NURS 6630 Final Exam
NURS 6630 Final Exam Week 11
Question 1 2 pts
Which of the following alcohol screening tools lack sensitivity to detect hazardous/problem drinking?
Group of answer choices
AUDIT
AUDIT-C
SASQ
CAGE
Question 2 2 pts
Which club drug is structurally similar to GABA?
Group of answer choices
3,4 – methylendedioxy-methamphetamine
Ketamine
γ-hydroxybutyrate
Ecstasy
Flag question: Question 3
Question 3 2 pts
Daytrana is the MPH transdermal system of methylphenidate approved for the treatment of ADHD in children aged 6 years and older. What is the difference in terms of the metabolism compared to the other formulations in this class?
Group of answer choices
It is mainly metabolized by the enzyme carboxylesterase once absorbed.
It does not undergo first-pass metabolism by the enzyme carboxylesterase in the liver.
It can be cut up and sprinkled onto food so it can bypass first-pass metabolism in the liver.
It uses an osmotic releasing oral system technology to slowly deliver the drug to the enzyme carboxylesterase in order to make the drug last longer.
Question 4 2 pts
Which medication below would you use in addition to benzodiazepine treatment if the patient is experiencing psychosis during alcohol withdrawal delirium?
Group of answer choices
Naltrexone
Haloperidol
Propofol
Chlordiazepoxide
Question 5 2 pts
Which enzyme does disulfiram inhibit leading to a build-up of the ethanol metabolite acetaldehyde?
Group of answer choices
Alcohol dehydrogenase
Microsomal ethanol oxidizing enzyme
Aldehyde dehydrogenase
Aldehyde reductase
NURS 6630 Final Exam Question 6 2 pts
A new patient presents to your clinic today. The patient is a 13-year-old boy who complains that he has no interest in anything. The patient states, “I just want to sleep more than I normally do, and I don’t care much for playing my video games anymore.” His mother states he cannot focus on anything for more than a few minutes at a time, and that he often gets in trouble at school because he cannot sit still. What would you recommend at this time?
Group of answer choices
Recommend doing a full evaluation to distinguish if this patient is presenting with ADHD symptoms or depressive symptoms
Begin a stimulant at appropriate dose once patient’s weight is known
Refer to a behavioral counselor
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Question 7 2 pts
Which of the following is the only Black Box Warning associated with the medication atomoxetine?
Group of answer choices
Increased risk for cardiovascular events
Suicidal ideation
Substance abuse potential
Slight growth inhibition
Begin an SSRI at lowest initial dose and provide counseling on the increased risk of suicide during the first few months of therapy
Question 82 pts
Which neurotransmitters are likely involved in the pathophysiology of withdrawal seizures?
Serotonin
Endorphins
Glutamate
GABA
Dopamine
Group of answer choices
I and II
II and V
I and III
III and IV
Question 92 pts
Which of the following psychiatric conditions is present in both domains (i.e., core psychopathology & pain-related psychological symptoms) of chronic pain that will likely lead to an outcome of disability, pain, and poor quality of life?
Group of answer choices
Major depression
Personality disorder
Anger
Anxiety
Question 102 pts
Which of the following drugs is structurally similar to tramadol; thus, its opioid-mediated analgesia can be reversed by naloxone in mice?
Group of answer choices
Venlafaxine
Ketorolac
Duloxetine
Gabapentin
Question 112 pts
Of the following medications, which one is contraindicated with stimulants such as Ritalin or Adderall?
Group of answer choices
Atomoxetine
Clonidine
Amitriptyline
Phenelzine
Question 122 pts
Of the following neurotransmitters, which ones play a critical role in modulating attention in ADHD?
Dopamine
Epinephrine
GABA
Norepinephrine
Glutamate
Group of answer choices
II, III, and V
II and IV
I and IV
III only
Question 132 pts
Which features are consistent with delirium?
Acute onset
Gradual onset
Course of disease fluctuates
Course of diseases does not fluctuate
Impaired attention
Normal attention
Group of answer choices
II, IV, and VI
I and III
II and IV
I, III, and V
Question 142 pts
Which medication is a selective alpha-adrenergic agonist that works by mimicking norepinephrine binding in the pre-frontal cortex, which makes it particularly useful in the treatment of ADHD?
Group of answer choices
Guanfacine
Modafinil
Lisdexamfetamine
Bupropion
Question 152 pts
C. is an 88-year-old male who is diagnosed at your clinic with Dementia with Lewy Bodies. He currently has some debilitating gait issues, which makes his quality of life very poor. His memory is still intact with minor deficits. Which medication would likely benefit T. C. as his initial therapy?
