NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam Question 1 There are many different types of dementia. Which dementia is NOT a direct result of disrupted neurotransmitters, but a result of degeneration of different regions in the brain? Onset of the disease is typically before the age of 60, and very rare after the age of 75. A. Alzheimer?s Disease B. Dementia with Lewy Bodies C. Creutzfeldt-Jakob Disease D. Frontotemporal Dementias ? Question 2 J. is a 55-year-old male who attended a funeral and found himself laughing during the service, but later that evening he was irritated with himself for what he had done. His wife said this was abnormal behavior and took him to his doctor to be evaluated. After L. J.?s MRI was reviewed, he was diagnosed with frontotemporal dementia. Which medication is recommended to help L. J. with his emotional outbursts? A. NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam ? B. NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam ? C. NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam ? D. NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam ? ? Results Displayed Feedback ????????? Question 1 There are many different types of dementia. Which dementia is NOT a direct result of disrupted neurotransmitters, but a result of degeneration of different regions in the brain? Onset of the disease is typically before the age of 60, and very rare after the age of 75. ? Response Feedback: under subtitle ?Epidemiology and genetic risk factors? ????????? Question 2 L. J. is a 55-year-old male who attended a funeral and found himself laughing during the service, but later that evening he was irritated with himself for what he had done. His wife said this was abnormal behavior and took him to his doctor to be evaluated. After L. J.?s MRI was reviewed, he was diagnosed with frontotemporal dementia. Which medication is recommended to help L. J. with his emotional outbursts? ? Response Feedback: under Treatment subtitle: ?The behavioral features are sometimes helped by SSRIs, and these are the best-studied treatments for these disorders.? ????????? Question 3 E. B., a 55-year-old female, is a patient at your clinic today who has a past medical history significant for breast cancer, hypertension, hepatic cirrhosis, type 2 diabetes, and a recent diagnosis of alcohol use disorder. She has no known drug allergies. She states she is ready to quit drinking but fears the cravings that it may bring. Which medication would you recommend for E. B. to begin? ? Response Feedback: ?It is preferred for patients with liver damage since acamprosate is metabolized through the kidneys and not the liver? & Table 15-3 shows it reduces alcohol cravings; benzodiazepines are used in the acute setting if a patient is experiencing severe alcohol withdrawal that leads to seizures; thiamine is if a patient is admitted for alcohol intoxication. ? ? ? Question 3 B., a 55-year-old female, is a patient at your clinic today who has a past medical history significant for breast cancer, hypertension, hepatic cirrhosis, type 2 diabetes, and a recent diagnosis of alcohol use disorder. She has no known drug allergies. She states she is ready to quit drinking but fears the cravings that it may bring. Which medication would you recommend for E. B. to begin? A. Naltrexone B. Acamprosate C. Any benzodiazepine D. Thiamine ? Question 4 What should our treatment goal be with our patients when it comes to managing chronic pain? A. The goal is to make the pain go completely away. B. The goal is to make the patient feel numb so that the pain cannot be thought about. C. There are no specific treatment goals that we should discuss with our patients, just so they don?t get their expectations too high. D. The goal is to improve their function and to drop their pain scale to less than 5 out of 10. ? ? Choose the correct statement regarding medications used for alcoholism A. Disulfiram: NMDA receptor antagonist & GABAA agonist B. Naltrexone: ?-opioid receptor antagonist that reduces the reinforcement/euphoria produced by alcohol C. Acamprosate: enhances the?effect?of the inhibitory neurotransmitter gamma-aminobutyric acid on the GABA receptors by binding to a site that is distinct from the GABA binding site in the central nervous system. D. Lorazepam: inhibits alcohol dehydrogenase, leading to a buildup of acetaldehyde ? ? ? Question 6 Which medication below would you use in addition to benzodiazepine treatment if the patient is experiencing psychosis during alcohol withdrawal delirium? A. NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam ? B. NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam ? C. NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam ? D. NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam ? ? Question 7 Of the following neurotransmitters, which ones play a critical role in modulating attention in ADHD? Dopamine Epinephrine GABA Norepinephrine Glutamate A. II, III, and V B. II and IV C. I and IV D. III only ? Question 8 Which of the following is the only Black Box Warning associated with the medication atomoxetine? A. Increased risk for cardiovascular events B. Suicidal ideation C. Substance abuse potential D. Slight growth inhibition ? Question 9 Which of the following drugs is structurally similar to tramadol; thus, its opioid-mediated analgesia can be reversed by naloxone in mice? A. ? B. ? C. NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam ? D. Gabapentin ? Question 10 Which medication is a selective alpha-adrenergic agonist that works by mimicking norepinephrine binding in the pre-frontal cortex, which makes it particularly useful in the treatment of ADHD? A. NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam ? B. ? C. ? D. ? ? ? Question 11 Daytrana is the MPH transdermal system of methylphenidate approved for the treatment of ADHD in children aged 6 years and older. What is the difference in terms of the