression

Pharmacological Interventions for ADHD

Table B. KQ2: Long-term (>1 year) effectiveness of interventions for ADHD in people 6 years and older

Pharmacological Interventions Article

Clancy, C.M., Change, S., Slutsky, J., & Fox, S. (2011). Attention deficit hyperactivity disorder: Effectiveness of treatment in at-risk preschoolers; long-term effectiveness in all ages; and variability in prevalence, diagnosis, and treatment. Table B. KQ2: Long-term(>1 year) effectiveness of interventions for ADHD in people 6 years and older. NURS 6630 Midterm & Final Exam Study Guides.

NURS 6630 MIDTERM EXAM- WALDEN

QUESTION 1

A noncompliant patient states, “Why do you want me to put this poison in my body?” Identify the best response made by the psychiatric-mental health nurse practitioner (PMHNP).

A.”You have to take your medication to become stable.”

B.”Most medications will increase the number of neurotransmitters that you already have in the brain.”

C.”Most medications used in treatment are either increasing or decreasing neurotransmitters that your body already has.”

D.”Why do you believe that your medication is poison?”

1 points

QUESTION 2

Which statement about neurotransmitters and medications is true? My correct answer was several psychiatric meds were developed after discovery of endogenous neurotransmitters. (The answer wording is different.

A.Natural neurotransmitters such as endorphins have been discovered after the development of medications.

B.Some medications were developed after the discovery and known action of the neurotransmitters in the brain.

C.Neurotransmitters receive messages from most medications.

D.The neurotransmitter serotonin is directly linked to depression. Following this discovery, the antidepressant Prozac was developed.

1 points

QUESTION 3

When an unstable patient asks why it is necessary to add medications to his current regimen, the PMHNP’s best response would be:

A.”In an extreme case such as yours, more than one medication is often needed.”

B.”Due to the ineffectiveness of your current medication, we need to try something else that can possibly potentiate its effects.

C.”Medications are often specific to the neurotransmitter(s) they are affecting and, due to more than one neurotransmitter involvement, it is often necessary to use more than one medication to improve symptoms.”

D.”I understand your concern. We can discontinue your current medication and switch to a different one that may better manage your symptoms.”

1 points

QUESTION 4 ?

During gene expression, what must occur prior to a gene being expressed?

A.Transcription factor must bind to the regulatory region within the cell’s nucleus.

B.RNA must be converted to mRNA.

C.The coding region must separate from the regulatory region. This is wrong

RNA polymerase must inhibit the process of changing RNA to mRNA.

1 points

QUESTION 5

While genes have potential to modify behavior, behavior can also modify genes. How do genes impact this process?

A.Genes impact neuron functioning directly.

B.Changes made to proteins lead to changes in behavior.

C.Neurons are able to impact protein synthesis.

D.Genes impact the DNA of a cell, leading to changes in behavior.

1 points

QUESTION 6

Though medications have the ability to target neurotransmitters in the synapse, it is not always necessary. The PMHNP understands that this is because:

A.Neurotransmission that occurs via the axon allows for transport of a neurotransmitter.

B.Active transport is a different type of energy that allows the transport of certain neurotransmitters.

C.Neurotransmitters can spread by diffusion.

D.The postsynaptic neuron can release the neurotransmitter.

1 points

QUESTION 7

Why is the cytochrome P450 enzyme system of significance to the PMHNP?

A.The kidneys play a role with excretion of the medication, and if a patient has kidney damage, the dose must be increased to be effective.

B.The bioavailability of the medication after it passes through the stomach and liver can be altered. Correct answer

C.The medication’s chemical composition changes when it comes in contact with the acid in the stomach.

D.The CYP enzyme system is a steady and predictable process that prescribers must understand to treat conditions effectively.

1 points

QUESTION 8

It is important for the PMHNP to recognize differences in pharmacokinetics to safely prescribe and monitor medications. Which of the following statements does the competent PMHNP identify as true?

A.About 1 out of 5 Asians requires lower-than-normal doses of some antidepressants and antipsychotics.

B.The term polymorphic refers to the body’s ability to break a medication down several ways, and this patient may require higher doses of certain antidepressants and antipsychotics.

C.About 1 out of 30 Caucasians requires lower doses of some antidepressants and antipsychotics.

D.Most enzyme pathways do not have interactions between the newer medications.

1 points

QUESTION 9

As it relates to G-protein linked receptors, what does the PMHNP understand about medications that are used in practice?

A.Most medications that act on G-protein linked receptors have antagonistic traits.

B.The majority of medications used in practice are full agonists and are used to stimulate the body’s natural neurotransmitters.

C.Most medications act as partial agonists because they allow the body to use only what is needed.

D.Medications used in practice may act as inverse agonists if the dosage is too high.

1 points

QUESTION 10

The PMHNP is considering prescribing a 49-year-old male clozapine (Clozaril) to treat his schizophrenia and suicidal ideations. The PMHNP is aware that which factor may impact the dose needed to effectively treat his condition:

A.The patient smokes cigarettes. This is correct!

B.The patient has hypertension.

C.The patient has chronic kidney disease, stage 2.

D.The patient drinks a cup of coffee a day.

1 points

QUESTION 11

A patient is diagnosed with bipolar disorder and is currently taking carbamazepine (Tegretol), aripiprazole (Abilify), and melatonin. The PMHNP has just written an order to discontinue the carbamazepine (Tegretol) for drug-induced thrombocytopenia. The PMHNP is aware that his next best action is to:

A.Alert staff to possible seizures

B.Write an order for a different mood stabilizer For some reason I got 0/1 points for this??

C.Decrease the amount prescribed for aripiprazole (Abilify)

D.Explain to the patient that it will be more difficult to control his temper

1 points

QUESTION 12

A patient recently transferred following a suicide attempt has a history of schizophrenia, depression, and fibromyalgia. He is currently taking Amitriptyline (Elavil), Lisinopril, aspirin, and fluoxetine (Prozac). Which is the best action for the PMHNP to take for this patient?

A.Review Amitriptyline (Elavil) level Correct answer

B.Order a liver function test

C.Check the patient’s blood pressure and pulse

D.Order a stat platelet count

1 points

QUESTION 13

A patient with schizophrenia is given an inverse agonist that acts on the receptor 5HT and neurotransmitter serotonin. What is the rationale for prescribing a medication such as this?

