NURS6630 Midterm Exam week 5 new version 2024 Latest
Question 11
What channel in the plasma membrane of the nerve cell responds to direct changes in membrane potentials?
Mechanically gated channels
Leakage channels
Ligand-gated channels
Voltage-gated channels
Question 21
True or false: If an older adult achieves remission of depression with the current medication treatment and without side effects, the treatment should continue indefinitely
True
False
Question 31
Trazodone, commonly used as a sleep aid, acts primarily by:
Blocking norepinephrine reuptake
Blocking 5-HT2A receptors
Blocking monoamine oxidase
Stimulating postsynaptic 5-HT1A receptors
Stimulating serotonin reuptake
Question 41
In adolescents, the prevalence of depression:
Is higher in females than in males after puberty.
Is approximately 1%
Is higher in males than in females after puberty.
Is equal between males and females throughout adolescence.
Is lower than the prevalence in younger children.
Question 51
Besides treating refractory major depression, what is an additional indication for medications within the serotonin antagonist and reuptake inhibitor (SARI) drug class?
Chronic pain
Weight loss
Smoking cessation
Insomnia
Psychosis
Question 61
What is the main reason behind limited bioavailability of benzylpenicillin?
The beta-lactam ring of benzylpenicillin is highly prone to acid catalyzed intermolecular hydrolysis.
The beta-lactam ring of benzylpenicillin is highly prone to alkali catalyzed intermolecular hydrolysis.
The beta-lactam ring of benzylpenicillin is highly prone to alkali catalyzed intramolecular hydrolysis.
The beta-lactam ring of benzylpenicillin is highly prone to acid catalyzed intramolecular hydrolysis.
The beta-lactam ring of benzylpenicillin is highly prone to H2O2 catalyzed intermolecular hydrolysis.
Question 71
Amy comes to the clinic saying that she is having difficulty staying asleep and is tired during the day. What is the most effective long-term treatment for her dyssomnia?
Using stimulant medications
Drinking a glass of wine before sleeping
Improving sleep hygiene
Taking sedative medications
Watching TV in bed
Question 81
The 1st-line pharmacological treatment for depression in adolescents typically includes:
Benzodiazepines
Monoamine oxidase inhibitors (MAOIs)
Selective serotonin reuptake inhibitors (SSRIs)
Tricyclic antidepressants
Antidepressants are not recommended in children under 18 years of age.
Question 91
Which of the following is a common pharmacokinetic characteristic of tricyclic antidepressants (TCAs)?
Low volume of distribution
Rapid elimination from the body
High volume of distribution
Easily dialyzable
Insignificant first-pass metabolism
Question 101
A patient’s grandmother developed severe nutritional deficiencies during the Great Depression. The patient currently struggles with being overweight. How might the grandmother’s history contribute to the patient’s condition?
The grandmother’s nutritional deficiencies led to genetic mutations passed down to the patient, causing weight issues.
The patient’s condition is entirely due to their own lifestyle choices and is unrelated to the grandmother’s nutritional history.
Nutritional deficiencies in the grandmother caused a permanent change in the family’s DNA, affecting all subsequent generations.
The grandmother’s nutritional deficiencies directly altered her DNA sequence, which was inherited by the patient.
Epigenetic changes due to the grandmother’s nutritional deficiencies may have influenced the patient’s gene expression, such as the desire to eat.
Question 111
Which of the following is categorized as a non-selective alpha-adrenergic blocker?
Atenolol
Yohimbine
Phentolamine
Prazosin
Butaxamine
Question 121
Which of the following neurotransmitters belongs to the catecholamine class?
Acetylcholine
Dopamine
Glutamate
Serotonin
Substance P
Question 131
What is the result of an excitatory postsynaptic potential?
Subthreshold postsynaptic potential
Depolarizing postsynaptic potential
Repolarizing postsynaptic potential
Hyperpolarizing postsynaptic potential
Question 141
All the following symptoms are seen in serotonin syndrome, EXCEPT:
Mydriasis
Hypotonia
Agitation
Increased sweating
Hyperthermia
Question 151
Which symptom is NOT typically associated with a manic episode in bipolar disorder type I?