metabolism compared to the other formulations in this class? A. It is mainly metabolized by the enzyme carboxylesterase once absorbed. B. It does not undergo first-pass metabolism by the enzyme carboxylesterase in the liver. C. It can be cut up and sprinkled onto food so it can bypass first-pass metabolism in the liver. D. It uses an osmotic releasing oral system technology to slowly deliver the drug to the enzyme carboxylesterase in order to make the drug last longer. ? Question 12 A 59-year-old male has been admitted to the E. D. due to a methamphetamine overdose. The patient?s friend reported he ingested up to 2 grams because ?he thought cops were coming to get him.? The patient?s vitals are all within normal limits, except his blood pressure is 180/110. What is the best recommendation to make at this time? A. Administer a beta-blocker like labetalol to help bring his blood pressure down B. Patient?s blood pressure is considered a hypertension urgency, but it is probably due to the drug overdose. No action is needed at this time until the drug has cleared his system. C. Blood pressure is not a concern right now, but supportive therapy should be provided in the incidence of respiratory depression. D. Administer an alpha-blocker like phentolamine to help bring his blood pressure down. ? Question 40 SSRIs can be used in alcohol use disorder and offer modest drinking reduction through an anti-craving effect. A. True B. False ? ? Question 41 K. is a 72-year-old female who has suffered many strokes in the past, likely due to uncontrolled hypertension and hyperlipidemia. She has now been diagnosed with vascular dementia due to memory loss and motor system slowing. What is the recommended treatment for T. K.? A. T. K. needs the drug donepezil to help with her memory loss only. B. T. K. needs the drug donepezil to help with her memory loss, but also needs her hypertension and hyperlipidemia controlled. C. T. K. needs the drug donepezil to help with her memory loss, but also needs her hypertension controlled. D. T. K. needs her hypertension controlled only. ? ? ? Question 42 The patient is a 16-year-old girl with a past history of substance use disorder. She has been known to abuse prescription opioids and smokes one pack of cigarettes every day. She has been in and out of recovery for the past year. During her last admission into a recovery center, she was diagnosed with ADHD, which may have contributed to her addictive personality. She presents to your clinic today to initiate pharmacotherapy for her new diagnosis. What would you recommend in this patient? Her current weight is 55 kg. A. Ritalin 10 mg twice daily B. Focalin 10 mg twice daily C. Daytrana 30 mg patch worn for 12 hours daily D. Atomoxetine 60 mg once daily ? Question 43 A new patient presents to your clinic today. The patient is a 13-year-old boy who complains that he has no interest in anything. The patient states, ?I just want to sleep more than I normally do, and I don?t care much for playing my video games anymore.? His mother states he cannot focus on anything for more than a few minutes at a time, and that he often gets in trouble at school because he cannot sit still. What would you recommend at this time? A. Recommend doing a full evaluation to distinguish if this patient is presenting with ADHD symptoms or depressive symptoms B. Begin a stimulant at appropriate dose once patient?s weight is known C. Refer to a behavioral counselor D. Begin an SSRI at lowest initial dose and provide counseling on the increased risk of suicide during the first few months of therapy ? ? ? Question 44 Disulfiram has been proven effective in the treatment of alcoholism, but recently it has been trialed in the management of cocaine addiction. What is the mechanism of action that likely helps produce these aversive effects? A. Inhibition on dopamine beta-hydroxylase B. Inhibition on aldehyde dehydrogenase C. Inhibition on alcohol dehydrogenase D. Inhibition on aldehyde reductase ? Question 45 Which medication below should be routine for all suspected cases of alcohol intoxication and dependence? A. B vitamin thiamine 100 mg B. Haloperidol 5 mg C. Lorazepam 2 mg D. Acamprosate 666 mg ? Question 46 FILL IN THE BLANK: ___________ is the main neurotransmitter behind reward systems in the brain, which usually leads to addiction when altered in any way. A. NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam ? B. NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam ? C. NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam ? D. NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam ? ? Question 47 If a patient suffers from a multitude of small strokes and later begins experiencing mood disturbances in an acute fashion that sometimes resolve, from what type of dementia would you think that patient may suffer? A. Vascular Dementia B. Frontotemporal Dementias C. Alzheimer?s Disease D. Dementia with Lewy Bodies ? ? Question 48 Drug addiction includes many prescription medications and illegal substances. Of the drugs listed, which ones can be withdrawn abruptly WITHOUT medical intervention to prevent withdraw seizures? A. Alcohol B. Adderall C. Lorazepam D. Butalbital ? Question 49 The experience of pain is ALWAYS subjective A. True B. False ? Question 50 B. is a 55-year-old male who has diagnosed with type 2 diabetes 10+ years ago. He has since had complications from the disease and is suffering from severe neuropathy. On top of that, T. B. is struggling with his mental health and was recently told he could be depressed but he had refused treatment at that time. Besides getting his blood sugar under control, what medication(s) can we use that may be useful in helping T. B.? Nortriptyline Venlafaxine Duloxetine Fluoxetine A. I, II, and III B. I and II C. II and III D. IV only NURS 6630: Psychopharmalogical Approaches to Treat Psychopathology Final Exam

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