A.To promote the availability of serotonin

B.To decrease serotonin

C.To indirectly increase the amount of dopamine in the body

D.To help decrease the amount of serotonin and dopamine

1 points

QUESTION 14

The PMHNP is caring for four patients. Which patient statement indicates that benzodiazepines would be beneficial?

A.”I have trouble staying asleep in the middle of the night.”

B.”My spouse told me that I seem to have trouble remembering things sometimes.”

C.”I really want to stop smoking, but the cravings are too strong.”

D.”I feel nervous to go outside and be in large crowds.”

1 points

QUESTION 15

Ms. Harlow is a 42-year-old patient who is prescribed a drug that acts on ionotropic receptors. She is curious about the effects of the drug and how it will act on her symptoms. Which statement made by the PMHNP demonstrates proper understanding of Ms. Harlow’s prescription?

A.”The drug will have an almost immediate effect.”

B.”The drug can take a while to build up in your system.”

C.”The drug is slow to release but lasts for a long time.”

D.”The drug will make a subtle difference in your symptoms.”

1 points

QUESTION 16

A patient is seeking pharmacological treatment for smoking cessation. Which drug class does the PMHNP prescribe to the patient?

A.Benzodiazepine

B.Mirtazapine (Remeron)

C.Ketamine

D.Varenicline (Chantix)

1 points

QUESTION 17

The PMHNP is caring for a new patient who has been transferred from another office. When meeting with the new patient, the patient reports, “I feel like I am improving with the stabilizers.” The PMHNP immediately recognizes that the patient is describing which kind of drug?

A.Full agonists

B.Antagonists

C.Partial agonists

D.Inverse agonists

1 points

QUESTION 18

A patient presents with frequent episodes of mania. Which statement describes an appropriate treatment approach for this patient?

A.”The patient needs to have an inverse agonist.”

B.”The patient could benefit from an anticonvulsant.”

C.”The patient’s calcium, sodium, chloride, and potassium levels must be regulated.”

D.”The patient should have a drug that acts on ligand-gated ion channels.”

1 points

QUESTION 19

The PHMNP is caring for a patient who would benefit from nicotine cholinergic, serotonin 3, or glycine receptors. What kind of agent does the PHMNP want to prescribe for this patient?

A.Ligand-gated ion channels with a pentameric structure

B.Ligand-gated ion channels with a tetrameric structure

C.Voltage-sensitive ion channels

D.Anticonvulsants

1 points

QUESTION 20 ?

Which statement made by the patient suggests the patient will need to be treated with antipsychotics that target paranoid psychosis?

A.”It’s my fault that all of this is happening. I don’t think I could ever forgive myself.” Not correct

B.”I have to talk to the President because I’m the only one who can help him.”

C.”I’m not sure why that lady is wearing a red jacket since it’s the dogs who need food.”

D.”I don’t know that I even want to go to that meeting. It doesn’t seem worth it anymore.”

1 points

QUESTION 21

A patient has been treated with a number of novel psychotropic drugs. How is it theoretically possible to identify cognitive improvement in the patient using neuropsychological assessment batteries after the pharmacologic therapy? I did not have this question

A.Obtaining raw normative metrics and using them to assess functionality

B.Having the patient report on cognitive function based on personal experiences

C.Monitoring the patient in a controlled setting

D.Measuring symptoms of psychosis

1 points

QUESTION 22

Mr. McCullin is 64 years old with Parkinson’s disease. The PMHNP caring for Mr. McCullin wants to start him on a dopamine agonist to help manage and treat his condition. The PHMNP selects this agent because of which action it has on patients like Mr. McCullin?

A.Dopamine is terminated through multiple mechanisms.

B.The D2 autoreceptor regulates release of dopamine from the presynaptic neuron.

C.MAO-B presents in the mitochondria within the presynaptic neuron.

D.D2 receptors are the primary binding site for dopamine agonists.

1 points

QUESTION 23

Mrs. Trevor is a 44-year-old patient who does not have a diagnosis of schizophrenia but occasionally reports symptoms of psychosis, followed by severe fatigue. Mrs. Trevor inquires about the use of amphetamines to help with her energy levels. Which response made by the PMHNP is most appropriate?

A.”Amphetamines may help you, as they can alleviate psychotic conditions.”

B.”Amphetamines can inhibit negative symptoms of schizophrenia, so this might be a good choice for you.”

C.”Amphetamines can cause hallucinations, so I would advise against this type of prescription.

D.”Amphetamines can lead to a dopamine deficiency, so I will not prescribe this for you.”

1 points

QUESTION 24

The PMHNP is caring for a patient with schizophrenia and is considering a variety of treatment approaches. The PHMNP selects a viable treatment that is consistent with the “dopamine hypothesis of schizophrenia.” What action does the PMHNP anticipate this treatment having on the patient?

A.Blocking the release of dopamine facilitates the onset of positive schizophrenia symptoms.

B.Hyperactivity in the mesolimbic dopamine pathway mediates the positive symptoms of schizophrenia.

C.Antipsychotic drugs that open D2 receptor pathways can treat schizophrenia.

D.The neuroanatomy of dopamine neuronal pathways can explain symptoms of schizophrenia.

1 points

QUESTION 25

A patient is diagnosed with schizophrenia. What increases the patient’s potential to mediate the cognitive symptoms of the disease?

A.Achieving underactivity of the mesocorticol projections to the prefrontal cortex

B.Achieving overactivity of the mesocorticol projections to the ventromedial prefrontal cortex

C.Achieving underactivity of the mesocortical projections to the ventromedial prefrontal cortex

D.Achieving overactivity of the mesocorticol projections to the prefrontal cortex

1 points

QUESTION 26

The PMNHP is assessing a 29-year-old patient who takes antipsychotics that block D2 receptors. What patient teaching should the PMHNP include related to the possible side effects of this type of drug?

A.Hypersexuality

B.Amenorrhea

C.Dystonia

D.Tardive dyskinesia correct answer

1 points

QUESTION 27

The PMHNP is caring for a patient who is taking antipsychotics heard the psychiatrist tell the patient that the patient would be placed on a different antipsychotic agent. Which of the following requires the longest transition time for therapeutic benefit?

A.Olanzapine to clozapine

B.Asenapine to Risperidone

C.Aripripazole to ziprasidone

D.Aripripazole to clozapine

1 points

QUESTION 28

The PMHNP is assessing a patient who has cirrhosis of the liver and anticipates that the patient will be prescribed an antipsychotic. Which medication does the PMHNP suspect will be ordered for this patient?

