Take Test: Week 6 Midterm Exam
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Timed Test This test has a time limit of 2 hours.You will be notified when
time expires, and you may continue or submit.
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minute, and 30 seconds remain.
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Remaining Time:
13 minutes, 04 seconds.
Question Completion Status:
QUESTION 1
1. A noncompliant patient states, “Why do you want me to put this poison in my body?”
Identify the best response made by the psychiatric-mental health nurse practitioner
(PMHNP).
A
.
“You have to take your medication to become stable.”
B
.
“ Medications work by increasing the types of neurotransmitters produced by the human brain.”
C
.
“Most medications that work in the brain will result in restoring an imbalance of one or more
neurotransmitters that your body already produces helping to alleviate your symptoms .”
D
.
“Why do you believe that your medication is poison?”
1 points
QUESTION 2
1.
Ms. Hill is currently being treated for schizophrenia but has stopped taking
her medications due to some side effects she claims she was experiencing.
She presents to the clinic today with worsening symptoms. She is
experiencing anhedonia, agitation, attentional impairment, and affective
blunting. Which one of the symptoms mentioned is considered a positive
symptom of schizophrenia?

A
.
Anhedonia
B
.
Agitation
C
.
Attentional Impairment
D
.
Affective Blunting
1 points
QUESTION 3
1. Which statement about neurotransmitters and medications is true?
A
.
Endorphins were discovered before morphine which lead to the use of the opioids for pain
control.
B
.
Several psychiatric medications have been developed after discoveries of endogenous
neurotransmitters and defining their function in the brain.
C
.
Medications work by sending messages to neurotransmitters enabling them to work more
effectively.
D
.
An imbalance of serotonin has been directly linked to depression. Following the discovery of this
neurotransmitter, pharmacologists were able to develop a well-known drug- Prozac as the first
medication used to restore the balance of serotonin.
1 points
QUESTION 4
1. When an unstable patient asks why it is necessary to add medications to his current
regimen, the PMHNP’s best response would be:
A
.
"More often than you would think, multiple medications should always be tried together to see
what happens.”
B
.
“Due to this being your first hospitalization after starting medication treatment for the first time
in your life, the only way to effectively manage your symptoms is by adding additional
medications in hopes that it will work for you."
C
.
“Many psychiatric illnesses involve several dys-functioning neurotransmitter systems in the
brain. Often, a single medication may only effect one or two of the dys-functioning systems. The
addition of another medication can work with the current medication in stabilizing multiple
neurotransmitter systems and help to alleviate your symptoms.”
D
.
“I understand your concerns. Often times, it is necessary to switch medications after short
periods of time to better manage your symptoms. We will discontinue your current regimen and
start another single drug agent.”
1 points
QUESTION 5
1. During gene expression, what must occur prior to a gene being expressed?
A
.
Transcription factor must bind to the regulatory region within
the cell’s nucleus.

B
.
RNA must be converted to mRNA.
C
.
The coding region must separate from the regulatory region.
D
.
RNA polymerase must inhibit the process of changing RNA to
mRNA.
1 points
QUESTION 6
1. While genes have potential to modify behavior, behavior can also modify genes. How
do genes impact this process?
A
. Genes impact neuron functioning directly.
B
. Changes made to proteins lead to changes in
behavior.
C
. Neurons are able to impact protein synthesis.
D
. Genes impact the DNA of a cell, leading to
changes in behavior.
1 points
QUESTION 7
1. Though medications have the ability to target neurotransmitter release into the synapse
by the presynaptic neuron it is not always necessary. The PMHNP understands that this is
because:
A
.
Neurotransmission occurring along the axon is normally at a level to prevent symptoms of
mental illness and rarely require augmentation from medication therapy.
B
.
Neurotransmission is minimally affected by medication therapy when compared to the baseline
neurotransmitter release of a resting neuron.
C
.
Neurotransmitters can spread by diffusion.
D
.
The post synaptic neuron can produce and release its’ own neurotransmitter allowing it to
function properly.
1 points
QUESTION 8
1. Why is the cytochrome P450 enzyme system of significance to the PMHNP?
A
.
The kidneys play a role with excretion of the medication, and if a patient has kidney
damage, the dose must be increased to be effective.
B
.
The bioavailability of the medication after it passes through the stomach and liver
can be altered.
C
.
The medication’s chemical composition changes when it comes in contact with the
acid in the stomach.

