NU664 2022 MAY Week 9 Midterm Exam Latest

NU664 Primary Care of the Psychiatric Mental Health Client I

Week 9 Midterm Exam   

Question 1A patient is demonstrating efficacy to clozapine 600 mg/day. This week's granulocyte count is less than 500 mm3. What is the most appropriate initial recommendation?

Select one:

 a.Substitute haloperidol for clozapine.

 b.Discontinue clozapine and do not restart.

 c.Reduce dosage.

 d.Start dyphenhydramine 25mg po bid.

 e.Restart clozapine in 4 weeks.

Question 2A patient with generalized anxiety disorder (GAD) for 8-10 years is to be tapered from benzodiazepines and started on buspirone. Which statement is TRUE about buspirone in this case?

Select one:

 a.It takes 3 to 4 weeks to be an effective anxiolytic.

 b.It is an effective anxiolytic within 72 hours.

 c.It can elevate the benzodiazepine to toxic levels.

 d.It can be administered safely with MAOI.

Question 3A PMHNP uses cognitive therapy strategies with a patient who has an anxiety disorder. The patient's homework is to keep a diary of symptoms of anxiety and events that transpired just before the onset of symptoms. The rationale for this strategy is ________.

Select one:

 a.to keep the patient intellectually occupied to prevent dwelling on physiological phenomena

 b.to link symptoms with precipitating events, which provides a basis for discussion and reframing

 c.that anxiety gives rise to automatic, negative obsessive thoughts that must be analyzed

 d.that antecedent events have less to do with the anxiety onset than internal events

Question 4All of the following are common baseline labs and history that you would obtain before any atypical antipsychotic is initiated EXCEPT ________.

Select one:

 a.CPK

 b.Family medical history

 c.Fasting blood sugar (FBS)

 d.Fasting lipids

Question 5Benzodiazepine indications can include ________.

Select one:

 a.panic attacks

 b.alcohol or benzodiazepine withdrawal

 c.anxiety or sleep

 d.seizures, muscle spasms

 e.All of these

Question 6Common disadvantages of antihistamines such as diphenhydramine include ________.

Select one:

 a.NMS

 b.EPS

 c.anticholinergic side effects

 d.postural hypotension

Question 7Harry was released from the state hospital on risperidone 4 mg twice a day. His positive and negative symptoms of schizophrenia are improved, but he complains of "painful muscle spasms and neck muscles pulling his head to the side." He reports that some of these effects started a few days after the medicine was started. Which effect is Harry experiencing?

Select one:

 a.NMS

 b.Dystonia

 c.Tardive dyskinesia

 d.Akathesia

Question 8John, age 25 and diagnosed with paranoid schizophrenia, was admitted to the hospital in an agitated, combative state and received haloperidol. The PMHMP should investigate for signs of neuroleptic malignant syndrome if John had ________.

Select one:

 a.a subnormal temperature

 b.a reduction in WBCs

 c.an elevated FBS

 d.an elevated CPK

 e.a decreased CPK

Question 9Mrs. Baker has developed diabetes, is 25 pounds overweight, and has a waist circumference of 45. She has been treated the past year for schizophrenia with olanzapine. Which agent would be the next best alternative that is least likely to cause weight gain neutral?

Select one:

 a.Chlorpromazine

 b.Clozapine

 c.Aripiprazole

 d.Risperdal consta

Question 10Name a quick screen for a lifetime history of mania or hypomania.

Select one:

 a.Mood Disorder Questionnaire

 b.Beck scale

 c.Hamilton Rating Scales

 d.GAD

Question 11What is a common effect of smoking on the antipsychotic drug therapy agent olanzapine?

Select one:

 a.Increased incidence of tardive dyskinesia

 b.No effect on antipsychotic plasma levels

 c.Decreased antipsychotic plasma levels

 d.Increased incidence of neuroleptic malignant syndrome

 e.Increased antipsychotic blood levels

Question 12Which of the following factors increases someone’s risk of suicide?

Select one:

 a.Previous attempts

 b.Anniversaries of lost loved ones

 c.Substance abuse

 d.A means and plan

 e.All of the answers

Question 13Which agent would be the best treatment option for the person who is noncompliant and has had several relapses in past year?

Select one:

 a.Clozapine

 b.Risperdal consta

 c.Aripiprazole

 d.Asenapine

 e.Haloperidol

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Question 14Which drug for Alzheimer's disease can be given transdermally?

Select one:

 a.Aricept

 b.Reminyl

 c.Exelon

 d.Namenda

Question 15Which drug is used for a benzodiazepine overdose?

Select one:

 a.Flumazenil (Romazicon)

 b.Alcohol

 c.Raltrexone (Narcan)

 d.Midazolam (Versed)

Question 16Which group has the shortest life expectancy?

Select one:

 a.White men

 b.White women

 c.Black men

 d.Black women

Question 17Which of the following is the route of administration for the newer agent asenapine?

Select one:

 a.Oral tab

 b.IV

 c.Sublingual

 d.IM rapid acting

 e.Patch formulation

Question 18Which of the following is TRUE regarding Lurasidone?

Select one:

 a.Take on an empty stomach and do not eat for 30 minutes after dosing.

 b.It is in pregnancy category D.

 c.It is in pregnancy category X.

 d.It has a high incidence of EPS.

 e.It is taken with at least a 350-calorie meal.

Question 19Which of the following statements regarding antidepressant therapy is FALSE?

Select one:

 a.Antidepressant therapy may be maintained for 6 to 12 months at full dose.

 b.All antidepressants are equally effective.

 c.Use monoamine oxidase inhibitors together with SSRIs in treatment-resistant cases.

 d.The side effect profile is a consideration in antidepressant selection.

Question 20Which organ is most likely to be affected by valproate acid (Depakote)?

Select one:

 a.Kidney

 b.Liver

 c.Skin

 d.Heart

Question 21Which symptom can be minimized by clonidine in a patient withdrawing from heroin or other opiates?

Select one:

 a.Seizures

 b.Respiratory depression

 c.Severe flu-like symptoms

 d.Confusion

Question 22________ is an adverse effect of Zyprexa Relprevv that requires a three-hour observation in a registered facility with ready access to emergency response.

Select one:

 a.Akathesia

 b.Agranulocytosis

 c.Tardive dyskinesia

 d.Post-injection delirium/sedation syndrome

 e.Neuroleptic malignant syndrome (NMS)

Question 23________ is an atypical antipsychotic with the greatest incidence of prolonged QTc interval.

Select one:

 a.Perphenazine

 b.Risperidone

 c.Ziprasidone

 d.Haloperidol

 e.Aripiprazole

Question 24Which is the best pharmacotherapy for a patient with a borderline personality disorder?

Select one:

 a.Antipsychotic

 b.Benzodiazepine

 c.MAOI

 d.No usual group of meds, but it depends upon the symptoms presented at the time of the visit