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

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Take Test: Week 6 Midterm ExamTest InformationDescriptionInstructionsTimed TestThis test has a time limit of 2 hours.You will be notified whentime expires, and you may continue or submit.Warnings appear whenhalf the time,5 minutes,1minute, and30 secondsremain.MultipleAttemptsNot allowed. This test can only be taken once.ForceCompletionOnce started, this test must be completed in one sitting. Donot leave the test before clickingSave and Submit.Remaining Time:13minutes,04seconds.Question Completion Status:QUESTION 11.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 moreneurotransmitters that your body already produces helping to alleviate your symptoms.”D.“Why do you believe that your medication is poison?”1 pointsQUESTION 21.Ms. Hill is currently being treated for schizophrenia but has stopped takingher medications due to some side effects she claims she was experiencing.She presents to the clinic today with worsening symptoms. She isexperiencing anhedonia, agitation, attentional impairment, and affectiveblunting. Which one of the symptoms mentioned is considered a positivesymptom of schizophrenia?

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A.AnhedoniaB.AgitationC.Attentional ImpairmentD.Affective Blunting1 pointsQUESTION 31.Which statement about neurotransmitters and medications is true?A.Endorphins were discovered before morphine which lead to the use of the opioids for paincontrol.B.Several psychiatric medications have been developed after discoveries of endogenousneurotransmitters and defining their function in the brain.C.Medications work by sending messages to neurotransmitters enabling them to work moreeffectively.D.An imbalance of serotonin has been directly linked to depression. Following the discovery of thisneurotransmitter, pharmacologists were able to develop a well-known drug- Prozac as the firstmedication used to restore the balance of serotonin.1 pointsQUESTION 41.When an unstable patient asks why it is necessary to add medications to his currentregimen, the PMHNP’s best response would be:A."More often than you would think, multiple medications should always be tried together to seewhat happens.”B.“Due to this being your first hospitalization after starting medication treatment for the first timein your life, the only way to effectively manage your symptoms is by adding additionalmedications in hopes that it will work for you."C.“Many psychiatric illnesses involve several dys-functioning neurotransmitter systems in thebrain. Often, a single medication may only effect one or two of the dys-functioning systems. Theaddition of another medication can work with the current medication in stabilizing multipleneurotransmitter systems and help to alleviate your symptoms.”D.“I understand your concerns. Often times, it is necessary to switch medications after shortperiods of time to better manage your symptoms. We will discontinue your current regimen andstart another single drug agent.”1 pointsQUESTION 51.During gene expression, what must occur prior to a gene being expressed?A.Transcription factor must bind to the regulatory region withinthe cell’s nucleus.

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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 tomRNA.1 pointsQUESTION 61.While genes have potential to modify behavior, behavior can also modify genes. Howdo genes impact this process?A.Genes impact neuron functioning directly.B.Changes made to proteins lead to changes inbehavior.C.Neurons are able to impact protein synthesis.D.Genes impact the DNA of a cell, leading tochanges in behavior.1 pointsQUESTION 71.Though medications have the ability to targetneurotransmitter release into the synapseby the presynaptic neuronit is not always necessary. The PMHNP understands that this isbecause:A.Neurotransmission occurring along the axon is normally at a level to prevent symptoms ofmental illness and rarely require augmentation from medication therapy.B.Neurotransmission is minimally affected by medication therapy when compared to the baselineneurotransmitter 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 tofunction properly.1 pointsQUESTION 81.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 kidneydamage, the dose must be increased to be effective.B.The bioavailability of the medication after it passes through the stomach and livercan be altered.C.The medication’s chemical composition changes when it comes in contact with theacid in the stomach.

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D.The CYP enzyme system is a steady and predictable process that prescribers mustunderstand to treat conditions effectively.1 pointsQUESTION 91.It is important for the PMHNP to recognize differences in pharmacokinetics to safelyprescribe and monitor medications. Which of the following statements does the competentPMHNP identify as true?A.About 1 out of 5 Asians requires lower-than-normal doses of some antidepressantsand antipsychotics.B.The term polymorphic refers to the body’s ability to break a medication down severalways, and this patient may require higher doses of certain antidepressants andantipsychotics.C.About 1 out of 30 Caucasians requires lower doses of some antidepressants andantipsychotics.D.Most enzyme pathways do not have interactions between the newer medications.1 pointsQUESTION 1 01.As it relates to G-protein linked receptors, what does the PMHNP understand aboutmedications 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 tostimulate the body’s natural neurotransmitters.C.Most medications act as partial agonists because they allow the body to use onlywhat is needed.D.Medications used in practice may act as inverse agonists if the dosage is too high.1 pointsQUESTION 1 11.The PMHNP is considering prescribing a 49-year-old male clozapine (Clozaril) to treathis schizophrenia and suicidal ideations. The PMHNP is aware that which factor may impactthe dose needed to effectively treat his condition:A.The patient smokes cigarettes.B.The patient has hypertension.C.The patient has chronic kidneydisease, stage 2.DThe patient drinks a cup of coffee a