Group of answer choices
Levodopa/carbidopa
Galantamine
Memantine
Benztropine
Question 162 pts
Choose the correct statement regarding medications used for alcoholism
Group of answer choices
Disulfiram: NMDA receptor antagonist & GABAA agonist
Naltrexone: µ-opioid receptor antagonist that reduces the reinforcement/euphoria produced by alcohol
Acamprosate: enhances the effect of the inhibitory neurotransmitter gamma-aminobutyric acid on the GABA receptors by binding to a site that is distinct from the GABA binding site in the central nervous system. NURS 6630 Final Exam
Lorazepam: inhibits alcohol dehydrogenase, leading to a buildup of acetaldehyde
Question 172 pts
B., a 55-year-old female, is a patient at your clinic today who has a past medical history significant for breast cancer, hypertension, hepatic cirrhosis, type 2 diabetes, and a recent diagnosis of alcohol use disorder. She has no known drug allergies. She states she is ready to quit drinking but fears the cravings that it may bring. Which medication would you recommend for E. B. to begin?
Group of answer choices
Naltrexone
Acamprosate
Any benzodiazepine
Thiamine
Question 182 pts
Which of the following drugs is often used in the management of opioid addiction due to its ceiling effect?
Group of answer choices
Buprenorphine
Naloxone
Clonidine
Methadone
Question 192 pts
In the pathophysiology of Alzheimer’s Disease, there are certain proteins that lead to the plaques and tangles that result in this progressive, irreversible brain disorder. Choose the appropriate protein with its corresponding pathology.
Tau – tangles
Beta-amyloid – tangles
Tau – plaques
Beta-amyloid – plaques
Group of answer choices
I and II
II and III
II and IV
I and IV
Question 202 pts
Patient is a 10-year-old female with diagnosed ADHD who was started on Ritalin 5 mg twice a day over 2 months ago. She is still experiencing the triad of symptoms associated with ADHD (impaired attention, impulsivity, and excessive motor activity). Her mother reports that she is now having difficulty in falling asleep since starting the medication. She has been on no other anti-ADHD medications and the mother reports full compliance with medication regimen. What is the appropriate recommendation to make based on this scenario?
Group of answer choices
Recommend psychotherapy in addition to current treatment
Switch to low dose Focalin
Add Clonidine
Switch to low-dose Adderall and titrate as appropriate in addition to psychotherapy
Question 212 pts
A 59-year-old male has been admitted to the E. D. due to a methamphetamine overdose. The patient’s friend reported he ingested up to 2 grams because “he thought cops were coming to get him.” The patient’s vitals are all within normal limits, except his blood pressure is 180/110. What is the best recommendation to make at this time?
Group of answer choices
Administer a beta-blocker like labetalol to help bring his blood pressure down
Patient’s blood pressure is considered a hypertension urgency, but it is probably due to the drug overdose. No action is needed at this time until the drug has cleared his system.
Blood pressure is not a concern right now, but supportive therapy should be provided in the incidence of respiratory depression.
Administer an alpha-blocker like phentolamine to help bring his blood pressure down.
Question 222 pts
SSRIs can be used in alcohol use disorder and offer modest drinking reduction through an anti-craving effect.
Group of answer choices
True
False
Question 232 pts
This medication cannot be used for more than 5 days, it is a non-steroidal, anti-inflammatory drug, and it is often substituted for morphine due to its rapid onset and high potency. What is this medication?
Group of answer choices
Naproxen
Ketorolac
Sulindac
Etodolac
Question 242 pts
FILL IN THE BLANK: ___________ is the main neurotransmitter behind reward systems in the brain, which usually leads to addiction when altered in any way.
Group of answer choices
Norepinephrine
Serotonin
Dopamine
Acetylcholine
Question 252 pts
The patient is a 16-year-old girl with a past history of substance use disorder. She has been known to abuse prescription opioids and smokes one pack of cigarettes every day. She has been in and out of recovery for the past year. During her last admission into a recovery center, she was diagnosed with ADHD, which may have contributed to her addictive personality. She presents to your clinic today to initiate pharmacotherapy for her new diagnosis. What would you recommend in this patient? Her current weight is 55 kg.
Group of answer choices
Ritalin 10 mg twice daily
Focalin 10 mg twice daily
Daytrana 30 mg patch worn for 12 hours daily
Atomoxetine 60 mg once daily
Question 262 pts
What baseline levels should you perform before initiating an anti-ADHD medication?
