2020 NURS6630 Walden University Pharmacology Final Exam Version 1 With Answers (76 Solved Questions)

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NURS6630 Final Exam: Walden UniversityQUESTION 1What will the PMHNP most likely prescribe to a patient with psychotic aggression who needs tomanage the top-down cortical control and the excessive drive from striatal hyperactivity?A. Stimulants B. AntidepressantsC. AntipsychoticsD. SSRIsQUESTION 2The PMHNP is selecting a medication treatment option for a patient who is exhibiting psychoticbehaviors with poor impulse control and aggression. Of the available treatments, which can helptemper some of the adverse effects or symptoms that are normally caused by D2 antagonism?A. First-generation, conventional antipsychotics B. First-generation, atypical antipsychotics C.Second-generation, conventional antipsychoticsD. Second-generation, atypical antipsychoticsQUESTION 3The PMHNP is discussing dopamine D2 receptor occupancy and its association with aggressivebehaviors in patients with the student. Why does the PMHNP prescribe a standard dose ofatypical antipsychotics?A. The doses are based on achieving 100% D2 receptor occupancy. B. The doses are based onachieving a minimum of 80% D2 receptor occupancy.C. The doses are based on achieving60% D2 receptor occupancy.D. None of the above.

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QUESTION 4Why does the PMHNP avoid prescribing clozapine (Clozaril) as a first-line treatment to thepatient with psychosis and aggression?A. There is too high a risk of serious adverse side effects.B. It can exaggerate the psychoticsymptoms. C. Clozapine (Clozaril) should not be used as high-dose monotherapy. D. There is nodocumentation that clozapine (Clozaril) is effective for patients who are violent.QUESTION 5The PMHNP is caring for a patient on risperidone (Risperdal). Which action made by thePMHNP exhibits proper care for this patient?A. Explaining to the patient that there are no risks of EPS B. Prescribing the patient 12 mg/dailC. Titrating the dose by increasing it every 5–7 daysD. Writing a prescription for a higherdose of oral risperidone (Risperdal) to achieve high D2 receptor occupancyQUESTION 6The PMHNP wants to prescribe Mr. Barber a mood stabilizer that will target aggressive andimpulsive symptoms by decreasing dopaminergic neurotransmission. Which mood stabilizer willthe PMHNP select?A. Lithium (Lithane)B. Phenytoin (Dilantin) C. Valproate (Depakote) D.Topiramate (Topamax)

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QUESTION 7The parents of a 7-year-old patient with ADHD are concerned about the effects of stimulants ontheir child. The parents prefer to start pharmacological treatment with a non-stimulant. Whichmedication will the PMHNP will most likely prescribe?A. StratteraB. Concerta C. Daytrana D. AdderallQUESTION 88 The PMHNP understands that slow-dose extended release stimulants are most appropriate forwhich patient with ADHD?A. 8-year-old patientB. 24-year-old patient C. 55-year-old patient D. 82-year-old patientQUESTION 9A patient is prescribed D-methylphenidate, 10-mg extended-release capsules. What should thePMHNP include when discussing the side effects with the patient?A. The formulation can have delayed actions when taken with food. B. Sedation can be acommon side effect of the drug.C. The medication can affect your blood pressure.D. Thisdrug does not cause any dependency.QUESTION 10The PMHNP is teaching parents about their child’s new prescription for Ritalin. What will thePMHNP include in the teaching?

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A. The second dose should be taken at lunch.B. There are no risks for insomnia. C. There isonly one daily dose, to be taken in the morning. D. There will be continued effects into theevening.QUESTION 11A young patient is prescribed Vyvanse. During the follow-up appointment, which comment madeby the patient makes the PMHNP think that the dosing is being done incorrectly?A. “I take my pill at breakfast.”B. “I am unable to fall asleep at night.”C. “I feel okay all daylong.” D. “I am not taking my pill at lunch.”QUESTION 12A 14-year-old patient is prescribed Strattera and asks when the medicine should be taken. Whatdoes the PMHNP understand regarding the drug’s dosing profile?A. The patient should take the medication at lunch.B. The patient will have one or two doses aday.C. The patient will take a pill every 17 hours. D. The dosing should be done in the morningand at night.QUESTION 13The PMHNP is meeting with the parents of an 8-year-old patient who is receiving an initialprescription for D-amphetamine. The PMHNP demonstrates appropriate prescribing practiceswhen she prescribes the following dose:A. The child will be prescribed 2.5 mg. B. The child will be prescribed a 10-mg tablet. C. Thechild’s dose will increase by 2.5 mg every other week.D. The child will take 10–40 mg, daily.