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.day.1 pointsQUESTION 1 21.A patient is diagnosed with bipolar disorder and is currently taking carbamazepine(Tegretol), aripiprazole (Abilify), and melatonin. The PMHNP has just written an order todiscontinue the carbamazepine (Tegretol) for drug-induced thrombocytopenia. The PMHNPis aware that his next best action is to:A.Alert staff to possible seizuresB.Write an order for a different mood stabilizerC.Decrease the amount prescribed for aripiprazole(Abilify)D.Explain to the patient that it will be more difficult tocontrol his temper1 pointsQUESTION 1 31.A patient recently transferred following a suicide attempt has a history ofschizophrenia, depression, and fibromyalgia. He is currently taking Amitriptyline (Elavil),Lisinopril, aspirin, and fluoxetine (Prozac).When assessing the psychiatric medications and thereason for admission, what would be the best course of action for the PMHNP with this client?A.Review Amitriptyline (Elavil) levelB.Order a STAT BUN/SCrC.Asses the client for nystagmusD.Order a STAT platelet, D-dimer, and PT/INR1 pointsQUESTION 1 41.A patient with schizophrenia is given an inverse agonist that acts on the receptor 5HTand neurotransmitter serotonin. What is the rationale for prescribing a medication such asthis?A.To promote the availability of serotoninB.To decrease serotoninC.To indirectly increase the amount of dopaminein the bodyDTo help decrease the amount of serotonin and

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.dopamine1 pointsQUESTION 1 51.The PMHNP is caring for four patients. Which patient statement indicates thatbenzodiazepines 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 rememberingthings 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 pointsQUESTION 1 61.Ms. Harlow is a 42-year-old patient who is prescribed a drug that acts on ionotropicreceptors. 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’sprescription?A.“The drug will have an almost immediateeffect.”B.“The drug can take a while to build up in yoursystem.”C.“The drug is slow to release but lasts for a longtime.”D.“The drug will make a subtle difference in yoursymptoms.”1 pointsQUESTION 1 71.A patient is seeking pharmacological treatment for smoking cessation. Which drugclass does the PMHNP prescribe to the patient?A.BenzodiazepineB.Mirtazapine(Remeron)C.KetamineD.Varenicline(Chantix)

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1 pointsQUESTION 1 81.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 thestabilizers.” The PMHNP immediately recognizes that the patient is describing which kind ofdrug?A.Full agonistsB.AntagonistsC.PartialagonistsD.Inverseagonists1 pointsQUESTION 1 91.A patient presents with frequent episodes of mania. Which statement describes anappropriate 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 levelsmust be regulated.”D.“The patient should have a drug that acts on ligand-gated ionchannels.”1 pointsQUESTION 2 01.What characteristics do the nicotinic, cholinergic, serotonin 3, and glycine receptors all have incommon?A.Ligand-gated ion channels with apentameric structureB.Ligand-gated ion channels with atetrameric structureC.Voltage-sensitive ion channelsD.Are G-coupled protein receptors1 pointsQUESTION 2 1

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1.Which statement made by the patient suggests the patient will need to be treatedwith antipsychotics that target paranoid psychosis?A.“It’s my fault that all of this is happening. I don’t think I could everforgive myself.”B.“I have to talk to the President because I’m the only one who canhelp him.”C.“I’m not sure why that lady is wearing a red jacket since it’s the dogswho need food.”D.“I don’t know that I even want to go to that meeting. It doesn’t seemworth it anymore.”1 pointsQUESTION 2 21.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 thepresynaptic neuron.C.MAO-B presents in the mitochondria within the presynapticneuron.D.D2 receptors are the primary binding site for dopamineagonists.1 pointsQUESTION 2 31.Mrs. Trevor is a 44-year-old patient who does not have a diagnosis of schizophreniabut occasionally reports symptoms of psychosis, followed by severe fatigue. Mrs. Trevorinquires about the use of amphetamines to help with her energy levels. Which responsemade 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 agood choice for you.”C.“Amphetamines can cause hallucinations, so I would advise against this type ofprescription.”D.“Amphetamines can lead to a dopamine deficiency, so I will not prescribe this foryou.”1 pointsQUESTION 2 4