Group of answer choices
Electrolytes, height, weight, white-blood cells
ECHO, heart rate, pulse
Height, weight, blood pressure, pulse
Blood pressure and pulse
Question 272 pts
Drug addiction includes many prescription medications and illegal substances. Of the drugs listed, which ones can be withdrawn abruptly WITHOUT medical intervention to prevent withdraw seizures?
Group of answer choices
Alcohol
Adderall
Lorazepam
Butalbital
Question 282 pts
Of the axons involved in the transmission of pain, which one is thinly myelinated and conducts that first feeling of pain that is often felt as coming on as a sharp, rapid feeling?
Group of answer choices
ß-∆ fibers
A-∆ fibers
A-ß fibers
C fibers
Question 292 pts
There are many different types of dementia. Which dementia is NOT a direct result of disrupted neurotransmitters, but a result of degeneration of different regions in the brain? Onset of the disease is typically before the age of 60, and very rare after the age of 75.
Group of answer choices
Alzheimer’s Disease
Dementia with Lewy Bodies
Creutzfeldt-Jakob Disease
Frontotemporal Dementias
Question 302 pts
What is the difference between Ritalin and Focalin?
Group of answer choices
Focalin is a D-isomer
Ritalin is the D-isomer
Focalin is the S-isomer
There is no difference other than the formulations involved.
Question 312 pts
Disorientation, tremor, hyperactivity, fever, hallucinations, marked wakefulness, and increased autonomic tone are all features that are consistent with which part of alcohol withdrawal?
Group of answer choices
Alcohol withdrawal seizures
Korsakoff’s Psychosis
Wernicke’s encephalopathy
Alcohol withdrawal delirium
Question 322 pts
Which of the following drugs in the treatment of Alzheimer’s Disease helps normalize glutamate by antagonizing the NMDA receptor?
Group of answer choices
Memantine
Donepezil
Rivastigmine
Galantamine
Question 332 pts
Select the correct description of a somatoform disorder.
Group of answer choices
Somatization disorder – manifests as a pain syndrome with a significant loss of or alteration in physical function that mimics a physical disorder
Conversion disorder – pain that causes significant impairment in occupation or social function, induces marked distress, or both
Hypochondriasis – persistent belief that one has a serious illness, despite extensive medical evaluation
Pain disorder – intentional production or feigning of physical symptoms
NURS 6630 Final Exam
Question 342 pts
K. is a 72-year-old female who has suffered many strokes in the past, likely due to uncontrolled hypertension and hyperlipidemia. She has now been diagnosed with vascular dementia due to memory loss and motor system slowing. What is the recommended treatment for T. K.?
Group of answer choices
K. needs the drug donepezil to help with her memory loss only.
K. needs the drug donepezil to help with her memory loss, but also needs her hypertension and hyperlipidemia controlled.
K. needs the drug donepezil to help with her memory loss, but also needs her hypertension controlled.
K. needs her hypertension controlled only.
Question 352 pts
Of the following neurotransmitters, which one(s) are known to be severely disrupted in the disease Dementia with Lewy Bodies?
Acetylcholine
Glutamate
Dopamine
GABA
Norepinephrine
Group of answer choices
II only
III only
I and II
I and III
Question 362 pts
What should our treatment goal be with our patients when it comes to managing chronic pain?
Group of answer choices
The goal is to make the pain go completely away.
The goal is to make the patient feel numb so that the pain cannot be thought about.
There are no specific treatment goals that we should discuss with our patients, just so they don’t get their expectations too high.
The goal is to improve their function and to drop their pain scale to less than 5 out of 10. NURS 6630 Final Exam
Question 372 pts
J. is a 55-year-old male who attended a funeral and found himself laughing during the service, but later that evening he was irritated with himself for what he had done. His wife said this was abnormal behavior and took him to his doctor to be evaluated. After L. J.’s MRI was reviewed, he was diagnosed with frontotemporal dementia. Which medication is recommended to help L. J. with his emotional outbursts?
Group of answer choices
Memantine
Escitalopram
Donepezil
Risperidone
NURS 6630 Final Exam
Question 382 pts
When can buprenorphine be initiated in a patient who is suffering from an opioid overdose?
Group of answer choices
As soon as the patient is stabilized
It should be administered as soon as you find the patient unconscious
Right after naloxone is administered to prevent the patient from going back into opioid overdose
When the patient is experiencing mild-to-moderate symptoms of withdrawal
Question 392 pts
If a patient suffers from a multitude of small strokes and later begins experiencing mood disturbances in an acute fashion that sometimes resolve, from what type of dementia would you think that patient may suffer?