D
.
The CYP enzyme system is a steady and predictable process that prescribers must
understand to treat conditions effectively.
1 points
QUESTION 9
1. It is important for the PMHNP to recognize differences in pharmacokinetics to safely
prescribe and monitor medications. Which of the following statements does the competent
PMHNP identify as true?
A
.
About 1 out of 5 Asians requires lower-than-normal doses of some antidepressants
and antipsychotics.
B
.
The term polymorphic refers to the body’s ability to break a medication down several
ways, and this patient may require higher doses of certain antidepressants and
antipsychotics.
C
. About 1 out of 30 Caucasians requires lower doses of some antidepressants and
antipsychotics.
D
. Most enzyme pathways do not have interactions between the newer medications.
1 points
QUESTION 1 0
1. As it relates to G-protein linked receptors, what does the PMHNP understand about
medications that are used in practice?
A
.
Most medications that act on G-protein linked receptors have antagonistic traits.
B
.
The majority of medications used in practice are full agonists and are used to
stimulate the body’s natural neurotransmitters.
C
.
Most medications act as partial agonists because they allow the body to use only
what is needed.
D
.
Medications used in practice may act as inverse agonists if the dosage is too high.
1 points
QUESTION 1 1
1. The PMHNP is considering prescribing a 49-year-old male clozapine (Clozaril) to treat
his schizophrenia and suicidal ideations. The PMHNP is aware that which factor may impact
the dose needed to effectively treat his condition:
A
.
The patient smokes cigarettes.
B
.
The patient has hypertension.
C
.
The patient has chronic kidney
disease, stage 2.
D The patient drinks a cup of coffee a

. day.
1 points
QUESTION 1 2
1. A patient is diagnosed with bipolar disorder and is currently taking carbamazepine
(Tegretol), aripiprazole (Abilify), and melatonin. The PMHNP has just written an order to
discontinue the carbamazepine (Tegretol) for drug-induced thrombocytopenia. The PMHNP
is aware that his next best action is to:
A
.
Alert staff to possible seizures
B
.
Write an order for a different mood stabilizer
C
.
Decrease the amount prescribed for aripiprazole
(Abilify)
D
.
Explain to the patient that it will be more difficult to
control his temper
1 points
QUESTION 1 3
1. A patient recently transferred following a suicide attempt has a history of
schizophrenia, depression, and fibromyalgia. He is currently taking Amitriptyline (Elavil),
Lisinopril, aspirin, and fluoxetine (Prozac). When assessing the psychiatric medications and the
reason for admission, what would be the best course of action for the PMHNP with this client?
A
.
Review Amitriptyline (Elavil) level
B
.
Order a STAT BUN/SCr
C
.
Asses the client for nystagmus
D
.
Order a STAT platelet, D-dimer, and PT/INR
1 points
QUESTION 1 4
1. A patient with schizophrenia is given an inverse agonist that acts on the receptor 5HT
and neurotransmitter serotonin. What is the rationale for prescribing a medication such as
this?
A
.
To promote the availability of serotonin
B
.
To decrease serotonin
C
.
To indirectly increase the amount of dopamine
in the body
D To help decrease the amount of serotonin and

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. dopamine
1 points
QUESTION 1 5
1. The PMHNP is caring for four patients. Which patient statement indicates that
benzodiazepines would be beneficial?
A
.
“I have trouble staying asleep in the middle of the night.”
B
.
“My spouse told me that I seem to have trouble remembering
things sometimes.”
C
.
“I really want to stop smoking, but the cravings are too strong.”
D
.
“I feel nervous to go outside and be in large crowds.”
1 points
QUESTION 1 6
1. Ms. Harlow is a 42-year-old patient who is prescribed a drug that acts on ionotropic
receptors. She is curious about the effects of the drug and how it will act on her symptoms.
Which statement made by the PMHNP demonstrates proper understanding of Ms. Harlow’s
prescription?
A
. “The drug will have an almost immediate
effect.”
B
. “The drug can take a while to build up in your
system.”
C
. “The drug is slow to release but lasts for a long
time.”
D
. “The drug will make a subtle difference in your
symptoms.”
1 points
QUESTION 1 7
1. A patient is seeking pharmacological treatment for smoking cessation. Which drug
class does the PMHNP prescribe to the patient?
A
.
Benzodiazepine
B
.
Mirtazapine
(Remeron)
C
.
Ketamine
D
.
Varenicline
(Chantix)

