• Question 4
NURS 6630 PSYCHOPHARMACOLOGY MIDTERM EXAMS (3
VERSIONS) WEEK 6 2024 WINTER QTR/ NURS 6630 LATEST
MIDTERM EXAMS (3 VERSIONS) QUESTIONS AND
CORRECT ANSWERS GRADED A+ WALDEN UNIVERSITY
REVIEW TEST SUBMISSION WEEK 6 -MIDTERM
VERSION 1
Which drug below has an interaction with cigarette smoking and should be adjusted based on patient’s tobacco use/non-use?
Response
Feedback:
“Clozapine blood levels are significantly lowered by cigarette smoking and by other hepatic enzyme-inducers.”
Which of the following medications is best to AVOID in maintenance treatment of bipolar disorder and why?
Response
Feedback:
“As noted previously, antidepressants may contribute to an increase in mood episode frequency.”
Glia cells play a supportive role in the neuron. A few of the functions of the glial cells include providing nutrition, maintaining homeostasis, stabilizing synapses, and myelinating axons. The glial cells are categorized as microglia or macroglia. Of the macroglia cells, which one plays a role in myelinating axons, which may contribute to mood disorders if altered?
Which of the following are NOT primary target(s) symptom for antipsychotic agents in schizophrenia?
- Depression, anxiety, demoralization, suicidality, excitability, and agitation
ii. Delusions, hallucinations, disorganized thoughts iii. Affective flattening, alogia, avolition, anhedonia, social withdrawal iv. Attention, memory, and executive functions Response
Feedback:
“For schizophrenia, the primary target symptoms for antipsychotic agents
fall into three categories: psychotic symptoms (e.g., hallucinations,
delusions, disorganization); agitation (e.g., distractibility, affective lability, tension, increased motor activity); and negative symptoms (e.g. apathy, diminished affect, social withdrawal, poverty of speech.” AND “Although cognitive deficits are an important contributor to disability in schizophrenia, cognitive deficits usually are not considered a target for antipsychotic agents because they are not very responsible to current agents.”
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A 32-year-old males calls you complaining of decreased libido since starting Paroxetine 20 mg 2 weeks ago. He reported stopping the medication 1 day ago and is now experiencing extreme irritability and nervousness. He wishes to stop this medication due to side effects. What do you recommend?
Response
Feedback:
under selective serotonin re-uptake inhibitors discontinuation syndrome
subtitle: “The risk of such adverse events occurring seems to be
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• Question 6 • Question 9 • Question 10 • Question 11 inversely related to the half-life of the SSRI, with fluoxetine reported as having a significantly lower risk than paroxetine in two studies. For more severe discontinuation-related adverse events, re-institution of the SSRI and slow taper may be necessary to alleviate these symptoms.”
With second-generation antipsychotics, what is the main side effect that requires frequent monitoring?
Response
Feedback:
table 7-6 & page 80, table 7-7; Page 78: “However, attention over the
past decade has focused on effect of second-generation antipsychotics on glucose metabolism and lipids and associated metabolic syndrome.”
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
Feedback:
“In 2004, the FDA asked manufacturers of almost all the new 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."
Which anticonvulsant below induces its own metabolism over time?
In order for the NMDA receptor to fully open and allow an influx of calcium, both glutamate and glycine must bind to cause a depolarization of the cell that will ultimately displace which ion? Is the NMDA receptor an ionotropic or metabotropic receptor?
Which of the following medications are known as selective serotonin re-uptake inhibitors (SSRIs)?
- Nortriptyline
- Venlafaxine
ii. Citalopram iii. Duloxetine iv. Fluoxetine
Which disease state of a non-adherent patient is at greater risk for substance use, • Question 7 • Question 8 3 / 4
• Question 16 violence, and victimization as well as worse overall quality of life?
Response
Feedback:
“Moreover, non-adherent patients with schizophrenia are at greater risk for substance use, violence, and victimization as well as worse overall quality of life.”
An 81-year-old male comes to your clinic today complaining of dry mouth, blurred vision, and constipation. He has a past medical history significant for hypertension, heart failure, and depression. Of the following medications, which one is likely contributing to these side effects?
Response
Feedback:
Only TCA is listed with most anticholinergic effects; Page 39 for TCA side
effect profile: “dry mouth, blurred vision, constipation, urinary hesitancy,
tachycardia, memory difficulties, and ejaculatory difficulties”
Choose the appropriate statement regarding lamotrigine dosing.
Response
Feedback:
Carbamazepine induced metabolism of lamotrigine – increase dose of lamotrigine; Valproate may inhibit clearance of lamotrigine, so dose reduction of lamotrigine is needed
Of the following medications used in the treatment of social anxiety disorder, which one would you AVOID in a patient who has uncontrolled hypertension?
Response
Feedback:
Phenelzine reported to have hypertensive reactions as a limitation/primary side effect
What is the therapeutic plasma level of carbamazepine?
Which of the following statements below is NOT considered an appropriate treatment strategy for treatment-resistant depression?
Response
Feedback:
“Combination of an SSRI OR an SNRI with a norepinephrine-dopamine re-uptake inhibitor (bupropion) or a serotonin-norepinephrine antagonist (mirtazapine or mianserin) is a commonly used combination”
Choose the correct statement(s) regarding lithium levels. SELECT ALL THAT
APPLY.
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