A.Quetiapine

B.Paliperidone

C.Lurasidone

D.Clozapine

1 points

QUESTION 29

Which statement made by the PMHNP exemplifies correct teaching of physiological effects in the body?

A.Muscarinic antagonists are more likely to cause decreased prolactin levels.

B.D2 antagonists decrease the likelihood of EPS symptoms.

C.D2 antagonism is linked to antidepressant properties.

D.D2 partial agonists are associated with increased efficacy in treating positive symptoms of schizophrenia.

1 points

QUESTION 30

Mrs. Schwartzman is a 52-year-old patient with schizophrenia and no established history of depression. When meeting with the PMHNP, she presents with apathy and withdrawn social behavior, and she reports a loss of joy from enjoyable activities. What does the PMHNP infer from this encounter with the patient?

A.An underlying depressive disorder

B.The recent change of a 2nd generation antipsychotic to a conventional one

C.The recent change of a 1st generation antipsychotic to a 2nd generation antipsychotic

D.All of the above

1 points

QUESTION 31

The PMHNP is taking a history on a patient who has been on antipsychotics for many years. Which risk factors are most likely to contribute to a person developing tardive dyskinesia (TD)?

A.Long-term use of antipsychotics

B.Genetic disposition

C.Age

D.A and C

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E.All of the above

1 points

QUESTION 32

The student inquires about antipsychotic medications. Which response by the PMHNP describes the factors that contribute to reduced risk of extrapyramidal symptoms (EPS) for patients who take antipsychotics?

A.Those that are potent D2 antagonists

B.Those that are potent D2 antagonists with 5HT2A antagonism properties

C.D2 receptors that are blocked in the nigrostriatal pathway

D.Potent D2 antagonists that block the muscarinic anti-M1 cholinergic receptors

1 points

QUESTION 33

Mr. Gordon is a middle-aged patient who is taking antipsychotics. When meeting with the PMHNP, he reports positive responses to the medication, stating, “I really feel as though the effects of my depression are going away.” Which receptor action in antipsychotic medications is believed to be the most beneficial in producing the effects described by Mr. Gordon?

A.5HT2 antagonism

B.D2 antagonism

C.Alpha-2 antagonism

D.D2 partial agonist

1 points

QUESTION 34

A patient who was recently admitted to the psychiatric nursing unit is being treated for bipolar disorder. Which neurotransmitter is the PMHNP most likely to target with pharmaceuticals?

A.Norepinephrine

B.Dopamine

C.Serotonin

D.A and C

E.All of the above

1 points

QUESTION 35

Ms. Ryerson is a 28-year-old patient with a mood disorder. She recently requested to transfer to a new PMHNP, after not getting along well with her previous provider. The new PHMNP is reviewing Ms. Ryerson’s medical chart prior to their first appointment. Upon review, the PMHNP sees that the former provider last documented “patient had rapid poop out.” What does the PMHNP infer about the patient’s prescription based on this documentation?

A.The patient has an unsustained response to antidepressants.

B.The patient has antidepressant-induced hypomania.

C.The patient has a depletion of monoamine neurotransmitters.

D.The patient has an adverse effect to atypical antipsychotics.

1 points

QUESTION 36

The PMHNP recognizes that which patient would be contraindicated for antidepressant monotherapy?

A.Patient with a bipolar I designation

B.Patient with a bipolar II designation

C.Patient with a bipolar III designation

D.None of the above

1 points

QUESTION 37

Why does the PMHNP avoid treating a patient with cyclothymia, and has major depressive episodes, with antidepressant monotherapy?

A.The patient may experience paranoid avoidant behavior.

B.The patient may experience severe depression.

C.The patient may experience auditory hallucinations.

D.The patient may experience increased mood cycling.

1 points

QUESTION 38

The PMHNP is caring for a patient with the s genotype of SERT. What does the PMHNP understand regarding this patient’s response to selective serotonin reuptake inhibitor (SSRI)/SNRI treatment?

A.The patient has a higher chance of tolerating SSRI/SNRI treatment.

B.The patient will have a positive response to SSRI/SNRI treatment.

C.The patient will develop severe mood cycling in response to treatment.

D.The patient may be less responsive or tolerant to the treatment.

1 points

QUESTION 39

Ms. Boeckh is a 42-year-old patient with major depression. The PMHNP understands that which action of norepinephrine will affect Ms. Boeckh’s serotonin levels?

A.Norepinephrine potentiates 5HT release through a2 postsynaptic receptors.

B.Norepinephrine inhibits 5HT release through a2 receptors.

C.Norepinephrine inhibits α2 receptors on axon terminals.

D.Norepinephrine potentiates 5HT release through a1 and a2 receptors.

1 points

QUESTION 40

Which statement made by the PMHNP correctly describes the relationship between NE neurons and pharmaceutical treatment?

A.”Drugs inhibit the release of NE.”

B.”Drugs can mimic the natural functioning of the NE neuron.”

C.”Drugs are unable to simulate the effects of NE neurons.”

D.”Drugs prevent the natural functioning of the NE neuron by stopping the presynaptic a2 neuron.”

1 points

QUESTION 41

The PMHNP is assessing a patient in the psychiatric emergency room. The patient tells the PMHNP that he does not understand why his depression has not lifted after being on four different antidepressants over the course of a year. Which of the following symptoms can be residual symptoms for patients who do not achieve remission with major depressive disorder?

A.Insomnia

B.Suicidal ideation

C.Problems concentrating

D.A and C

1 points

QUESTION 42

Fluoxetine (Prozac) has been prescribed for a patient. Which of the following statements is true regarding the action of this medication?

A.Neuronal firing rates are not dysregulated in depression.

B.Blocking the presynaptic SERT will immediately lead to a great deal of serotonin in many synapses.

C.Upon the acute administration of a SSRI, 5HT decreases.

D.The action at the somatodendritic end of the serotonin neuron may best explain the therapeutic action of SSRIs.

1 points

QUESTION 43

The nurse educator knows that teaching was effective when one of the students compares fluvoxamine to sertraline and notes which of the following similarities?

A.Both have a sedative-like, calming effect.

B.Both contribute to antipsychotic actions.

C.Both demonstrate favorable findings in treating depression in the elderly.

D.Both are known for causing severe withdrawal symptoms such as dizziness, restlessness, and akathisia.

