Rivier NSG502 PSYCHOPHARMACOLOGY Quiz 1

Question 1Which of the following medications are FDA approved for Major Depressive Disorder? SELECT ALL THAT APPLY.

Paxil (Paroxetine)

Celexa (Citalpram)

Lexapro (Escitalopram)

Prozac (fluoxetine)

Luvox (Fluvoxamine)

Question 2The PMHNP has determined that Prozac (Fluoxetine) is not effective for the patient. The patient must be educated about how to stop this medication. Which of the following statements is correct?

Because Prozac (Fluoxetine) has very low percentage of protein binding you may stop the medication immediately

Because Prozac is not inhibitor, it must be tapered slowly over several weeks

Due the short half life of the medication you take half the doss for one week, then one half of the dose for a second week

Due to the long half life of Prozac (Fluoxetine), you may stop the medication without taper

 Question 3An inducing agent of the CYP450 system can increase the rate of another medication’s metabolism, resulting in decreased plasma level of that medication.  True or False?

True

False

Question 4Which of the following Selective Serotonin Reuptake Inhibitor (SSRI) would be the best choice for treating someone with Major Depressive Disorder with Psychotic Features?

Prozac (fluoxetine)

Lexapro ( Escitalopram)

Celexa (Citalopram)

Zoloft ( Sertraline)

Question 5The PMHNP has decided to start the patient on a Selective Serotonin Re-uptake Inhibitor. Which of the following should be included in patient education? SELECT ALL THAT APPLY

There is a Black Box Warning for increased suicidal thoughts in children, adolescents, and young adults.

If you experience side effects, they may go away in 2-4 weeks

Side effects may include diaphoresis, sexual dysfunction, and sedation

If you experience any side effect stop the medication immediately

Therapeutic effect may take at least 4-8 weeks

Question 6The PMHNP is assessing the patient who is being treated for Major Depressive Disorder. The patient is noted to be exhibiting the following symptoms:

-Tachycardia

-Fever of 101 degrees

-Diarrhea

-Diaphoresis, color is pink

Increased muscle tone

-Muscle spams/jerking

-Hyperreflexia

The PMHNP is concerned the client may be suffering from___________

Serotonin Syndrome

Hypertensive Crisis

A drug interaction due to the CYP450 System

Discontinuation Syndrome

Question 7Which class of medications are considered first line treatment for first episode of Major Depressive Disorder?

Monoamine oxidase inhibitors (MAOIs)

Norepinephrine-Dopamine Reuptake Inhibitors (NDRI)

Tricyclic antidepressants (TCA)

Selective Serotonin Reuptake Inhibitors (SSRI)

Question 8Which of the following test would the PMHNP consider ordering for a patient who is on Celexa?

EKG

Lab Values for therapeutic level

Lipid panel

MRI

Question 9The PMHNP is assessing a patient who has been tapering off Paxil. The patient is noted to be exhibiting the following symptoms:

•             Dizziness

•             Vertigo

•             Paresthesia

•             “Electric Shock”

•             Fever, Sweating

•             Nausea

•             Vomiting

•             Muscle pain

•             Fatigue

•             Tremor

•             Headache

The PMHNP is concerned the client may be suffering from___________

A drug interaction due to the CYP450 System

Discontinuation Syndrome

Serotonin syndrome

Hypertensive Crisis

Question 10Which of the following receptors is associated with Anxiety?

DA reuptake blockade

NE reuptake blockade

5HT2 Blockade

5HT1A Blockade

Question 11The PMHNP is seeing a 48 year old Female with Major Depressive Disorder. During the initial evaluation it is identified that the patient has is being treated for hypertension. Which of the following medications would the PMHNP want to avoid?

Prozac (fluoxetine)

Effexor ( Venlafaxine)

Zoloft (Sertraline)

Lexapro (Escitalopram)

Question 12The only class of antidepressants that have a black box warning for suicidal thoughts for children, adolescents, and young adults is Selective Serotonin Re-uptake Inhibitors. True or False

True

False

Question 13The PMHNP is care for a patient with Major Depressive Disorder, Alcohol Use Disorder, and Cirrhosis of the Liver. The PMHNP should avoid which of the following Serotonin and Norepinephrine Reuptake Inhibitors (SNRI).

Cymbalta (Duloxetine)

Pristiq (Desvenlafaxine)

Savella (Milnacipran)

Fetzima (Levomilnacipran)

Question 14Which of the following conditions are contraindicated when prescribing Wellbutrin (Bupropion)? SELECT ALL THAT APPLY.

Bulimia

Hypertension

Anorexia nervosa

Concurrent Use of Cocaine

History of Seizures

Question 15The Tricyclic antidepressants are known to cause multiple side effects including  anticholinergic side effects. These include dry mouth, constipation, blurred vision, urinary hesitancy, esophageal reflux

This is due to the ________ of the ___________ receptor.

Blockade of the M1 Ach ( Muscarinic Acetylcholine Receptors)

Agonism of the 5HT1A (Sub type of the Serotonin Receptor

Agonism of the M1 Ach ( Muscarinic Acetylcholine Receptors)

Blockade of the 5HT1A (Sub type of the Serotonin Receptor)

Question 16A prescriber should avoid prescribing Tricylclic Antidepressants (TCA) in patients who are suicidal.

True

False

Question 17 The PMHNP has decided to change the patient’s MAOI medication to a SSRI. Which of the following must be done to ensure a safe transition? SELECT ALL THAT APPLY

Monitor for signs of Serotonin Syndrome

Allow for an appropriate wash out period

Start the SSRI the day after stopping the MAO

Weekly lab work

Question 18The PMHNP is assessing the patient, who is taking Phenelzine for Major Depressive Disorder. The patient reports the following symptoms:

•             headache

•             Neck stiffness, soreness

•             Nausea, vomiting

•             Sweating

•             Fever, with cold, clammy skin

•             Photophobia

•             Racing Heart

The PMHNP is concerned that the patient may be experiencing a ________________.

Discontinuation Syndrome

A drug interaction due to the CYP450 System

Hypertensive Crisis

Serotonin syndrome

Question 19The PMHNP is doing education with a patient who is taking a Monoamine oxidase inhibitors (MAOIs).  Education should include which of the following. SELECT ALL THAT APPLY

Report a headache or neck stiffness immediately

Lab work must be drawn weekly for one month

Consult your provider befor taking over the counter sleep aids or cold medication

Avoid aged or smoked meats and cheeses

Avoid Beer

 Question 20 Dietary and drug restrictions must be maintained for 2 weeks after stopping Monoamine oxidase inhibitors (MAOIs). True or False

True

False

 

 

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