NURS 6630 A-2 NURS 6630 N2 NURS 6630D-2

NURS 6630 A-2 / NURS 6630 N2 / NURS 6630D-2 /

NURS C-2 MIDTERM EXAM QUESTION S AND

CORRECT ANSWER S 2023

• Question 1

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

• 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 “At least one trial with an antidepressant with established efficacy in Feedback: MDD (with sufficient duration and doses) is considered to be adequate antidepressant treatment.” • Question 2 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 3 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:

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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 4

• 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

II. Quetiapine III. Diazepam IV. Escitalopram Response “As is true for panic and the other anxiety disorders, the SSRIs and Feedback: SNRIS are generally considered first-line agents for the treatment of GAD because of their favorable side effect profile….” • Question 5 Which one of the anticonvulsants mentioned below has sufficient data to support its use in bipolar disorder?Response Carbamazepine has data to support its use in the treatment of

Feedback: bipolar disorder. The other medications listed do not have data to

support the use in any phase of bipolar disorder.

• Question 6 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 “In 2004, the FDA asked manufacturers of almost all the new Feedback: 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 7 Choose the correct option regarding the major classes of GABA receptors and the ions involved in inhibition of the neurotransmitter pathway

Response “GABAB receptors, akin to the metabotropic glutamate receptors, are Feedback: 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 8

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