1 points

QUESTION 44

A 45-year-old female patient with allergic rhinitis and normal blood pressure has had no reduction in depressive symptoms after trying bupropion, paroxetine, and venlafaxine. What precautions are needed in considering monoamine oxidase inhibitors (MAOI) in treating her depression?

A.Since all MAOIs require dietary restrictions, the patient will need to avoid all cheeses and aged, smoked, or fermented meats.

B.The patient cannot take any antihistamines.

C.The patient cannot have two wisdom teeth extracted while on a MAnOI.

D.The patient will need to minimize dietary intake of foods such as tap and unpasteurized beer, aged cheeses, and soy products/tofu.

1 points

QUESTION 45

After sitting in on an interdisciplinary treatment team meeting, the student nurse asks the instructor to explain a system-based approach to the treatment of depression. What is the appropriate response?

A.Symptoms help create a diagnosis, then symptoms are deconstructed into a list of specific symptoms experienced by a patient.

B.Symptoms are matched first with the brain circuits that hypothetically mediate them and then with the known neuropharmacological regulation of these circuits by neurotransmitters.

C.Treatment options that target neuropharmacological mechanisms are selected to eliminate symptoms one by one.

D.All of the above.

1 points

QUESTION 46

A 51-year-old female patient presents with symptoms of depression, including lack of motivation and difficulty sleeping. What risk factors would increase her vulnerability for a diagnosis of depression?

A.First onset in puberty or early adulthood

B.Late onset of menses

C.Premenstrual syndrome

D.A and C

1 points

QUESTION 47

A nurse overhears that a patient has failed single therapy with an SSRI and SNRI. She also learns that the patient has been on dual SSRI/SNRI therapy without adequate symptom control. She approaches the PMHNP and asks what the next treatment option could be in this seemingly treatment-resistant patient. The PMHNP tells the nurse she will treat the patient with the following regimen:

A.MAOI plus SNRI

B.SSRI/SNRI plus NDRI

C.NDRI/SNRI plus mirtazapine

D.NDRI plus modafinil

1 points

*Q/UESTION 48

Mrs. Radcliff is a 42-year-old patient who is considering stopping paroxetine. Why does her PMHNP advise against this abrupt discontinuation of the medicine?

A.She may experience withdrawal symptoms.

B.She may experience increased trauma.

C.Effects of abrupt cessation are unknown.

D.It can lead to difficulties with concentration.

1 points

QUESTION 49

A patient is prescribed fluoxetine but is concerned about the side effects. Which statement demonstrates accurate patient teaching when discussing the side effects associated with fluoxetine?

A.Weight gain can be problematic.

B.Sedation is very common.

C.Induction of mania is rare.

D.Seizures are not unusual.

1 points

QUESTION 50

The PMHNP is caring for a patient with anxiety who develops mild to moderate hepatic impairment. Which action does the PMHNP take regarding 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

A 25-year-old female patient is being prescribed milnacipran to treat fibromyalgia, and expresses concern regarding “how she will feel and look” from taking the medicine. Which statement correctly describes the side effects as a result of taking this medication?

A.It can affect her menstruation.

B.Suicidality can be common among young adults.

C.Sedation may be problematic.

D.Weight gain is unusual.

1 points

QUESTION 52

Mr. Ruby is a 33-year-old single father who is requesting pharmacological intervention to treat his fibromyalgia. The PMHNP sees in the medical chart that he has a recent diagnosis of arrhythmia and a BMI of 29. During his assessment, the PMHNP learns that Mr. Ruby works 40-50 hours a week as a contractor and “manages his stress” by smoking 3-4 cigarettes a day and having 8-10 drinks 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 overweight.

1 points

QUESTION 53

A patient is prescribed sertraline to treat panic disorder. Knowing that sertraline can initially cause anxiety or insomnia, what should the PMHNP do?

A.Prescribe long-acting benzodiazepine for 2 weeks, then increase the dose.

B.Prescribe short-acting benzodiazepine for 2 weeks, then discontinue.

C.Prescribe long-acting benzodiazepine for 2 weeks, then discontinue.

D.Prescribe short-acting benzodiazepine for 2 weeks, then increase the dose.

1 points

QUESTION 54

A patient is prescribed 50 mg of desvenlafaxine to take every other day for major depressive disorder. What does the PMHNP understand about this patient?

A.The patient has hepatic impairment.

B.The patient has moderate renal impairment.

C.The patient has severe renal impairment.

D.The patient has cardiac impairment.

1 points

QUESTION 55

The PMHNP understands that which mechanism contributes to a worse tolerability profile for patients taking tricyclic antidepressants (TCAs)?

A.Histamine H1 receptor blockade can cause insomnia.

B.Muscarinic M1 receptor blockade causes blurred vision.

C.Alpha 1 adrenergic receptor blockade causes weight gain.

D.Muscarinic M3 receptor blockade causes sedation.

1 points

QUESTION 56

A patient who was prescribed an MAO inhibitor is learning about dietary modifications. Which statement made by the PMHNP demonstrates proper teaching of the food-drug interactions for MAO inhibitors?

A.”You must avoid soy products, such as tofu.”

B.”You should not consume processed meats.”

C.”You may consume fermented foods, like sauerkraut.”

D.”You may continue to drink beers on tap.”

1 points

QUESTION 57

A patient who is prescribed MAO inhibitors asks about whether he can continue taking pseudoephedrine to relieve his congestion. Which response by the PMHNP indicates proper understanding of drug-drug interactions?

A.”Decongestants are fine to continue taking with MAO inhibitors.”

B.”Decongestants are okay to take with MAO inhibitors in moderation.”

C.”Decongestants should be avoided due to risk of serotonin syndrome.”

D.”Decongestants should be avoided due to risk of hypertensive crisis.

1 points

QUESTION 58

Ms. Skidmore presents for a follow-up appointment after being prescribed phenelzine (Nardil), and reports “I take my 45 mg pill, three times a day, just like I’m supposed to.” What does the PMHNP understand about this patient?

A.Ms. Skidmore is taking the correct dose of phenelzine (Nardil).

B.Ms. Skidmore is not taking enough of the phenelzine (Nardil); she should be taking three times that amount.

C.Ms. Skidmore is taking too much of the phenelzine (Nardil); she should be taking the 45 mg in three doses.

D.Ms. Skidmore is taking too much of the phenelzine (Nardil); she is supposed to take 45 mg every 24 hours.