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1 points
QUESTION 1 8
1. The PMHNP is caring for a new patient who has been transferred from another office.
When meeting with the new patient, the patient reports, “I feel like I am improving with the
stabilizers.” The PMHNP immediately recognizes that the patient is describing which kind of
drug?
A
.
Full agonists
B
.
Antagonists
C
.
Partial
agonists
D
.
Inverse
agonists
1 points
QUESTION 1 9
1. A patient presents with frequent episodes of mania. Which statement describes an
appropriate treatment approach for this patient?
A
. “The patient needs to have an inverse agonist.”
B
. “The patient could benefit from an anticonvulsant.”
C
. “The patient’s calcium, sodium, chloride, and potassium levels
must be regulated.”
D
. “The patient should have a drug that acts on ligand-gated ion
channels.”
1 points
QUESTION 2 0
1. What characteristics do the nicotinic, cholinergic, serotonin 3, and glycine receptors all have in
common?
A
. Ligand-gated ion channels with a
pentameric structure
B
. Ligand-gated ion channels with a
tetrameric structure
C
. Voltage-sensitive ion channels
D
.
Are G-coupled protein receptors
1 points
QUESTION 2 1

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1. Which statement made by the patient suggests the patient will need to be treated
with antipsychotics that target paranoid psychosis?
A
. “It’s my fault that all of this is happening. I don’t think I could ever
forgive myself.”
B
. “I have to talk to the President because I’m the only one who can
help him.”
C
. “I’m not sure why that lady is wearing a red jacket since it’s the dogs
who need food.”
D
. “I don’t know that I even want to go to that meeting. It doesn’t seem
worth it anymore.”
1 points
QUESTION 2 2
1. Mr. McCullin is 64 years old with Parkinson’s disease. The PMHNP caring for Mr.
McCullin wants to start him on a dopamine agonist to help manage and treat his condition.
The PHMNP selects this agent because of which action it has on patients like Mr. McCullin?
A
. Dopamine is terminated through multiple mechanisms.
B
. The D2 autoreceptor regulates release of dopamine from the
presynaptic neuron.
C
. MAO-B presents in the mitochondria within the presynaptic
neuron.
D
. D2 receptors are the primary binding site for dopamine
agonists.
1 points
QUESTION 2 3
1. Mrs. Trevor is a 44-year-old patient who does not have a diagnosis of schizophrenia
but occasionally reports symptoms of psychosis, followed by severe fatigue. Mrs. Trevor
inquires about the use of amphetamines to help with her energy levels. Which response
made by the PMHNP is most appropriate?
A
.
“Amphetamines may help you, as they can alleviate psychotic conditions.”
B
.
“Amphetamines can inhibit negative symptoms of schizophrenia, so this might be a
good choice for you.”
C
.
“Amphetamines can cause hallucinations, so I would advise against this type of
prescription.”
D
.
“Amphetamines can lead to a dopamine deficiency, so I will not prescribe this for
you.”
1 points
QUESTION 2 4

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1. The PMHNP is caring for a patient with schizophrenia and is considering a variety of
treatment approaches. The PHMNP selects a viable treatment that is consistent with the
“dopamine hypothesis of schizophrenia.” What action does the PMHNP anticipate this
treatment having on the patient?
A
. Blocking the release of dopamine facilitates the onset of positive schizophrenia
symptoms.
B
. Hyperactivity in the mesolimbic dopamine pathway mediates the positive
symptoms of schizophrenia.
C
. Antipsychotic drugs that open D2 receptor pathways can treat schizophrenia.
D
. The neuroanatomy of dopamine neuronal pathways can explain symptoms of
schizophrenia.
1 points
QUESTION 2 5
1. A patient is diagnosed with schizophrenia. What increases the patient’s potential to
mediate the cognitive symptoms of the disease?
A
.
Achieving underactivity of the mesocorticol projections to the prefrontal
cortex
B
.
Achieving overactivity of the mesocorticol projections to the ventromedial
prefrontal cortex
C
.
Achieving underactivity of the mesocortical projections to the
ventromedial prefrontal cortex
D
.
Achieving overactivity of the mesocorticol projections to the prefrontal
cortex
1 points
QUESTION 2 6
1. What is accurate about the clinical description of psychosis?
A
.
It is simply a separate way to clinically describe the diagnosis of schizophrenia in
a client.
B
.
Psychosis is listed in the DSM as a distinct disorder with unique screening criteria.
C
.
It is a syndrome that can be associated with a number of psychiatric disorders.
D
.
Psychosis is always demonstrated by a paranoia in the client.
1 points
QUESTION 2 7
1. The PMNHP is assessing a 29-year-old client who takes antipsychotics that
block D2 receptors. This client has begun to develop a common side effect of this
medication. What is this side effect?

