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• Question 2
3.75 out of 3.75 points John is a 41 - year old-patient who presents to the clinic with diarrhea, fatigue, and recently has been having tremors. He was diagnosed 19 years ago with bipolar disorder and is currently managed on Lithium 300mg BID. As the PMHNP, you decide to order a lithium level that comes back at 2.3mmol/l. What is the most appropriate course of action?
Selected
Answer:
c.
Tell John he needs to go to the hospital and call an ambulance to bring him.
Answers: a.
Investigate other differential diagnoses for his symptoms.
b.
Tell John to skip his next four Lithium doses and resume therapy.
c.
Tell John he needs to go to the hospital and call an ambulance to bring him.
d.
Prescribe loperamide to treat the diarrhea and ropinirole to treat the tremors Stephanie is a 36-year-old female who presents to the clinic with a history of anxiety. Social history is unremarkable. For the last 4 years, she has been well controlled on paroxetine, however she feels “it just doesn't work anymore.” You have decided to change her medication regimen to vortioxetine 5mg, titrating up to a max dose of 20mg per day based on tolerability. The patient states, "I can't even last 1 more day without feeling like my insides are going to explode with anxiety." The most appropriate course of action would be:
Selected
Answer:
b.
Prescribe a short-term course of low dose benzodiazepine, such as alprazolam.
Answers: a.
Inform the patient to try yoga or other natural remedies until the
NURS 6630 WEEK 9 QUESTIONS & CORRECT ANSWERS WALDEN UNIVERSITY
• Question 1
3.75 out of 3.75 points
• Question 3
3.75 out of 3.75 points
• Question 4
3.75 out of 3.75 points vortioxetine takes effect.
b.
Prescribe a short-term course of low dose benzodiazepine, such as alprazolam.
c.
Prescribe an SNRI, such as venlafaxine, in addition to the vortioxetine.
d.
Recommend in-patient mental health for the foreseeable future. Richard is a 54 - year-old male who suffers from schizophrenia. After exhausting various medication options, you have decided to start him on Clozapine. Which of the statements below is true regarding Clozapine?
Selected
Answer:
d.
A & B
Answers: a.
Regular blood monitoring must be performed to monitor for neutropenia.
b.
Clozapine can only be filled by a pharmacy that participates in the REMS program.
c.
Bradycardia is a common side effect of Clozapine.
d.
A & B
e.
All of the above Melvin is an 89 - year-old male who presents to the clinic with signs/symptoms consistent with MDD. Which of the following would be the LEAST appropriate medication to prescribe to this elderly patient?
Selected
Answer:
b.
amitriptyli ne
Answers: a.
nortriptylin e
b.
• Question 7
3.75 out of 3.75 points
• Question 8
0 out of 3.75 points
• Question 9
0 out of 3.75 points
d.
venlafaxi ne Cindy is a 55 - year-old patient who presents with symptoms consistent with Generalized anxiety disorder. The patient has an unremarkable social history other than she consumes two or three glasses of wine per night. Which of the following would be an appropriate therapy to start this patient on?
Selected
Answer:
b.
Escitalopram 10mg daily
Answers: a.
Xanax 0.25mg BID PRN Anxiety
b.
Escitalopram 10mg daily
c.
Buspirone 10mg BID
d.
Aripiprazole 10mg daily Mirza is a 75 - year-old patient with a long history of schizophrenia. During the past 5 years, she has shown significant cognitive decline consistent with dementia. The patient has been well controlled on a regimen of risperidone 1mg BID. As the PMHNP, the most appropriate course of action for this patient is:
Selected
Answer:
d.
Augment the patient's risperidone with brexpiprazole.
Answers: a.
Increase the risperidone to 1mg QAM, 2mg QPM
b.
Discontinue risperidone and prescribe a long-acting injectable such as Invega Sustenna.
c.
Discontinue risperidone and initiate therapy with clozapine.
d.