1 points

QUESTION 59

The PMHNP is caring for several patients who present with various symptoms and health issues. For which patient does the PMHNP prescribe pregabalin (Lyrica)?

A.Patient with PTSD

B.Patient with partial seizures

C.Patient with galactose intolerance

D.Patient with Lapp lactase deficiency

1 points

QUESTION 60

Mr. Gutier is 72 years old with anxiety and depressive symptoms. His PMHNP is prescribing lorazepam (Ativan). What does the PMHNP understand regarding this prescription?

A.The PMHNP will prescribe less than 2-6 mg for Mr. Gutier to take daily.

B.The PMHNP will require Mr. Gutier to take 2-4 doses of lorazepam (Ativan) per day.

C.The PMHNP will prescribe more than 2-6 mg for Mr. Gutier to take daily.

D.The PMHNP will have Mr. Gutier take 6 mg of lorazepam (Ativan) as a PRN.

1 points

QUESTION 61

A patient is being prescribed a sedating antidepressant, but is concerned about weight gain. Which medication is most likely to be prescribed to addresses the patient’s concerns?

A.mirtazapine (Remeron)

B.doxepin (Silenor)

C.alprazolam (Xanax)

D.trazadone (Oleptro)

1 points

QUESTION 62

A patient who was diagnosed with bipolar disorder without mania, asks the PMHNP why he is being prescribed a mood stabilizer. What is the appropriate response?

A.Mood stabilizers are only prescribed to treat manic phases of bipolar depression

B.Mood stabilizers can consistently treat both mania and bipolar depression

C.Mood stabilizers can target mania and mania relapse and also reduce symptoms of bipolar depression and relapse of bipolar depression symptoms but no drug has been proven to target all four therapeutic actions

D.Certain mood stabilizers, such as lithium, are able to consistently target mania and bipolar depression

1 points

QUESTION 63

The PMHNP is assessing a patient in the emergency room. The patient shares that he has been on lithium (Lithobid) for many years. What blood tests does the PMHMP order?

A.Thyroid Stimulating Hormone (TSH)

B.Complete Blood Count (CBC)

C.Erythrocyte Sedimentation Rate

D.Platelet Count

1 points

QUESTION 64

A 39-year old female patient presently on lithium would like to try a new medication to treat her bipolar disorder. She has had concerns about side effects from lithium and wants to learn more about Lamotrigine (Lamictal) as a treatment option. The PMHNP conveys some of the unique aspects of this agent, including which of the following? I don’t think I had this question

A.There is some indication lamotrigine can prevent progression from mild cognitive impairment to Alzheimer’s disease

B.Lamotrigine may cause rashes, including the life-threatening Stevens-Johnson syndrome

C.It was one of the first anticonvulsants approved by the FDA to treat bipolar depression

D.There is a risk for amenorrhea and polycystic ovarian disease in women of childbearing age

1 points

QUESTION 65

A nursing student is seeking clarification on the use of anticonvulsants to treat depression and is unclear about most effective outcomes. Which of the following agents does the PMHNP convey as having uncertain outcomes?

A.Carbamazepine (Tegretol)

B.Gabapentin (Neurontin)

C.Valporoic Acid (Depakene)

D.All of the above

1 points

QUESTION 66

A 46-year old male patient mentions several alternative treatments to Carbamazepine (Tegretol) as a way to manage symptoms of his bipolar depression. Which of the following does the PMHNP indicate would not be an agent to treat bipolar depression?

A.Omega-3-fatty-acids

B.Soybean lecithin

C.Inositol

D.L-methylfolate

1 points

QUESTION 67

The PMHNP is meeting with a new mother who would like to begin taking medication again to treat her bipolar depression; she is breastfeeding her 2-month old daughter. The PMHNP recognizes that which of the following medications is contraindicated for this patient?

A.Valporic Acid (Depakene)

B.Carbamazepine (Tegretol)

C.Lithium (Lithobid)

D.Lamotrigine (Lamictal)

1 points

QUESTION 68

The PMHNP assesses a 10-year old male child in the ER and suspects mania. Which of the following symptoms and recommendations for follow-up evaluation are appropriate?

A.Irritability, euphoria, anger; the child should be evaluated further for conduct disorder.

B.Irritability, violent outbursts, hyperactivity; the child should also be evaluated further for ADHD

C.Irritability, lethargy, anger; the child should be evaluated further for ADHD.

D.Irritability, acute mania, hyperactivity; the child should be evaluated further for conduct disorder.

1 points

QUESTION 69

A patient was diagnosed with GAD 4 weeks ago and was placed on Clonazepam (klonopin) twice a day and citalopram (citalopram (celexa)) once daily. When he asks the PMHNP why it is necessary to wean him off of the Clonazepam (klonopin) the best response is:

A.Clonazepam (klonopin) may interfere with citalopram (celexa)s targeted areas in the brain

B.Clonazepam (klonopin) is not recommended for long term use due to possible sedation

C.Clonazepam (klonopin) was used as an aid to treat your condition while you were adjusting to citalopram (celexa)

D.Clonazepam (klonopin) and citalopram (celexa) target the same area in the brain and after long-term use they will begin to compete making one more or less effective than the other

1 points

QUESTION 70

During assessment a patient states “Why are you asking me about my heart, I am here for my head”, the PMHNP’s best response is:

A.”Some medications can cause heart issues so it is necessary to rule those out before you begin medication.”

B.”This is a part of our routine admission and it is important that you give me truthful answers.”

C.”Chronic conditions such as Lupus can cause an area in your brain to malfunction, specifically your hippocampus.”

“Anxiety can cause cortisol levels to increase and when this happens frequently it puts you at risk for comorbidities such as type 2 diabetes.”

1 points

QUESTION 71

The PMHNP understands that the potential of alcohol abuse in the anxious patient is higher for the following reason:

A.Alcohol is legal and is a common way that most people deal with their problems.

B.Alcohol works similar to benzodiazepines

C.Up to 30% of people with anxiety use alcohol to self-medicate

D.Alcohol increases serotonin at the synapse and the patient may temporarily feel happy

1 points

QUESTION 72

After ordering flumazenil (Rumazicon) the PMHNP cautions the staff to monitor for which possible effect?

