NR 508 week 4 Quiz - 1. Switching medications after an 8- to 12-week...

NR 508 week 4 Quiz

Common mistakes practitioners make in treating anxiety disorders include:

• Switching medications after an 8- to 12-week trial
• Maximizing dosing of antianxiety medications
• Encouraging exercise and relaxation therapy before starting medication
• Thinking a partial response to medication is acceptable

(ANS- 4. Thinking a partial response to medication is acceptable

An appropriate first-line drug to try for mild to moderate generalized anxiety

disorder would be:

• Alprazolam (Xanax)
• Diazepam (Valium)
• Buspirone (Buspar)
• Amitriptyline (Elavil)

(ANS- 3. Buspirone (Buspar)

An appropriate drug to initially treat panic disorder is:

• Alprazolam (Xanax)
• Diazepam (Valium)
• Buspirone (Buspar)
• Amitriptyline (Elavil)

(ANS- 2. Diazepam (Valium)

Prior to starting antidepressants, patients should have laboratory testing to rule out:

• Hypothyroidism
• Anemia
• Diabetes mellitus
• Low estrogen levels

(ANS- 1. Hypothyroidism

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David is a 34-year-old patient who is starting on paroxetine (Paxil) for depression.

David's education regarding his medication would include:

• Paroxetine may cause intermittent diarrhea.
• He may experience sexual dysfunction beginning a month after he starts therapy.
• He may have constipation and he should increase fluids and fiber.
• Paroxetine has a long half-life so he may occasionally skip a dose.

(ANS- 2. He may experience sexual dysfunction beginning a month after he starts therapy.

Jamison has been prescribed citalopram (Celexa) to treat his depression. Education regarding how quickly selective serotonin reuptake inhibitor (SSRI)

antidepressants work would be:

• Appetite and concentration improve in the first 1 to 2 weeks.
• Sleep should improve almost immediately upon starting citalopram.
• Full response to the SSRI may take 2 to 4 months after he reaches the full

therapeutic dose.

• His dysphoric mood will improve in 1 to 2 weeks.

(ANS- 1. Appetite and concentration improve in the first 1 to 2 weeks.

An appropriate drug for the treatment of depression with anxiety would be:

• Alprazolam (Xanax)
• Escitalopram (Lexapro)
• Buspirone (Buspar)
• Amitriptyline (Elavil)

(ANS- 2. Escitalopram (Lexapro)

An appropriate first-line drug for the treatment of depression with fatigue and low

energy would be:

• Venlafaxine (Effexor)
• Escitalopram (Lexapro)
• Buspirone (Buspar)
• Amitriptyline (Elavil)

(ANS- 1. Venlafaxine (Effexor)

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The laboratory monitoring required when a patient is on a selective serotonin

reuptake inhibitor is:

• Complete blood count every 3 to 4 months
• Therapeutic blood levels every 6 months after a steady state is achieved
• Blood glucose every 3 to 4 months
• There is no laboratory monitoring required

(ANS- 4. There is no laboratory monitoring required

Jaycee has been on escitalopram (Lexapro) for a year and is willing to try tapering off of the selective serotonin reuptake inhibitor. What is the initial dosage adjustment when starting a taper off antidepressants?

• Change dose to every other day dosing for a week
• Reduce dose by 50% for 3 to 4 days
• Reduce dose by 50% every other day
• Escitalopram (Lexapro) can be stopped abruptly due to its long half-life

(ANS- 2. Reduce dose by 50% for 3 to 4 days

The longer-term Xanax patient comes in and states they need a higher dose of the medication. They deny any additional, new, or accelerating triggers of their anxiety. What is the probable reason?

• They have become tolerant of the medication, which is characterized by the need

for higher and higher doses.

• They are a drug seeker.
• They are suicidal.
• They only need additional counseling on lifestyle modification.

(ANS- 1. They have become tolerant of the medication, which is characterized by the need for higher and higher doses.

What "onset of action" symptoms should be reviewed with patients who have been newly prescribed a selective serotonin reuptake inhibitor?

• They will have insomnia for a week.
• They can feel a bit of nausea, but this resolves in a week.
• They will have an "onset seizure" but this is considered normal.
• They will no longer dream.

(ANS- 2. They can feel a bit of nausea, but this resolves in a week.

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