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MSN 672 Psychopathopharmacology Final Exam at Nothern Kentucky University

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MSN 672 Psychopathopharmacology Final Exam at Nothern Kentucky University Nursing Exams
MSN 672 Psychopathopharmacology Final Exam at Nothern Kentucky University
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About MSN 672 Psychopathopharmacology Final Exam at Nothern Kentucky University

Get the EXACT MSN 672 Psychopathopharmacology Final Exam questions with verified answers. Stop guessing and start passing. Real questions from actual tests available now.

Free MSN 672 Psychopathopharmacology Final Exam at Nothern Kentucky University Questions

1.

A 75-year-old patient with Alzheimer's disease is currently being treated with donepezil. Donepezil increases acetylcholine by:

  • A. Inhibiting acetylcholinesterase
  • B. Inhibiting the choline transporter
  • C. A and B
  • D. Neither A nor B

Explanation

Explanation
Donepezil is a cholinesterase inhibitor used to treat Alzheimer's disease. It works by inhibiting acetylcholinesterase, the enzyme responsible for breaking down acetylcholine in the synaptic cleft. By inhibiting this enzyme, donepezil increases the levels of acetylcholine, thereby improving cholinergic neurotransmission, which is often deficient in Alzheimer's disease. This action helps to temporarily improve cognitive function or slow cognitive decline in patients with Alzheimer's. Donepezil does not inhibit the choline transporter, which is unrelated to its mechanism of action.
Correct Answer: A. Inhibiting acetylcholinesterase
2.

These medications are a highly selective agonist of the Alpha 2a adrenergic receptor, that are utilized for treatment of symptoms associated with ADHD. Select the medications that apply to this description (Select all that apply).

  • A. Atomoxetine
  • B. Guanfacine
  • C. Bupropion
  • D. Clonidine

Explanation

Explanation
B. Guanfacine
Guanfacine is a selective alpha-2 adrenergic agonist that is used to treat ADHD. It works by stimulating the alpha-2a receptors, which helps to reduce hyperactivity and improve attention and impulse control in individuals with ADHD. The extended-release formulation (Intuniv) is commonly prescribed for ADHD in both children and adults.
D. Clonidine
Clonidine is another alpha-2 adrenergic agonist that is used for ADHD. Similar to guanfacine, it works by stimulating alpha-2 receptors in the brain, leading to a calming effect that helps improve attention and reduce impulsivity. The extended-release formulation (Kapvay) is typically used for ADHD.
Correct Answer: B. Guanfacine
D. Clonidine
3.

A 44-year-old male with schizophrenia has been taking an antipsychotic medication since initial diagnosis twelve years ago. He has recently begun experiencing difficulty with smooth movement of his arms as well as involuntary facial grimaces. Which of the following likely underlies these symptoms?

  • A. Upregulation of serotonin 2A receptors
  • B. Downregulation of serotonin 2A receptors
  • C. Upregulation of dopamine 2 receptors
  • D. Downregulation of dopamine 2 receptors

Explanation

Explanation
The difficulty with smooth movement and involuntary facial grimaces are classic symptoms of tardive dyskinesia (TD), a long-term side effect of antipsychotic medications, particularly dopamine receptor antagonists (which are common in many antipsychotics). TD is characterized by abnormal, involuntary movements and typically involves the dopamine D2 receptors. The mechanism behind tardive dyskinesia involves downregulation of dopamine D2 receptors over time due to chronic blockade by the antipsychotic drugs. This downregulation leads to a dopaminergic imbalance, resulting in the movement disorders observed in TD. Therefore, downregulation of dopamine 2 receptors is the most likely explanation for the client's symptoms.
Correct Answer: D. Downregulation of dopamine 2 receptors
4.

A patient with a history of opioid use disorder is requesting a prescription for buprenorphine, instead of the combination formulation with buprenorphine and naloxone. You analyze the patient's request, because as a PMHNP, you are aware that the combination formulation of buprenorphine and naloxone... (Select the best answer):

  • A. Is more effective for withdrawal symptoms
  • B. Is significantly cheaper
  • C. Produces a "high"
  • D. Prevents intravenous abuse

Explanation

Explanation
The combination formulation of buprenorphine and naloxone is designed to reduce the potential for misuse, particularly intravenous abuse. Naloxone is an opioid antagonist that has minimal effect when taken orally but will induce withdrawal symptoms if the medication is injected. This discourages individuals from attempting to misuse the medication intravenously.
Correct Answer: D. Prevents intravenous abuse
5.

The nurse practitioner is providing education for a 15-year-old male patient and his guardian. The patient has been diagnosed with Disruptive Mood Dysregulation Disorder (DMDD) and prescribed valproate. The nurse practitioner informs the patient and guardian to immediately report which symptom if it occurs? (Select all that apply)

  • A. Vomiting
  • B. Severe abdominal pain
  • C. Dark urine
  • D. Joint discomfort

Explanation

Explanation
Valproate, a medication commonly used to treat bipolar disorder and epilepsy, carries a risk of serious adverse effects, particularly hepatotoxicity and pancreatitis. The symptoms that should be reported immediately include:
A. Vomiting
Vomiting can be a sign of liver dysfunction or pancreatitis, both of which are serious potential side effects of valproate. If a patient taking valproate develops vomiting, it should be assessed promptly.
B. Severe abdominal pain
Severe abdominal pain is a warning sign of pancreatitis, a potentially life-threatening condition associated with valproate use. This symptom must be reported immediately.
C. Dark urine
Dark urine may indicate hepatic dysfunction or liver toxicity, which are significant concerns when using valproate. This requires immediate attention and possible adjustment of the medication.
Correct Answer: A. Vomiting
B. Severe abdominal pain
C. Dark urine
6.