A.Respiratory depression

B.Sedation and restlessness

C.Sweating and nausea (This question was marked wrong but I think the answers are different too)

D.Bradycardia and tachypnea

1 points

QUESTION 73

A patient is prescribed escitalopram (Lexapro) for his anxiety. When he asks why he was given an antidepressant the PMHNP’s best response is:

A.”SSRIs are used to treat anxiety because serotonin has been proven to help with feelings of fear and worry.”

B.”Even though you were diagnosed with anxiety there is a very high chance that you also have depression due to the similarities of both diseases.”

C.”Antidepressants are prescribed prophylactically to prevent symptoms of depression.”

D.”Escitalopram (Lexapro) is very effective with treating the panic attacks that can occur with anxiety.”

1 points

QUESTION 74 ?

The PMHNP evaluates the patient for “fear conditioning” when he asks:

A.Have you ever experienced any type of trauma?

B.What do you do when you feel fear?

C.Does your mother or father have a history of fear and/or worrying?

D.What makes your fear better?

1 points

QUESTION 75

A patient diagnosed with PTSD is prescribed propranolol (Inderal) and the PMHNP understands that he was prescribed this medication for what purpose:

A.He has uncontrolled high blood pressure and this must be treated before focusing on his PTSD.

B.Beta blockers are linked to reconsolidation.

C.This medication will allow the patient to sleep throughout the night.

D.This medication is linked to the increase of serotonin in the brain.

1 points

Click Save and Submit to save and submit. Click Save All Answers to save all answers.

Here are some parts of other questions I had that I jotted down a enough of the ? so you know what Its about and my answers and if they were right or wrong:

What is an accurate description of psychosis? It’s a syndrome associated with a number of psychiatric disorders (Correct)

Mrs. Schwalzman 52 has schizophrenia and has no history of depression. She has apathy and no joy in life. What can the PMHNP infer? Her new medication is blocking D2 receptors in the mesolimbic system correct

All of the following are signs of mania except: Low self esteem

Which of the following statements about Prozac is true? Fluoxitine inhibits serotonin transporter (SERT)

The patient has failed monotherapy with both SSRI and SNRI and then failed treatment with SNRI/SSRI both. What is the next treatment? SSRI + Mood stabilizer is incorrect

A nursing student seeks clarification of the use of anticonvulsants in bipolar disorder. Which of the following anticonvulsants is not used to treat bipolar disorder? Neurontin

Dear Bridgette, Thanks for this great study aide!!! I’d have been lost without it! I hope it helps you.

The PMHNP is selecting a medication treatment option for a patient who is exhibiting psychotic behaviors with poor impulse control and aggression. Of the available treatments, which can help temper some of the adverse effects or symptoms that are normally caused by O2 antagonism?

The PMHNP is discussing dopamine D2 receptor occupancy and its association with aggressive behaviors in patients with the student. Why does the PMHNP prescribe

Question 1

What is the therapeutic plasma level of carbamazepine?

Question 2

Which medication has been studied and recommended in patients with a social anxiety disorder who also suffer from an alcohol use disorder?

Response Feedback:

“Suggested that treatment with the SSRI paroxetine decreased the anxiety and may have reduced the alcohol use as well”

Question 3

Choose the correct statement(s) regarding lithium levels. SELECT ALL THAT APPLY.

Response Feedback:

under pharmacokinetics and pharmacodynamics subtitle

– “NSAIDs or other COX-2 inhibitors may decrease renal blood flow and thereby increase lithium levels by up to 25%.”

Question 4

Which amino acid is involved in the synthesis of both norepinephrine and dopamine?

Question 5

Response Feedback:

The best option for this patient is trazodone. Trazodone is helpful in patients that have depression and insomnia. Trazodone is taken at night to help the patient obtain sleep/rest.

Question 6

Response Feedback:

“The use of beta-blockers may be associated with orthostatic hypotension, lightheadedness, bradycardia, and nausea.”

Question 7

Close-ended questions will help identify when patients are taking medications incorrectly.
Question 8

Which neurotransmitter is considered the major inhibitory neurotransmitter?

Question 9

Of the following medications used in the treatment of social anxiety disorder, which one would you AVOID in a patient who has uncontrolled hypertension?

Response Feedback:

Phenelzine reported to have hypertensive reactions as a limitation/primary side effect

Question 10

The serotonin system is involved in many processes in psychiatry, including, most prominently, mood, sleep, and psychosis. Of the following neurons listed, from where is serotonin synthesized?

Response Feedback:

under serotonin subheading and figure 1-18 on page 16:

Locus Coeruleus: Norepinephrine

Nucleus basalis: cholinergic neurons

Substantia Nigra: dopamine Ventral

Tegmental area: dopamine

Question 11
Which of the following medications are known as selective serotonin re-uptake inhibitors (SSRIs)?

Nortriptyline

Citalopram

Duloxetine

Fluoxetine

Venlafaxine
Question 12

Which of the following is an appropriate strategy for managing treatment-resistant depression?
Question 13
Which answer choice includes all the components of patient-focused interventions to enhance adherence?

Education

Motivation

Skills

Logistics

Question 14

Response Feedback:

Only one of the SSRIs, fluvoxamine, is not approved for the treatment of depression in the United States, as it is approved only for the treatment of obsessive-compulsive disorder (OCD).

Question 15

Response Feedback:

Clonidine dampens the symptoms associated with opioid withdrawal. The stimulation of the alpha-2 adrenoreceptors activate an inhibitory neuron.

Question 16

Response Feedback:

Question 17

Response Feedback:

Question 18

A 23-year-old female was just diagnosed with major depressive disorder and is being started on escitalopram 10 mg daily. The patient should be counseled about which Black Box warning?

Response Feedback:

Question 19

Which anticonvulsant below induces its own metabolism over time?

Question 20

Which statement is TRUE regarding the use of selective serotonin reuptake inhibitors (SSRI)/serotonin-norepinephrine reuptake inhibitors (SNRI) in patients with Generalized Anxiety Disorder?

Response Feedback:

Question 21

Which of the following statements below is NOT considered an appropriate treatment strategy for treatment-resistant depression?

Response Feedback:

Question 22

Response Feedback:

Venlafaxine has been associated with increased hypertension and should not be used as an initial treatment option.