Excessive feelings of guilt
Inflated self-esteem or grandiosity
Flight of ideas
Excitability or aggression
Psychosis
Question 161
Which of the following is a first-line pharmacotherapy for long-term management of the panic disorder?
Nonsteroidal anti-inflammatory drugs
Opiates
Barbiturates
Selective serotonin reuptake inhibitors
Tetrahydrocannabinol
Question 171
Edward received a head injury while hiking. Afterward, friends note that he is easily angered and has difficulty in planning and completing complex tasks. What structure most likely was injured?
Amygdala
Cingulate gyrus
Temporal lobe
Prefrontal cortex
Postfrontal cortex
Question 181
Which area of the brain is least involved in emotional circuits?
Hippocampus
Hypothalamus
Pons
Amygdala
Prefrontal lobe
Question 191
A woman presents with a family history of breast cancer. Genetic testing reveals a single nucleotide polymorphism (SNP) commonly associated with breast cancer. This SNP is best described as:
A direct cause of breast cancer.
A causative gene that guarantees the development of breast cancer.
An unrelated genetic variation found coincidentally.
A mutation that affects the entire chromosome.
A genetic marker indicating a genetic predisposition to breast cancer.
Question 201
Which of the following is NOT risk factor for pediatric depression?
Chronic illness
High academic grades
Peer rejection
Family dysfunction
Family history of depression
Question 211
What is the most superior part of the brain stem?
Cerebrum
Pons
Midbrain
Medulla oblongata
Cerebellum
Question 231
A 50 year old patient has failed multiple trials of antidepressants, including SSRIs, NDRI, TCAs, and SNRIs. Currently, the patient is prescribed and taking duloxetine 90mg each day with minimal response. You and the patient decide to initiate an MAOI to treat depressive symptoms. How would you instruct the patient to make this change?
Initiate a cross taper-titration to reduce the risk of worsening of depression and possible hospitalization
Stop the duloxetine and wait 7 days (wash-out) and then initiate the MAOI
Taper off the duloxetine and wait 5 half-lives before starting the MAOI
An MAOI would be contraindicated for this patient and the patient should be referred to ECT or TMS
Question 221
Norepinephrine is responsible in regulating all of the following, except:
Focus
Sleep
Appetite
Cravings to use mood altering substances
Homeostasis
Question 241
Which of the following statements best differentiates dyssomnias from parasomnias?
Dyssomnias involve difficulties in the timing, quality, or amount of sleep, while parasomnias involve abnormal behaviors or physiological events occurring during sleep.
Dyssomnias are primarily treated with medication, whereas parasomnias are not.
Dyssomnias include conditions like narcolepsy and sleep apnea, whereas parasomnias include only psychological sleep disturbances.
Dyssomnias are less common than parasomnias in the general population.
Dyssomnias involve psychological events during sleep, while parasomnias involve abnormal behaviors during sleep.
Question 251
The following neurotransmitters are excitatory:
Histamine, GABA, and Norepinephrine ÊÊÊÊÊÊÊÊ
Dopamine, Serotonin, Norepinephrine
Acetylcholine, GABA, and Dopamine
Serotonin, Histamine, Glutamate
Glutamate, Norepinephrine, Dopamine
Question 261
Which of the following is a clinical feature of serotonin syndrome?
Bradycardia
Hyporeflexia
Hypothermia
Muscle paralysis
Mydriasis
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Question 271
Which of the following is considered a dyssomnia?
REM behavioral disorder
Night terrors
Somnambulism
Insomnia
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Question 281
The difference between acute stress disorder (ASD) and post-traumatic stress disorder (D) can be explained by which of the following statements?
D symptoms last > 1 week, while ASD symptoms last no longer than a month.
D symptoms last > 1 month, while ASD symptoms last no longer than a week.
D symptoms last > 1 month, while ASD symptoms last no longer than a month.
D symptoms last > 1 week, while ASD symptoms last no longer than 2 days.
D symptoms last > 1 year, while ASD symptoms last no longer than 6 months.
Question 291
What best describes EC50?
The dose required to achieve 50% mortality from toxicity.
The dose that is required to achieve 50% of the desired response in 50% of the population.
The effective concentration of a drug that produces 50% of the minimum effect.
The dose required to get 50% of the population reporting toxic side effects.
The effective concentration of a drug produces 50% of the maximal effect.