Group of answer choices
Vascular Dementia
Frontotemporal Dementias
Alzheimer’s Disease
Dementia with Lewy Bodies
NURS 6630 Final Exam Question 40 2 pts
Select all the criteria for what is considered “At-Risk Drinking.”
Women: > 7 drinks in any given week
Men: > 4 drinks per day
Women: > 4 drinks per day
Men: > 14 drinks per week
Group of answer choices
I, and II
I, II, and IV
I, II, and III
III and IV
Question 412 pts
Patient is a 75-year-old female with a confirmed diagnosis of Alzheimer’s Disease. She is currently on Donepezil 10 mg daily. She is accompanied to your clinic today by her daughter, who informs you that her mother has recently had an increase in depressive symptoms. She has no history of mood disorders. She has a history of hypertension and tonic-clonic seizures, but both are controlled. Assuming this patient will be thoroughly evaluated for the diagnosis of depression, what would you recommend as initial therapy?
Group of answer choices
Amitriptyline
Doxepin
Fluoxetine
Bupropion
Question 422 pts
B. is a 55-year-old male who has diagnosed with type 2 diabetes 10+ years ago. He has since had complications from the disease and is suffering from severe neuropathy. On top of that, T. B. is struggling with his mental health and was recently told he could be depressed but he had refused treatment at that time. Besides getting his blood sugar under control, what medication(s) can we use that may be useful in helping T. B.?
Nortriptyline
Venlafaxine
Duloxetine
Fluoxetine
Group of answer choices
I, II, and III
I and II
II and III
IV only
NURS 6630 Final Exam Question 43 2 pts
Which medication(s) requires a test dose to determine accurate use of the drug (i.e., how addicted the patient truly is on a certain drug) before beginning a titration schedule to withdrawal the patient?
Butalbital
Lorazepam
Hydrocodone
Group of answer choices
I only
II only
III only
I and II
Question 442 pts
Which of the following drugs in the treatment of Alzheimer’s Disease requires administration with food?
Group of answer choices
Memantine
Donepezil
Rivastigmine
Galantamine
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Question 452 pts
R. is a 35-year-old woman who presents to your clinic today complaining of ankle pain. She said she was running the trail when she saw a snake. During a quick turn to run away from the snake, she twisted her ankle. Which of the following medications may be a good choice in helping Y. R. with her pain?
Group of answer choices
Oxycodone
Amitriptyline
Ibuprofen
Duloxetine
Question 462 pts
If a patient is being managed for chronic pain and is not getting better after months of therapy with multiple agents (i.e., NSAIDs with opioids, muscle relaxants with NSAIDs, etc.), what should be your next step in helping the patient?
Add a high-dose opioid if patient is not already on the maximum dose.
Assess for a co-morbid psychiatric condition.
Tell the patient you have exhausted all your options and there is nothing more you can do.
Refer the patient for a second opinion.
Group of answer choices
I and II
II and IV
III only
IV only
Question 47 2 pts
The experience of pain is ALWAYS subjective
Group of answer choices
True
False
NURS 6630 Final Exam Question 48 2 pts
Disulfiram has been proven effective in the treatment of alcoholism, but recently it has been trialed in the management of cocaine addiction. What is the mechanism of action that likely helps produce these aversive effects?
Group of answer choices
Inhibition on dopamine beta-hydroxylase
Inhibition on aldehyde dehydrogenase
Inhibition on alcohol dehydrogenase
Inhibition on aldehyde reductase
Question 49 2 pts
Choose the correct statement regarding an anti-ADHD medication and its respectful mechanism of action
Group of answer choices
Methylphenidate – blocks reuptake of dopamine in the pre-synaptic neuron and promotes release of dopamine from their storage sites in the pre-synaptic neuron
Amphetamines – blocks reuptake of norepinephrine and dopamine into presynaptic neurons
Clonidine – blocks reuptake of dopamine in the pre-synaptic neuron and promotes release of dopamine from their storage sites in the pre-synaptic neuron
Atomoxetine – acts by blocking the norepinephrine pump on the pre-synaptic membrane
Guanfacine – blocks reuptake of norepinephrine and dopamine into presynaptic neurons
Question 50 2 pts
Benzodiazepines can be withdrawn abruptly despite duration of therapy/abuse.
Group of answer choices
True
False
NURS 6630 Final Exam
