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NR 607 Psychopharmacology exam with correct answers.
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Which |of |the |following |antipsychotics |pose |the |least |cardiometabolic |risk? |- |✔✔Ziprasidone |and | Ariprazole |are |two |examples |of |antipsychotics |associated |with |lower |cardiometabolic |risk. A |16-year-old |boy |with |a |history |of |substance |use |disorder |reports |fatigue, |apathy, |and |anhedonia | almost |every |day |and |his |mother |reports |increasing |irritability |and |raging |behavior. |The |boy |says |he | smokes |marijuana |daily |just |to |feel |good |and |is |unwilling |to |give |it |up. |The |mother |wants |some |sort | of |medication |to |help |him |feel |better |so |that |he |stops |smoking |marijuana. |The |PMHNP |agrees |to | prescribe |fluoxetine | 20 |mg |daily. |What |is |the |most |common |side |effect |associated |with |this | medication? |- |✔✔Nausea Keenan |is |an |72-year-old |male |admitted |to |the |hospital |with |a |diagnosis |of |delirium. |Medications | with |anticholinergic |side |effects |are |known |to |cause |delirium. |Which |of |the |following |medications |are |most |suspect |in |contributing |to |delirium? |- |✔✔Diphenhydramine |and |similar |medications |are | contraindicated |in |persons |over | 65 |given |their |elevated |anticholinergic |activity. A |patient |who |had |previously |reported |feeling |much |better |on |her |antidepressant |suddenly |says |the |"drug |seems |to |have |stopped |working. |This |is |known |as: |- |✔✔Tachyphylaxis One |of |the |most |common |electrolyte |abnormalities |associated |with |the |use |of |psychotropic | medication |is: |- |✔✔Hyponatremia A |patient |who |has |been |taking |paroxetine |for | 3 |years |wants |to |come |off |due |to |sexual |side |effects. | He |had |gradually |tried |to |wean |the |dose |on |his |own |but |noticed |a |feelings |of |dizziness, |fatigue, | headaches, |anxiety, |and |electric-like |shocks |in |his |head. |These |findings |are |most |consistent |with |SSRI | discontinuation. |What |would |be |a |reasonable |action |for |the |PMHNP |to |take? |- |✔✔Prescribe |the | patient |fluoxetine |for | 1 |week The |PMHNP |knows |that |the |study |of |how |the |body |absorbs, |distributes, |metabolizes, |and |excretes |a | medication |is |known |as: |- |✔✔Pharmacokinetics The |PMHNP |in |the |ED |is |evaluating |a |68-year-old |woman |who |was |recently |diagnosed |with |mild | cognitive |impairment |and |cannot |remember |the |name |of |the |medication |that |she |has |recently | started | 1 |week |ago. |The |patient |is |complaining |of |increased |heart |rate, |sweating, |and |muscle |spasms | progressively |worsening |for |the |last | 3 |days. |Which |neurotransmitter |is |associated |with |this |adverse | effect? |- |✔✔Acetylcholine A |79-year-old |female |with |no |past |psychiatric |history |is |admitted |with |new |onset |auditory | hallucinations. |The |patient |states |her |most |bothersome |symptom |is |the |voices, |which |have |kept |her |
from |sleeping |through |the |night |for |the |last | 3 |weeks, |and |as |a |result, |she |is |tired |and |irritable. |Which |medication |should |the |PMHNP |order |for |bedtime |for |sleep? |- |✔✔Olanzapine |2.5 |mg |PO Codeine |is |converted |to |morphine |via |CYP2D6 |in |the |liver. |This |is |an |example |of |what? |- |✔✔A | prodrug |is |a |medication |that |is |converted |into |a |pharmacological |active |drug |via |metabolism. Which |of |the |following |statements |is |true? |- |✔✔TD |may |result |from |metocloprmaide |use. |Lip | smacking |is |a |symptom |of |TD |that |results |from |blocking |D2 |receptors |in |the |Nigrostriatal |pathway. | EPS |can |occur |immediately |after |starting |an |antipsychotic |or |any |time |there |after. Which |of |the |following |is |true |regarding |Benign |Ethnic |Neutropenia |(BEN) |in |regards |to |Clozapine | treatment? |- |✔✔BEN |is |more |commonly |observed |in |African |descent, |middle |eastern |and |other |non- Caucasian |groups |with |darker |skin. |It |is |more |common |in |men |and |patients |with |BEN |are |not |at |an | increased |risk |of |clozapine |related |neutropenia. After |a |drug |is |absorbed |the |substrate |binds |to |protein |for |transport. |Which |portion |of |the |drug |is | available |for |therapeutic |effects? |- |✔✔Unbound Which |of |the |following |is |an |example |of |a |drug |inducer? |- |✔✔Tobacco |smoking |is |a |well |known | CYP1A2 |inducer. Gabe |receives |psychotherapy |for |performance |anxiety. |He |has |a |rare |request |for |a |medication |to |help |with |sleep. |He |is |required |to |travel |for |work |and |is |requesting |help. |He |has |no |trouble |with |sleep | latency, |but |wants | 6 |hours |of |sleep. |Which |of |the |following |best |fits |Gabe's |needs? |- |✔✔Eszopiclone | (Lunesta) |may |help |with |short |term |insomnia |related |to |sleep |maintenance |issues. An |uninsured |patient |who |was |discharged |from |the |hospital |on |haloperidol | 10 |mg |twice |daily | presents |to |the |PMHNP |for |a |2-week |follow-up |medication |check |visit. |On |exam |the |patient |has | tachypnea, |tachycardia, |and |tremors, |the |skin |is |hot |to |the |touch, |and |is |overall |very |rigid. |What | should |the |PMHNP |do |first? |- |✔✔Call | 911 |for |transfer |to |the |emergency |department Sunny |is |a |50-year |-old |female |who |presents |to |the |clinic |with |a |recent |ECG |tracing. |Her |QTC |is | recorded |at | 327 |ms. |Mary |is |on |Citalopram | 40 |mg |daily |x | 3 |years |secondary |to |generalized |anxiety | disorder. |Given |this |information, |you |decide |to |do |what? |- |✔✔A |QTC |of | 388 |ms |is |considered | normal. |Persons |over | 60 |are |limited |to |a |daily |dose |of |Citaloprma |20mg |given |the |potential |risk |of | prolonged |QTC. Pharmacodynamics |describe |which |of |the |following? |- |✔✔Pharmacodynamics |describe |how |the |drug | effects |the |body. A |45-year-old |man |who |takes |olanzapine | 5 |mg |twice |daily |for |psychosis |reports |a |perpetual |sense |of | restlessness |and |an |inability |to |sit |still. |He |says, |"sometimes |it |gets |so |bad |I |want |to |jump |out |of |my | own |skin." |Which |of |the |following |is |the |most |likely |explanation? |- |✔✔Akathisia A |patient |who |has |required |increasing |amounts |of |medication |to |achieve |the |desired |effect |and | develops |withdrawal |symptoms |when |dosing |is |delayed |is |said |to |be: |- |✔✔Dependent
Which |of |the |following |would |help |the |PMHNP |differentiate |between |NMS |and |serotonin |syndrome? |- |✔✔A |febrile |patient |with |muscle |rigidity |may |have |either |NMS |or |serotonin |syndrome. |Clonus |is | associated |with |serotonin |syndrome. |Low |Vitamin |B12 |does |not |help |narrow |the |differential |diagnosis |in |this |clinical |scenario. The |PMHNP |is |monitoring |a |serum |drug |level |for |a |medication |with |a |24-hour |half-life. |How |many | hours |will |it |take |to |reach |steady |state? |- |✔✔ 120 |hours Jena |is |a |32-year-old |female |who |presented |to |the |emergency |room |with |severe |weakness, |lethargy | and |an |AST/ALT |of |660/776 |U/L. |Which |of |the |following |could |have |contributed |to |this |laboratory | result? |- |✔✔Kava |has |the |potential |for |severe |liver |injury.