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QUESTION 14A patient is being prescribed bupropion and is concerned about the side effects. What will thePMHNP tell the patient regarding bupropion?A. Weight gain is not unusual. B. Sedation may be common.C. It can cause cardiacarrhythmias.D. It may amplify fatigue.QUESTION 15Which patient will receive a lower dose of guanfacine?A. Patient who has congestive heart failure B. Patient who has cerebrovascular disease C. Patientwho is pregnantD. Patient with kidney diseaseQUESTION 16An 18-year-old female with a history of frequent headaches and a mood disorder is prescribedtopiramate (Topamax), 25 mg by mouth daily. The PMHNP understands that this medication iseffective in treating which condition(s) in this patient?A. MigrainesB. Bipolar disorder and depression C. Pregnancy-induced depression D. Upperback painQUESTION 17The PMHNP is treating a patient for fibromyalgia and is considering prescribing milnacipran(Savella). When prescribing this medication, which action is the PMHNP likely to choose?

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A. Monitor liver function every 6 months for a year and then yearly thereafter. B. Monitormonthly weight.C. Split the daily dose into two doses after the first day.D. Monitor foroccult blood in the stool.QUESTION 18The PMHNP is assessing a patient she has been treating with the diagnosis of chronic pain.During the assessment, the patient states that he has recently been having trouble getting to sleepand staying asleep. Based on this information, what action is the PMHNP most likely to take?A. Order hydroxyzine (Vistaril), 50 mg PRN or as neededB. Order zolpidem (Ambien), 5mgat bedtime C. Order melatonin, 5mg at bedtime D. Order quetiapine (Seroquel), 150 mg atbedtimeQUESTION 19The PMHNP is assessing a female patient who has been taking lamotrigine (Lamictal) formigraine prophylaxis. After discovering that the patient has reached the maximum dose of thismedication, the PMHNP decides to change the patient’s medication to zonisamide (Zonegran). Inaddition to evaluating this patient’s day-to-day activities, what should the PMHNP ensure thatthis patient understands?A. Monthly blood levels must be drawn. B. ECG monitoring must be done once every 3 months.C. White blood cell count must be monitored weekly.D. This medication has unwanted sideeffects such as sedation, lack of coordination, and drowsiness.QUESTION 20

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A patient recovering from shingles presents with tenderness and sensitivity to the upper back. Hestates it is bothersome to put a shirt on most days. This patient has end stage renal disease(ESRD) and is scheduled to have hemodialysis tomorrow but states that he does not know howhe can lie in a recliner for 3 hours feeling this uncomfortable. What will be the PMHNP’spriority?A. Order herpes simplex virus (HSV) antibody testing B. Order a blood urea nitrogen (BUN) andcreatinine STATC. Prescribe lidocaine 5%D. Prescribe hydromorphone (Dilaudid) 2mgQUESTION 21The PMHNP prescribed a patient lamotrigine (Lamictal), 25 mg by mouth daily, for nerve pain 6months ago. The patient suddenly presents to the office with the complaint that the medication isno longer working and complains of increased pain. What action will the PMHNP most likelytake?A. Increase the dose of lamotrigine (Lamictal) to 25 mg twice daily.B. Ask if the patient hasbeen taking the medication as prescribed. C. Order gabapentin (Neurontin), 100 mg three times aday, because lamotrigine (Lamictal) is no longer working for this patient. D. Order a completeblood count (CBC) to assess for an infection.QUESTION 22An elderly woman with a history of Alzheimer’s disease, coronary artery disease, and myocardialinfarction had a fall at home 3 months ago that resulted in her receiving an open reductioninternal fixation. While assessing this patient, the PMHNP is made aware that the patientcontinues to experience mild to moderate pain. What is the PMHNP most likely to do?

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