nurs6630 all latest 2022 august final exam score 98/100

Question 1

Which of the following alcohol screening tools lack sensitivity to detect hazardous/problem drinking?

 

A.           AUDIT

 

B.           AUDIT-C

 

C.           SASQ

 

D.           CAGE

 

Question 2

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?

 

A.           Naproxen

Ketorolac

 

C.           Sulindac

 

D.           Etodolac

 

 

Question 3

What should our treatment goal be with our patients when it comes to managing chronic pain?

 

A.           The goal is to make the pain go completely away.

 

B.           The goal is to make the patient feel numb so that the pain cannot be thought about.

 

C.           There are no specific treatment goals that we should discuss with our patients, just so they don’t get their expectations too high.

 

D.           The goal is to improve their function and to drop their pain scale to less than 5 out of 10.

 

 

Question 4

Benzodiazepines can be withdrawn abruptly despite duration of therapy/abuse.

 

A.           True

 

B.           False

                            

 

 

Question 5

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?

 

A.           Recommend psychotherapy in addition to current treatment

 

B.           Switch to low dose Focalin

 

C.           Add Clonidine

 

D.           Switch to low-dose Adderall and titrate as appropriate in addition to psychotherapy

 

 

 

uestion 6

L. 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?

 

A.           Memantine

 

B.           Escitalopram

 

C.           Donepezil

 

D.           Risperidone

 

 

 

uestion 7

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?

I.            Butalbital

II.           Lorazepam

III.          Hydrocodone

 

A.           I only

 

B.           II only

 

C.           III only

 

D.           I and II

 

 

 

Question 8

The experience of pain is ALWAYS subjective

 

A.           True

 

B.           False

 

Question 9

SSRIs can be used in alcohol use disorder and offer modest drinking reduction through an anti-craving effect.

 

A.           True

 

B.           False

                            

 

 

Question 10

Which medication below would you use in addition to benzodiazepine treatment if the patient is experiencing psychosis during alcohol withdrawal delirium?

 

A.           Naltrexone

 

B.           Haloperidol

 

C.           Propofol

 

D.           Chlordiazepoxide

 

 

 

Question 11

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.

 

A.           Ritalin 10 mg twice daily

 

B.           Focalin 10 mg twice daily

 

C.           Daytrana 30 mg patch worn for 12 hours daily

 

D.           Atomoxetine 60 mg once daily

 

 

 

Question 12

Which of the following is the only Black Box Warning associated with the medication atomoxetine?

 

A.           Increased risk for cardiovascular events

 

B.           Suicidal ideation

 

C.           Substance abuse potential

 

D.           Slight growth inhibition

Question 13

Of the following neurotransmitters, which one(s) are known to be severely disrupted in the disease Dementia with Lewy Bodies?

I.            Acetylcholine

II.           Glutamate

III.          Dopamine

IV.          GABA

V.           Norepinephrine

 

A.           II only

 

B.           III only

 

C.           I and II

 

D.           I and III

 

 

Question 14

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?

 

A.           Major depression

 

B.           Personality disorder

 

C.           Anger

 

D.           Anxiety

                            

 

 

Question 15

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.

I.            Tau – tangles

II.           Beta-amyloid – tangles

III.          Tau – plaques

IV.          Beta-amyloid – plaques

 

A.           I and II

 

B.           II and III

 

C.           II and IV

 

D.           I and IV

Question 16

Select all the criteria for what is considered “At-Risk Drinking.”

I.            Women: > 7 drinks in any given week

II.           Men: > 4 drinks per day

III.          Women: > 4 drinks per day

IV.          Men: > 14 drinks per week

 

A.           I, and II

 

B.           I, II, and IV

 

C.           I, II, and III

 

D.           III and IV

 

 

Which medication below should be routine for all suspected cases of alcohol intoxication and dependence?

 

 

 

uestion 17

Which medication below should be routine for all suspected cases of alcohol intoxication and dependence?

 

A.           B vitamin thiamine 100 mg

 

B.           Haloperidol 5 mg

 

C.           Lorazepam 2 mg

 

D.           Acamprosate 666 mg

 

 

 

Question 18

Which of the following drugs is often used in the management of opioid addiction due to its ceiling effect?

 

A.           Buprenorphine

 

B.           Naloxone

 

C.           Clonidine

 

D.           Methadone

 

 

Question 19

When can buprenorphine be initiated in a patient who is suffering from an opioid overdose?

 

A.           As soon as the patient is stabilized

 

B.           It should be administered as soon as you find the patient unconscious

 

C.           Right after naloxone is administered to prevent the patient from going back into opioid overdose

 

D.           When the patient is experiencing mild-to-moderate symptoms of withdrawal

 

 

 

Question 20

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.

 

A.           Alzheimer’s Disease

 

B.           Dementia with Lewy Bodies

 

C.           Creutzfeldt-Jakob Disease

 

D.           Frontotemporal Dementias

Question 21

Of the following medications, which one is contraindicated with stimulants such as Ritalin or Adderall?

 

A.           Atomoxetine

 

B.           Clonidine

 

C.           Amitriptyline

 

D.           Phenelzine

 

 

 

Question 22

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?