Augment the patient's risperidone with brexpiprazole. Rebecca is a 32 - year-old female who was recently prescribed escitalopram for MDD. She presents to the clinic today complaining of diaphoresis, tachycardia, and confusion. The differential diagnosis for this patient, based on the symptoms presenting, is:
• Question 10
0 out of 3.75 points
• Question 11
0 out of 3.75 points
Selected
Answer:
a.
Panic disorder
Answers: a.
Panic disorder
b.
Gastroenteritis
c.
Abnormal gait
d.
Serotonin syndrome Stephanie is a 36 - year-old female who presents to the clinic with a history of anxiety. Social history is unremarkable. For the last 4 years, she has been well controlled on paroxetine, however she feels “it just doesn't work anymore.” You have decided to change her medication regimen to vortioxetine 5mg, titrating up to a max dose of 20mg per day based on tolerability. The patient asks, “When can I expect this to start kicking in?” The best response is:
Selected
Answer:
b.
1 or 2 weeks
Answers: a.
3 or 4 days
b.
1 or 2 weeks
c.
3 or 4 weeks
d.
10 weeks Jordyn is a 27 - year-old patient who presents to the clinic with GAD. She is 30 weeks pregnant and has been well controlled on a regimen of sertraline 50mg daily. Jordyn says that "about once or twice a week my husband really gets on my nerves and I can't take it." She is opposed to having the sertraline dose increased due to the risk of further weight gain. You have decided to prescribe the patient a short-term course of benzodiazepines for breakthrough anxiety. Which of the following is the LEAST appropriate benzodiazepines to prescribe to this patient?
Selected
Answer:
d.
lorazepa m
• Question 14
0 out of 3.75 points
• Question 15
0 out of 3.75 points Vilazodo ne
b.
Sertralin e
c.
Paroxetin e
d.
Citalopra m Which of the following statements are true?
Selected
Answer:
c.
There is evidence that atypical antipsychotics are significantly more effective than typical antipsychotics in the treatment of cognitive symptoms associated with schizophrenia.
Answers: a.
First-generation (typical) antipsychotics are associated with a higher incidence of EPS.
b.
Second-generation (atypical) antipsychotics are associated with a higher risk of metabolic side effects.
c.
There is evidence that atypical antipsychotics are significantly more effective than typical antipsychotics in the treatment of cognitive symptoms associated with schizophrenia.
d.
A & B
e.
A, B, and C Jane is a 17 - year-old patient who presents to the office with signs consistent with schizophrenia. She states multiple times that she is concerned about gaining weight, as she has the perfect prom dress picked out and she finally got a date. Which of the following is the least appropriate choice to prescribe Jane?
Selected
Answer:
d.
Brexpiprazo le
Answers: a.
Aripiprazole
• Question 16
0 out of 3.75 points
• Question 17
3.75 out of 3.75 points
b.
Olanzapine
c.
Haloperidol
d.
Brexpiprazo le Sam is a 48 - year-old male who presents to the clinic with signs and symptoms consistent with GAD & MDD. Which of the following medications would be the LEAST appropriate choice when initiating pharmacotherapy?
Selected
Answer:
c.
mirtazapi ne
Answers: a.
duloxetin e
b.
sertraline
c.
mirtazapi ne
d.
buproprio n Martin is a 92 - year-old male who presents to the clinic with signs/symptoms consistent with MDD. The patient suffers from glaucoma and just recently underwent surgery for a cataract. Which of the following is the LEAST appropriate course of therapy when treating the MDD?
Selected
Answer:
b.
amitriptyli ne
Answers: a.
sertraline
b.
amitriptyli ne
Steve is a 35 - year-old male who presents to the primary care office complaining of anxiety secondary to quitting smoking cold turkey 2 weeks ago. The patient has a 14 - year history of smoking two packs per day. The patient has an unremarkable social history other than a recent divorce from his wife, Brittany. Which of the following would be the LEAST effective medication to treat Steve's anxiety?
Selected
Answer:
d.
Alprazola m
Answers: a.
Buproprio n
b.
Sertraline
c.
Vareniclin e
d.
Alprazola m 0 out of 3.75 points
