NR 546 MIDTERM EXAM 2023-2024 ACTUAL EXAM TEST BANK 300 QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES |ALREADY GRADED A+

NR 546 MIDTERM EXAM 2023-2024 ACTUAL EXAM

TEST BANK 300 QUESTIONS AND CORRECT

DETAILED ANSWERS WITH RATIONALES |ALREADY

GRADED A+

Why is trazodone not used as a front-line antidepressant - ANSWER- Its

antidepressant that has a secondary effect of blocking histamine and

adrenergic receptors

-causes sedation and somnolence and as a result

*often used as an adjunct in therapy when a depressed patient has

difficulty sleeping

effect on neurotransmitters and side effects: Selective Serotonin

Reuptake Inhibitors (SSRIs) - ANSWER- Inhibits the reuptake of

serotonin, which can cause nausea, agitation, headache, and sexual

dysfunction

effect on neurotransmitters and side effects: Serotonin and

Norepinephrine Reuptake Inhibitors (SNRIs) - ANSWER- Inhibits the

reuptake of serotonin and norepinephrine, which can cause nausea,

sweating, insomnia, tremors, sexual dysfunction

effect on neurotransmitters and side effects: Tricyclic Antidepressants -

ANSWER- -Inhibits the reuptake of serotonin and norepinephrine,

which can cause sexual dysfunction

-Blocks norepinephrine receptors, which can cause hypotension and

tachycardia

-Blocks histamine receptors, which can cause sedation and weight gain

-Blocks acetylcholine receptors, which can cause dry mouth,

constipation, blurred vision, and urinary retention

effect on neurotransmitters and side effects: Monoamine Oxidase

Inhibitors (MAOIs) - ANSWER- Increases norepinephrine and serotonin

by inhibiting the enzyme that inactivates it, which can cause sedation,

dizziness, sexual dysfunction, and hypertensive crisis

effect on neurotransmitters and side effects: Benzodiazepines -

ANSWER- Increases the receptor affinity for GABA, which can cause

dependence and confusion

effect on neurotransmitters and side effects: Bupropion - ANSWERInhibits the reuptake of norepinephrine and dopamine, which can cause

insomnia, dry mouth, tremors, and seizures

antagonist - ANSWER- causes a conformational change that stabilizes

the receptor in the baseline state and thus is "silent."

-blocks the action of a neurotransmitter

agonists - ANSWER- fully stimulate G-protein-linked receptors

partial agonists - ANSWER- stimulate receptors to a lesser degree than

an agonist or natural neurotransmitter

SSRIs, SNRIs, and tricyclic antidepressants increase ________ levels.

___________ do not impact serotonin levels. - ANSWER- increase

serotonin levels.

Benzodiazepines do not impact serotonin levels.

Is nicotine an inducer or an inhibitor of the CYP 1A2 enzyme? -

ANSWER- inducer

Nicotine is an inducer of the CYP 1A2 enzyme. Does the PMHNP

anticipate Joshua may need a higher or lower dose of olanzapine to

achieve a therapeutic response? - ANSWER- Higher

-Nicotine is an inducer of the CYP 1A2 enzyme, so it lowers the

concentration of drugs. Therefore, a higher dose of olanzapine may be

needed to control his symptoms.

Ernesto, a 60-year-old, presents to the PMHNP with report of having

anxiety, frequent occurrences of feeling frozen in place and like his heart

is pounding out of his chest, as well as having difficulty sleeping.

The PMHNP suspects the client has an elevated level of which

neurotransmitter? - ANSWER- Norepinephrine

-responsible for the regulation of fight or flight responses and can impact

mood and sleep.

Which of the following is the best medication class for the PMHNP to

prescribe for Ernesto to address his elevated norepinephrine levels? -

ANSWER- selective serotonin reuptake inhibitor would block the

reuptake of serotonin, leaving a larger amount of serotonin available.

Increasing the amount of serotonin would help regulate the feelings of

fear and anxiety. Reducing the occurrence of fear would help reduce the

release of norepinephrine.

A serotonin and norepinephrine reuptake inhibitor would prevent the

reuptake of norepinephrine, which would not reduce the level of

norepinephrine as needed. Benzodiazepines increase the levels of GABA

and do not impact norepinephrine. A monoamine oxidase inhibitor

would increase levels of norepinephrine.

During a follow up appointment after 4 weeks, the PMHNP should

assess for the need to add which medication to Ernesto's treatment plan?

- ANSWER- The nurse should assess for sexual dysfunction and

anticipate the potential need for a phosphodiesterase inhibitor such as

sildenafil (Viagra).

-After 4 to 6 weeks, the client should be experiencing full effects of the

SSRI, so the need for a short-term medication like a benzodiazepine or a

beta blocker are not anticipated. St. John's Wort is contraindicated with

an SSRI and can cause serotonin syndrome.

Glu - ANSWER- Glutamate

-amino acid

-excitatory neurotransmitter

-"workhorse" of the brain-can affect almost every neuron in the brain

-affects: energy, memory, learning, neural plasticity