Question 23

Which of the following syndromes is characterized by disorientation + confusion, agitation, fever, diarrhea, and ataxia? This syndrome can occur when an MAOI is given with an SSRI

Response Feedback:

Question 24

Response Feedback:

Question 25

Choose the correct option regarding the major classes of GABA receptors and the ions involved in inhibition of the neurotransmitter pathway

Response Feedback:

Question 26


	Of the following medications, which ones are considered first-line in treatment of an acute manic episode of bipolar disorder (assuming monotherapy)? Lithium Fluoxetine Aripiprazole Risperidone Ziprasidone Venlafaxine Quetiapine Valproate

Question 27

Choose the appropriate pair regarding acetylcholine receptors.

Response Feedback:

Question 28

Response Feedback:

“Valproic acid may produce teratogenic effects.”

Question 29

When initiating lithium, how long should you wait before checking a lithium level? What is the therapeutic goal level of lithium?

Question 30


	In order for the NMDA receptor to fully open and allow an influx of calcium, both glutamate and glycine must bind to cause a depolarization of the cell that will ultimately displace which ion? Is the NMDA receptor an ionotropic or metabotropic receptor?

Question 31

Which one of the anticonvulsants mentioned below has sufficient data to support its use in bipolar disorder?

Response Feedback:

Carbamazepine has data to support its use in the treatment of bipolar disorder. The other medications listed do not have data to support the use in any phase of bipolar disorder.

Question 32

Which of the following medications is best to AVOID in maintenance treatment of bipolar disorder and why?

Response Feedback:

“As noted previously, antidepressants may contribute to an increase in mood episode frequency.”

Question 33

Response Feedback:

A maximum daily dose of 20 mg/day is recommended in patients greater than 60 years of age due to the increased risk of QT prolongation.

Question 34

Response Feedback:

– Answer choice A: Honor the patient’s request of discontinuing the medication.

– Answer Choice C: An abrupt stop of a benzodiazepine will likely send the patient into having withdrawal symptoms.

Question 35

Which of the following disease states contributes to a greater risk for substance use, violence, and victimization as well as worse overall quality of life?

Response Feedback:

“Moreover, non-adherent patients with schizophrenia are at greater risk for substance use, violence, and victimization as well as worse overall quality of life.”

Question 36

Which of the following symptoms is NOT part of the diagnostic features for bipolar disorder?

Response Feedback:

“Psychosis is not represented in the diagnostic features for BPD.”

– “Psychosis typically resolves along with the mood symptoms, though diagnostic criteria acknowledge that psychotic symptoms may linger beyond the end of the episode.”

Question 37

It is appropriate to start lamotrigine in combination with another atypical antipsychotic in treatment of an acute manic episode in bipolar disorder.

Response Feedback:

“Lamotrigine has also been extensively studied in bipolar depression as well….”

Question 38

M. B. was just diagnosed with Generalized Anxiety Disorder and pharmacotherapy is needed. Which of the following would be a first-line treatment option for M. B.?

Duloxetine
Quetiapine
Diazepam
Escitalopram

Response Feedback:

Question 39

Response Feedback:

Page numbers used: Page 39 for TCA side-effect profile

Question 40

Response Feedback:

Lamotrigine can cause a severe rash than can be life threatening

Question 41

Response Feedback:

“Therefore, in treatment-responders, most experts favor a continuation of antidepressant therapy for a minimum of 6 months following the achievement of remission.”

Question 42

Response Feedback:

Question 43

Alprazolam, phenobarbital, and alcohol all bind allosterically to GABA_A receptors. What occurs to the GABA_A receptor when these substances bind to the receptor?

Response Feedback:

The receptor becomes more sensitive to GABA. GABA is the major inhibitory neurotransmitter within the CNS.

Question 44

Response Feedback:

“Other bothersome adverse effects” Patient is likely experiencing lithium toxicity and labs should be verified first before continuing with other treatments for the tremor.

Question 45

Which of the following medications used for treatment of bipolar disorder may increase stroke risk among older patients, particularly those with dementia?

Response Feedback:

Question 46

What is the strongest established risk factor for bipolar disorder?

Response Feedback:

“The strongest established risk factor for BPD is a family history of BPD.”

Question 47


	Glia cells play a supportive role in the neuron. A few of the functions of the glial cells include providing nutrition, maintaining homeostasis, stabilizing synapses, and myelinating axons. The glial cells are categorized as microglia or macroglia. Of the macroglia cells, which one plays a role in myelinating axons, which may contribute to mood disorders if altered?

Question 48

Response Feedback:

Question 49

Choose the appropriate statement regarding lamotrigine dosing.

Response Feedback:

Carbamazepine induced metabolism of lamotrigine – increase dose of lamotrigine; Valproate may inhibit clearance of lamotrigine, so dose reduction of lamotrigine is needed

Question 50

Is this a TRUE or FALSE statement? The following patient case is considered an example of treatment-resistant depression.

She has trialed the following medications in the past with treatment duration listed:

– Paroxetine 40 mg daily for 6 weeks

– Citalopram 20 mg daily for 2 weeks

Response Feedback:

“At least one trial with an antidepressant with established efficacy in MDD (with sufficient duration and doses) is considered to be adequate antidepressant treatment.”

Question 51

When completing this exam, did you comply with Walden University’s Code of Conduct including the expectations for academic integrity?