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A
.
Increased hallucinations and positive symptoms
B
.
Hypersexuality
C
.
Reduction in negative symptoms
D
.
Tardive dyskinesia
1 points
QUESTION 2 8
1. The PMHNP is caring for a patient who is taking antipsychotics heard the psychiatrist
tell the patient that the patient would be placed on a different antipsychotic agent called an
atypical antipsychotic. What neurotransmitters will this new medication work on?
A
.
dopamine and serotonin
B
.
dopamine and norepinephrine
C
.
dopamine and GABA
D
.
GABA and glutamate
1 points
QUESTION 2 9
1. Which statement made by the PMHNP exemplifies correct teaching of physiological
effects in the body?
A
.
Muscarinic antagonists are more likely to cause decreased prolactin levels.
B
.
D2 antagonists decrease the likelihood of EPS symptoms.
C
.
D2 antagonism is linked to antidepressant properties.
D
.
D2 partial agonists are associated with increased efficacy in treating positive
symptoms of schizophrenia.
1 points
QUESTION 3 0
1. Mrs. Schwartzman is a 52-year-old patient with schizophrenia and no established
history of depression. When meeting with the PMHNP, she presents with apathy and
withdrawn social behavior, and she reports a loss of joy from enjoyable activities. What
does the PMHNP infer from this encounter with the patient?
A
. An underlying depressive disorder

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B
.
The recent change of a 2nd generation antipsychotic to a
conventional one
C
.
The recent change of a 1st generation antipsychotic to a 2nd
generation antipsychotic
D
.
All of the above
1 points
QUESTION 3 1
1. Mrs. Schwartzman is a 52-year-old client with schizophrenia and no established history of
depression. When meeting with the PMHNP, she presents with apathy and withdrawn social behavior,
and she reports a loss of joy from enjoyable activities since starting her new medication. What does the
PMHNP infer from this encounter with the client?
A
.
The client has been misdiagnosed with schizophrenia
B
.
The client is not compliant with this new medication
C
.
The new medication is blocking D2 receptors in the mesolimbic
system
D
.
The dose of this new antipsychotic medication is too low
1 points
QUESTION 3 2
1. The student inquires about antipsychotic medications. Which response by the PMHNP
describes the factors that contribute to reduced risk of extrapyramidal symptoms (EPS) for
patients who take antipsychotics?
A
. Those that are potent D2 antagonists
B
. Those that are potent D2 antagonists with 5HT2A antagonism
properties
C
.
D2 receptors that are blocked in the nigrostriatal pathway
D
. Potent D2 antagonists that block the muscarinic anti-M1
cholinergic receptors
1 points
QUESTION 3 3
1. Mr. Gordon is a middle-aged patient who is taking antipsychotics. When meeting with
the PMHNP, he reports positive responses to the medication, stating, “I really feel as
though the effects of my depression are going away.” Which receptor action in
antipsychotic medications is believed to be the most beneficial in producing the effects
described by Mr. Gordon?
A
. 5HT2
antagonism

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B
.
D2 antagonism
C
.
Alpha-2
antagonism
D
.
D2 partial
agonist
1 points
QUESTION 3 4
1. Mr. Gordon is a middle-aged client who was started on antidepressant monotherapy for
depression. After beginning this medication, the PMHNP noticed that this client seemed to swing into a
hypomanic episode. What can the PMHNP infer from this behavior change?
A
.
This client may have Bipolar III disorder
B
.
The antidepressant monotherapy should be
continued
C
.
A second antidepressant agent should be added as dual therapy
D
. A and C
1 points
QUESTION 3 5
1. Ms. Ryerson is a 28-year-old patient with a mood disorder. She recently requested to
transfer to a new PMHNP, after not getting along well with her previous provider. The new
PHMNP is reviewing Ms. Ryerson’s medical chart prior to their first appointment. Upon
review, the PMHNP sees that the former provider last documented “patient had rapid poop
out.” What does the PMHNP infer about the patient’s prescription based on this
documentation?
A
.
The patient has an unsustained response to
antidepressants.
B
.
The patient has antidepressant-induced
hypomania.
C
.
The patient has a depletion of monoamine
neurotransmitters.
D
.
The patient has an adverse effect to atypical
antipsychotics.
1 points
QUESTION 3 6
1. The PMHNP recognizes that which patient would be contraindicated for
antidepressant monotherapy?
A
. Patient with a bipolar I
designation

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NURS6630 Mental Health Mid term Exam Final Week 6 With Answers (75 Solved Questions)

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