 

A.           Alcohol

 

B.           Adderall

 

C.           Lorazepam

 

D.           Butalbital

 

 

Question 23

Which of the following drugs is structurally similar to tramadol; thus, its opioid-mediated analgesia can be reversed by naloxone in mice?

 

A.           Venlafaxine

 

B.           Ketorolac

 

C.           Duloxetine

 

D.           Gabapentin

 

 

 

Question 24

Y. 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?

 

A.           Oxycodone

 

B.           Amitriptyline

 

C.           Ibuprofen

 

D.           Duloxetine

 

 

Question 25

Which of the following drugs in the treatment of Alzheimer’s Disease requires administration with food?

 

A.           Memantine

 

B.           Donepezil

 

C.           Rivastigmine

 

D.           Galantamine

 

 

Question 26

FILL IN THE BLANK: ___________ is the main neurotransmitter behind reward systems in the brain, which usually leads to addiction when altered in any way.

 

A.           Norepinephrine

 

B.           Serotonin

 

C.           Dopamine

 

D.           Acetylcholine

 

 

Question 27

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?

 

A.           It is mainly metabolized by the enzyme carboxylesterase once absorbed.

 

B.           It does not undergo first-pass metabolism by the enzyme carboxylesterase in the liver.

 

C.           It can be cut up and sprinkled onto food so it can bypass first-pass metabolism in the liver.

 

D.           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 28

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?

 

A.           ß-? fibers

 

B.           A-? fibers

 

C.           A-ß fibers

 

D.           C fibers

 

 

Question 29

T. 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.?

 

A.           T. K. needs the drug donepezil to help with her memory loss only.

 

B.           T. K. needs the drug donepezil to help with her memory loss, but also needs her hypertension and hyperlipidemia controlled.

 

C.           T. K. needs the drug donepezil to help with her memory loss, but also needs her hypertension controlled.

 

D.           T. K. needs her hypertension controlled only.

 

 

 

Question 30

T. 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.?

I.            Nortriptyline

II.           Venlafaxine

III.          Duloxetine

IV.          Fluoxetine

 

A.           I, II, and III

 

B.           I and II

 

C.           II and III

 

D.           IV only

 

 

Question 31

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?

I.            Add a high-dose opioid if patient is not already on the maximum dose.

II.           Assess for a co-morbid psychiatric condition.

III.          Tell the patient you have exhausted all your options and there is nothing more you can do.

IV.          Refer the patient for a second opinion.

 

A.           I and II

 

B.           II and IV

 

C.           III only

 

D.           IV only

 

 

Question 32

Select the correct description of a somatoform disorder.

 

A.           Somatization disorder – manifests as a pain syndrome with a significant loss of or alteration in physical function that mimics a physical disorder

 

B.           Conversion disorder – pain that causes significant impairment in occupation or social function, induces marked distress, or both

 

C.           Hypochondriasis – persistent belief that one has a serious illness, despite extensive medical evaluation

 

.             Pain disorder – intentional production or feigning of physical symptoms

 

 

Question 33

Of the following neurotransmitters, which ones play a critical role in modulating attention in ADHD?

I.            Dopamine

II.           Epinephrine

III.          GABA

IV.          Norepinephrine

V.           Glutamate

 

A.           II, III, and V

 

B.           II and IV

 

C.           I and IV

 

D.           III only

 

Question 34

Which features are consistent with delirium?

I.            Acute onset

II.           Gradual onset

III.          Course of disease fluctuates

IV.          Course of diseases does not fluctuate

V.           Impaired attention

VI.          Normal attention

 

A.           II, IV, and VI

 

B.           I and III

 

C.           II and IV

 

D.           I, III, and V

 

 

 

Question 35

T. 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?

 

A.           Levodopa/carbidopa

 

B.           Galantamine

 

C.           Memantine

 

D.           Benztropine

 

 

Question 36

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?

 

A.           Guanfacine

 

B.           Modafinil

 

C.           Lisdexamfetamine

 

D.           Bupropion

                            

 

 

 

Question 37

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?

 

A.           Administer a beta-blocker like labetalol to help bring his blood pressure down

 

B.           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.

 

C.           Blood pressure is not a concern right now, but supportive therapy should be provided in the incidence of respiratory depression.

 

D.           Administer an alpha-blocker like phentolamine to help bring his blood pressure down.

 

 

Question 38

Select the correct treatment regarding drugs involved in addiction management and their corresponding mechanism of action.

 

A.           Benzodiazepines – GABA antagonist

 

B.           Buprenorphine – opioid antagonist

 

C.           Naltrexone – partial opiate agonist

 

D.           Flumazenil – GABA antagonist

 

 

Question 39

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?

 

A.           Inhibition on dopamine beta-hydroxylase

 

B.           Inhibition on aldehyde dehydrogenase

 

C.           Inhibition on alcohol dehydrogenase

 

D.           Inhibition on aldehyde reductase

                            

 

 

 

 

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?

 

A.           Amitriptyline

 

B.           Doxepin

 

C.           Fluoxetine

 

D.           Bupropion

 

 

 

uestion 41

Choose the correct statement regarding medications used for alcoholism

 

A.           Disulfiram: NMDA receptor antagonist & GABAA agonist

 

B.           Naltrexone: µ-opioid receptor antagonist that reduces the reinforcement/euphoria produced by alcohol

 

C.           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.

 

Question 42

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?

 

A. 

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