Name: NURS_6630_Week6_Assignment_Rubric

	Excellent Point range: 90–100	Good Point range: 80–89	Fair Point range: 70–79	Poor Point range: 0–69
Introduction to the case (1 page) Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.	9 (9%) – 10 (10%) The response accurately, clearly, and fully summarizes in detail the case for the Assignment. The response accurately and clearly explains in detail the specific patient factors that impact decision making when prescribing medication for this patient.	8 (8%) – 8 (8%) The response accurately summarizes the case for the Assignment. The response accurately explains the specific patient factors that impact decision making with prescribing medication for this patient.	7 (7%) – 7 (7%) The response inaccurately or vaguely summarizes the case for the Assignment. The response inaccurately or vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient.	0 (0%) – 6 (6%) The response inaccurately and vaguely summarizes the case for the Assignment, or is missing. The response inaccurately and vaguely explains the specific patient factors that impact decision making with prescribing medication for this patient.
Decision #1 (1–2 pages) • Which decision did you select? • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.	18 (18%) – 20 (20%) The response accurately and clearly explains in detail the decision selected. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients. Examples provided fully support the decisions and responses provided.	16 (16%) – 17 (17%) The response accurately explains the decision selected. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response. The response accurately explains how ethical considerations impact the treatment plan and communication with patients. Examples provided support the decisions and responses provided.	14 (14%) – 15 (15%) The response inaccurately or vaguely explains the decision selected. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients. Examples provided may support the decisions and responses provided.	0 (0%) – 13 (13%) The response inaccurately and vaguely explains the decision selected. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing. Examples provided do not support the decisions and responses provided, or is missing.
Decision #2 (1–2 pages) • Which decision did you select? • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.	18 (18%) – 20 (20%) The response accurately and clearly explains in detail the decision selected. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients. Examples provided fully support the decisions and responses provided.	16 (16%) – 17 (17%) The response accurately explains the decision selected. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response. The response accurately explains how ethical considerations impact the treatment plan and communication with patients. Examples provided support the decisions and responses provided.	14 (14%) – 15 (15%) The response inaccurately or vaguely explains the decision selected. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients. Examples provided may support the decisions and responses provided.	0 (0%) – 13 (13%) The response inaccurately and vaguely explains in detail the decision selected. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing. Examples provided do not support the decisions and responses provided, or is missing.
Decision #3 (1–2 pages) • Which decision did you select? • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature. • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature). • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.	18 (18%) – 20 (20%) The response accurately and clearly explains in detail the decision selected. The response accurately and clearly explains in detail why the decision was selected, with specific clinically relevant resources that fully support the decision selected. The response accurately and clearly explains in detail why the other two responses were not selected, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that fully support the response. The response accurately and clearly explains in detail how ethical considerations impact the treatment plan and communication with patients. Examples provided fully support the decisions and responses provided.	16 (16%) – 17 (17%) The response accurately explains the decision selected. The response explains why the decision was selected, with specific clinically relevant resources that support the decision selected. The response accurately explains why the other two responses were not selected, with specific clinically relevant resources that support the response. The response accurately explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that support the response. The response accurately explains how ethical considerations impact the treatment plan and communication with patients. Examples provided support the decisions and responses provided.	14 (14%) – 15 (15%) The response inaccurately or vaguely explains the decision selected. The response inaccurately or vaguely explains why the decision was selected, with specific clinically relevant resources that inaccurately or vaguely support the decision selected. The response inaccurately or vaguely explains why the other two responses were not selected, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that inaccurately or vaguely support the response. The response inaccurately or vaguely explains how ethical considerations impact the treatment plan and communication with patients. Examples provided may support the decisions and responses provided.	0 (0%) – 13 (13%) The response inaccurately and vaguely explains in detail the decision selected. The response inaccurately and vaguely explains why the decision was selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains why the other two responses were not selected, with specific clinically relevant resources that do not support the decision selected, or is missing. The response inaccurately and vaguely explains the outcome the student was hoping to achieve with the selected decision, with specific clinically relevant resources that do not support the response, or is missing. The response inaccurately and vaguely explains how ethical considerations impact the treatment plan and communication with patients, or is missing. Examples provided do not support the decisions and responses provided, or is missing.
Conclusion (1 page) • Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.	14 (14%) – 15 (15%) The response accurately and clearly summarizes in detail the recommendations on the treatment options selected for this patient. The response accurately and clearly explains a justification for the recommendations provided, including clinically relevant resources that fully support the recommendations provided.	12 (12%) – 13 (13%) The response accurately summarizes the recommendations on the treatment options selected for this patient. The response accurately explains a justification for the recommendation provided, including clinically relevant resources that support the recommendations provided.	11 (11%) – 11 (11%) The response inaccurately or vaguely summarizes the recommendations on the treatment options selected for this patient. The response inaccurately or vaguely explains a justification for the recommendations provided, including clinically relevant resources that inaccurately or vaguely support the recommendations provided.	0 (0%) – 10 (10%) The response inaccurately and vaguely summarizes the recommendations on the treatment options selected for this patient, or is missing. The response inaccurately and vaguely explains a justification for the recommendations provided, including clinically relevant resources that do not support the recommendations provided, or is missing.
Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.	5 (5%) – 5 (5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria.	4 (4%) – 4 (4%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment are stated, yet they are brief and not descriptive.	3.5 (3.5%) – 3.5 (3.5%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic.	0 (0%) – 3 (3%) Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion were provided.
Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation	5 (5%) – 5 (5%) Uses correct grammar, spelling, and punctuation with no errors.	4 (4%) – 4 (4%) Contains a few (1 or 2) grammar, spelling, and punctuation errors.	3.5 (3.5%) – 3.5 (3.5%) Contains several (3 or 4) grammar, spelling, and punctuation errors.	0 (0%) – 3 (3%) Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.	5 (5%) – 5 (5%) Uses correct APA format with no errors.	4 (4%) – 4 (4%) Contains a few (1 or 2) APA format errors.	3.5 (3.5%) – 3.5 (3.5%) Contains several (3 or 4) APA format errors.	0 (0%) – 3 (3%) Contains many (≥ 5) APA format errors.

Total Points: 100

NURS 6630 MIDTERM EXAM STUDY GUIDE

Stahl’s Essential Psychopharmacology

Chapter 1 – Chemical Neurotransmission

Chapter 2 – Transporters, receptors, and enzymes as targets of psychopharmacological drug action

Chapter 3 – Ion channels as targets of psychopharmacological drug action

Chapter 4 – Psychosis and schizophrenia

Chapter 5 – Antipsychotic agents

Chapter 6 – Mood disorders

Chapter 7 – Antidepressants

Stahl’s Illustrated Guide – Anxiety, Stress, and PTSD

Chapter 4 – First line medications for PTSD

NURS 6630 FINAL EXAM STUDY GUIDE

Stahl’s Essential Psychopharmacology

Chapter 10 – Chronic pain and its treatment

Chapter 11 – Disorders of sleep and wakefulness and their treatment

Chapter 12 – Attention deficit hyperactivity disorder and its treatment

Chapter 13 – Dementia and its treatment

Chapter 14 – Impulsivity, compulsivity, and addiction

Stahl’s Illustrated Guide – Chronic Pain and Fibromyalgia

Stahl’s Illustrated Guide – ADHA

Stahl’s Illustrated Guide – Substance Use and Impulsive Disorders

Stahl’s Illustrated Guide – Violence

Pharmacological Interventions for ADHD

Pharmacological Interventions Article

NURS 6630 MIDTERM EXAM- WALDEN

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Question 51

Name: NURS_6630_Week6_Assignment_Rubric

Name: NURS_6630_Week6_Assignment_Rubric

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