Hypnotics with moderate half-lives (15-30 hours) may not wear off until after the individual wakes up. What are the potential residual effects? (Select all that apply).

  • A. Loss of sleep maintenance
  • B. Memory problems
  • C. Rapid onset of action
  • D. "Hangover" effects

Explanation

Explanation
B. Memory problems
Hypnotics with moderate half-lives can cause residual sedative effects that impair cognitive functions, including memory. These effects can linger into the day after waking, leading to difficulty remembering events or conversations, especially when the medication hasn't completely cleared the system.
D. "Hangover" effects
"Hangover" effects, such as grogginess, drowsiness, or feeling mentally foggy, can occur because the hypnotic is still active in the system when the individual wakes up. This extended sedation can lead to feelings of sluggishness and decreased alertness, commonly reported when using hypnotics with a longer half-life.
Correct Answer: B. Memory problems
D. "Hangover" effects
7.

This is a Norepinephrine-dopamine reuptake inhibitor (NDRI) that can be used to treat ADHD. Select the medication that applies to this description.

  • A. Bupropion
  • B. Ritalin
  • C. Adderall
  • D. Fluoxetine

Explanation

Explanation
Bupropion is a Norepinephrine-dopamine reuptake inhibitor (NDRI). It works by inhibiting the reuptake of both norepinephrine and dopamine, which can be helpful in treating conditions like ADHD, depression, and smoking cessation. While not typically the first-line treatment for ADHD, bupropion is used in certain cases, especially when a stimulant medication is not suitable due to side effects or other concerns.
Correct Answer: A. Bupropion
8.

The majority of atypical antipsychotics (Select all that apply)

  • A. Have higher affinity for dopamine 2 receptors than for serotonin 2A receptors
  • B. Have higher affinity for serotonin 2A receptors than for dopamine 2 receptors
  • C. Have comparable affinity for dopamine 2 and serotonin 2A receptors
  • D. Have a higher ratio of serotonin type 2 (5-HT2) to D2 receptor blockade than typical antipsychotics

Explanation

Explanation
B. Have higher affinity for serotonin 2A receptors than for dopamine 2 receptors
Atypical antipsychotics are characterized by greater affinity for serotonin 2A receptors compared to dopamine 2 receptors. This results in a reduced risk of extrapyramidal symptoms (EPS), which are common with typical antipsychotics. The serotonin receptor blockade helps manage both the positive and negative symptoms of schizophrenia, and has fewer motor side effects.
D. Have a higher ratio of serotonin type 2 (5-HT2) to D2 receptor blockade than typical antipsychotics
The serotonin-dominant activity of atypical antipsychotics is a key feature that differentiates them from typical antipsychotics. Atypical antipsychotics block more serotonin receptors (5-HT2) compared to dopamine receptors (D2), which contributes to a better side-effect profile and reduced risk of EPS. This balance helps manage both positive and negative symptoms of schizophrenia more effectively.
Correct Answer: B. Have higher affinity for serotonin 2A receptors than for dopamine 2 receptors
D. Have a higher ratio of serotonin type 2 (5-HT2) to D2 receptor blockade than typical antipsychotics
9.

In the general population, which factor is the most common cause of Attention-Deficit Hyperactivity Disorder?

  • A. Acquired childhood diseases/infections
  • B. Hereditary factors
  • C. Fragile X syndrome
  • D. Atrophy of the parietal, temporal, and occipital lobes

Explanation

Explanation
Hereditary factors are the most common cause of Attention-Deficit Hyperactivity Disorder (ADHD) in the general population. Research has consistently shown that genetic predisposition plays a significant role in the development of ADHD. Children with a family history of ADHD are at a higher risk of developing the disorder themselves.
Correct Answer: B. Hereditary factors
10.

Which of these medications block serotonin 2A and 2C receptors as well as serotonin reuptake; classified as a serotonin antagonist/reuptake inhibitor (SARI); and known for its hypnotic effects with low effectiveness for antidepressant action?

  • A. Desyrel
  • B. Buspirone
  • C. Oxcarbazepine
  • D. Aripiprazole

Explanation

Explanation
Desyrel (trade name for Trazodone) is classified as a serotonin antagonist/reuptake inhibitor (SARI). It works by blocking serotonin 2A and 2C receptors and inhibiting serotonin reuptake. While Trazodone has hypnotic properties and is often prescribed for insomnia, it has low effectiveness as an antidepressant on its own. It is commonly used off-label for sleep disorders due to its sedating effects, but it may not be as effective in treating depression in some cases, especially at lower doses.
Correct Answer: A. Desyrel

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