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1.The PMHNP is caring for a patient with schizophrenia and is considering a variety oftreatment approaches. The PHMNP selects a viable treatment that is consistent with the“dopamine hypothesis of schizophrenia.” What action does the PMHNP anticipate thistreatment having on the patient?A.Blocking the release of dopamine facilitates the onset of positive schizophreniasymptoms.B.Hyperactivity in the mesolimbic dopamine pathway mediates the positivesymptoms of schizophrenia.C.Antipsychotic drugs that open D2 receptor pathways can treat schizophrenia.D.The neuroanatomy of dopamine neuronal pathways can explain symptoms ofschizophrenia.1 pointsQUESTION 2 51.A patient is diagnosed with schizophrenia. What increases the patient’s potential tomediate the cognitive symptoms of the disease?A.Achieving underactivity of the mesocorticol projections to the prefrontalcortexB.Achieving overactivity of the mesocorticol projections to the ventromedialprefrontal cortexC.Achieving underactivity of the mesocortical projections to theventromedial prefrontal cortexD.Achieving overactivity of the mesocorticol projections to the prefrontalcortex1 pointsQUESTION 2 61.What is accurate about the clinical description of psychosis?A.It is simply a separate way to clinically describe the diagnosis of schizophrenia ina 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 pointsQUESTION 2 71.The PMNHP is assessing a 29-year-old client who takes antipsychotics thatblock D2 receptors. This client has begun to develop a common side effect of thismedication. What is this side effect?

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A.Increased hallucinations and positive symptomsB.HypersexualityC.Reduction in negative symptomsD.Tardive dyskinesia1 pointsQUESTION 2 81.The PMHNP is caring for a patient who is taking antipsychotics heard the psychiatristtell the patient that the patient would be placed on a different antipsychotic agentcalled anatypical antipsychotic.What neurotransmitters will this new medication work on?A.dopamine and serotoninB.dopamine and norepinephrineC.dopamine and GABAD.GABA and glutamate1 pointsQUESTION 2 91.Which statement made by the PMHNP exemplifies correct teaching of physiologicaleffects 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 positivesymptoms of schizophrenia.1 pointsQUESTION 3 01.Mrs. Schwartzman is a 52-year-old patient with schizophrenia and no establishedhistory of depression. When meeting with the PMHNP, she presents with apathy andwithdrawn social behavior, and she reports a loss of joy from enjoyable activities. Whatdoes 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 aconventional oneC.The recent change of a 1st generation antipsychotic to a 2ndgeneration antipsychoticD.All of the above1 pointsQUESTION 3 11.Mrs. Schwartzman is a 52-year-old client with schizophrenia and no established history ofdepression. 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 thePMHNP infer from this encounter with the client?A.The client has been misdiagnosed with schizophreniaB.The client is not compliant with this new medicationC.The new medication is blocking D2 receptors in the mesolimbicsystemD.The dose of this new antipsychotic medication is too low1 pointsQUESTION 3 21.The student inquires about antipsychotic medications. Which response by the PMHNPdescribes the factors that contribute to reduced risk of extrapyramidal symptoms (EPS) forpatients who take antipsychotics?A.Those that are potent D2 antagonistsB.Those that are potent D2 antagonists with 5HT2A antagonismpropertiesC.D2 receptors that are blocked in the nigrostriatal pathwayD.Potent D2 antagonists that block the muscarinic anti-M1cholinergic receptors1 pointsQUESTION 3 31.Mr. Gordon is a middle-aged patient who is taking antipsychotics. When meeting withthe PMHNP, he reports positive responses to the medication, stating, “I really feel asthough the effects of my depression are going away.” Which receptor action inantipsychotic medications is believed to be the most beneficial in producing the effectsdescribed by Mr. Gordon?A.5HT2antagonism

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B.D2 antagonismC.Alpha-2antagonismD.D2 partialagonist1 pointsQUESTION 3 41.Mr. Gordon is a middle-aged client who was started on antidepressant monotherapy fordepression. After beginning this medication, the PMHNP noticed that this client seemed to swing into ahypomanic episode. What can the PMHNP infer from this behavior change?A.This client may have Bipolar III disorderB.The antidepressant monotherapy should becontinuedC.A second antidepressant agent should be added as dual therapyD.A and C1 pointsQUESTION 3 51.Ms. Ryerson is a 28-year-old patient with a mood disorder. She recently requested totransfer to a new PMHNP, after not getting along well with her previous provider. The newPHMNP is reviewing Ms. Ryerson’s medical chart prior to their first appointment. Uponreview, the PMHNP sees that the former provider last documented “patient had rapid poopout.” What does the PMHNP infer about the patient’s prescription based on thisdocumentation?A.The patient has an unsustained response toantidepressants.B.The patient has antidepressant-inducedhypomania.C.The patient has a depletion of monoamineneurotransmitters.D.The patient has an adverse effect to atypicalantipsychotics.1 pointsQUESTION 3 61.The PMHNP recognizes that which patient would be contraindicated forantidepressant monotherapy?A.Patient with a bipolar Idesignation

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