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Posted: January 19th, 2023

NURS 6630 Final Exam

NURS 6630 Final Exam Review Test Submission: Final Exam – Week 11

 

User xxx
Course DNRS-6630-14/DNRS-6630S-14/NURS-6630S-14/NURS-6630N-14-Approaches to Treatment-2022
Test NURS 6630 Final Exam – Week 11
Started xx
Submitted xx
Due Date xx
Status Completed
Attempt Score 97 out of 100 points
Time Elapsed 1 hour, 55 minutes out of 2 hours and 30 minutes
Results Displayed Feedback
  • Question 1
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 NURS 6630 Final Exam. Assuming this patient will be thoroughly evaluated for the diagnosis of depression, what would you recommend as initial therapy?

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Response Feedback: NURS 6630 Final Exam SSRIs are effective in treating depressive symptoms. Answer choices A & B are both TCAs and are advised against due to side effect profile and the fact this person is treatment naive (learned from previous exam) and answer choice D is contraindicated in a patient with seizures.
  • Question 2
Which club drug is structurally similar to GABA?

 

Response Feedback: under club drugs; Options A & D are the same drug
  • NURS 6630 Final Exam Question 3
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

 

Response Feedback: “Among the antidepressants these include the TCAs and SNRIs (duloxetine and venlafaxine).”

– SSRIs – page 204: “There is little evidence to support the independent analgesic activity of SSRIs.”
  • Question 4
What baseline levels should you perform before initiating an anti-ADHD medication?

 

Response Feedback: under Overview: “Before treatment with medications, it is usually important to measure baseline levels of height, weight, blood pressure, and pulse and to monitor them over the course of the treatment.”
  • NURS 6630 Final Exam Question 5
Which of the following alcohol screening tools lack sensitivity to detect hazardous/problem drinking?

 

NURS 6630 Final Exam Response Feedback: “Compared to the SASQ or the AUDIT and AUDIT-C, the CAGE lacks sensitivity to detect hazardous/problem drinking.”
  • Question 6
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

 

Response Feedback: under pathophysiology subtitle: “It is clear that both the cholinergic and dopaminergic neurotransmitter systems are severely disrupted.”
  • Question 7
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 NURS 6630 Final Exam.

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.

 

Response Feedback: Both are good options. If the patient has never been assessed for a psychiatric condition, then it needs to be done to treat the underlying cause of his or her pain. And doing a referral will help get a second set of eyes on the patient to see where something may have been missed when initially treating the patient.

– Page 208, Box 17-1 has a blurb: If treated with opioids for more than 3 months then get a second opinion NURS 6630 Final Exam.

– Page 209 under conclusions: It explains how if the patient has a co-morbid psychiatric condition, it will worsen their pain and disability and should be addressed in addition to treating the pain.
  • Question 8
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?

 

Response Feedback: “Amphetamines can be withdrawn abruptly”
  • Question 9
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

 

Response Feedback: III is wrong because it’s > 3 drinks per day for women
  • Question 10
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?

 

Response Feedback: “A-∆ fibers are 2 to 5 µcm in diameter and are thinly myelinated. They conduct “first pain,” which is immediate, rapid, and sharp with a velocity of 20 m/sec.”
  • Question 11
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.? NURS 6630 Final Exam

 

Response Feedback: “Treatment for vascular dementia involves control of vascular risk factors (e.g., hypercholesterolemia, hypertension, inactivity, diabetes, excess alcohol use, cigarette smoking, hyperhomocysteinemia).” In addition to treating these causes of CNS vascular disease, some literature indicates that symptomatic treatments (such as cholinesterase inhibitors or memantine) may be helpful for cognition.
  • Question 12
NURS 6630 Final Exam 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.

 

Response Feedback: under subtitle “Epidemiology and genetic risk factors”
  • Question 13
What is the difference between Ritalin and Focalin?

 

Response Feedback: “The primarily active form of MPH appears to be the d-threo isomer, which is available in both immediate-release tablets (Focalin 2.5, 5, and 10 mg)”
  • Question 14

 

Response Feedback: Table 15-3 has the three MOAs listed for the FDA-approved treatments of alcoholism.
  • Question 15
The experience of pain is ALWAYS subjective

 

Response Feedback: “The experience of pain is always subjective.”
  • Question 16
Which of the following drugs in the treatment of Alzheimer’s Disease helps normalize glutamate by antagonizing the NMDA receptor?
  • Question 17
Which of the following drugs is often used in the management of opioid addiction due to its ceiling effect?

 

Response Feedback: “Because of the ceiling effect seen with partial opiate agonists, there is no pharmacological benefit from doses higher than 32 mg/day.”
  • Question 18
Which medication below would you use in addition to benzodiazepine treatment if the patient is experiencing psychosis during alcohol withdrawal delirium?

 

Response Feedback: NURS 6630 Final Exam “Haloperidol 50 to 10 mg PO or IM may be added and repeated after 1 to 2 hours when psychosis or agitation is present.”
 

 

 

 

 

 

 

  • Question 47
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

 

Response Feedback: “The onset of delirium is typically acute or subacute, the course often has marked fluctuations, and level of consciousness and attention are impaired.”
  • Question 48
Select the correct treatment regarding drugs involved in addiction management and their corresponding mechanism of action.

 

Response Feedback: under Overdose subtitle: “Flumazenil, a specific benzodiazepine antagonist, reverses the life-threatening effects of a benzodiazepine overdose.”
  • Question 49
NURS 6630 Final Exam Benzodiazepines can be withdrawn abruptly despite duration of therapy/abuse.

 

Response Feedback: Benzodiazepines should never be stopped suddenly; Page 194 “Under no circumstances should benzodiazepines be stopped abruptly.”
  • Question 50
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

 

Response Feedback: “Treatment should begin with an oral test dose of 200 mg of pentobarbital, a short-acting-barbiturate.” NURS 6630 Final Exam

 

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