Question 301
Which of the following mechanisms of action are associated with tricyclic antidepressants (TCAs)?
Inhibits reuptake of serotonin only at the presynaptic cleft
Nonselectively inhibits monoamine oxidase
Stimulates release of norepinephrine and dopamine in the presynaptic cleft
Inhibits reuptake of serotonin and norepinephrine at the presynaptic cleft
Acts as an antagonist at dopamine and serotonin receptors
Question 311
Which of the following beta blockers is known for its combined alpha and beta receptor activity and is particularly used in cardiac failure?
Propranolol
Atenolol
Carvedilol
Nadolol
Timolol
Question 321
Which of the following neurotransmitters is most often affected in depression?
Histamine
Acetylcholine
GABA
Epinephrine
Serotonin
Question 331
Considering that Drug X has a dissociation constant (Kd) of 700 pg/mL and an effective dose 50 (ED50) of 700 pg/mL, which of the following statements is most accurate?
Drug X requires that all receptors be bound to produce 50% of the maximal effect.
ED50 represents the point at which 50% of the population will experience a toxic effect from the drug.
Drug X produces 100% of the maximal effect when 50% of the receptors are bound.
Kd represents the concentration at which 50% of the drug is metabolized.
if the Kd value for drug X were 200 pg/mL, that would indicate a higher binding affinity compared to its current Kd of 700 pg/mL.
Question 341
Which of the following statements regarding the management of post-traumatic stress disorder (D) is FALSE?
Early treatment may prevent chronicity.
SSRIs and other drugs are most effective in improving hyperarousal and mood.
An SSRI should be started at its lowest dose and gradually titrated.
Prazosin should be started with a dose of 3-15 mg to increase its efficacy.
TCAs and MAOIs are used as second-line agents
Question 351
A patient who is being treated with a monoamine oxidase inhibitor (MAOI) for major depressive disorder presents with a hypertensive crisis. This most likely resulted from ingestion of which of the following?
A banana
White bread
Red wine
Grilled chicken
A garden salad
Question 361
A nurse practitioner should recognize the importance of dreaming in:
Reducing sleep latency
Promoting physical healing
Improving motor skills
Regulating body temperature
Facilitating learning and problem-solving
Question 371
Which of the following is NOT associated with positive symptoms of schizophrenia?
Increased dopamine
Increased dopamine receptor sensitivity
Abnormal temporal lobe
Decreased brain size
Question 381
An adult man with a BMI of 32 kg/m2 presents with daytime sleepiness and fatigue despite getting 7-8 hours of sleep nightly. His wife reports loud snoring and periods where he seems to stop breathing for short durations. Which of the following treatments is most appropriate for this patient?
Cognitive behavioral therapy (CBT)
Continuous positive airway pressure (CPAP) machine
Scheduled daytime naps
Stimulant medications
Sedative hypnotic medications
Question 391
What is NOT an indication for beta-blocker therapy?
Rate control in atrial fibrillation
Social/performance anxiety
Supraventricular tachycardia management
Hypertension in pregnancy
Unstable heart failure
Question 401
Which of the following is NOT an indication for monoamine oxidase inhibitor (MAOI) therapy?
Bulimia nervosa
Depression
Obsessive-compulsive disorder
Psychosis
Panic attacks
Question 411
What is the antidote for a benzodiazepine overdose?
Naloxone
Flumazenil
Atropine
Naltrexone
Ethanol
Question 421
Which of the following phases is most concerned with drug absorption and metabolism?
Distribution phase
Pharmacokinetic phase
Storage phase
Pharmaceutical phase
Pharmacodynamic phase
Question 431
A patient undergoing a sleep study is found to be acting out their dreams during REM sleep. This behavior is most consistent with which sleep disorder?
Sleepwalking
Night terrors
Narcolepsy
REM behavior disorder
Sleep apnea
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Question 441
Which of the following medications is NOT classified as a selective serotonin reuptake inhibitor (SSRI)?
Escitalopram
Fluvoxamine
Paroxetine
Venlafaxine
Sertraline
Question 451
Which of the following correctly describes the relative length of preganglionic and postganglionic fibers in the sympathetic nervous system?
Both preganglionic and postganglionic fibers are long.
Preganglionic fibers are long; postganglionic fibers are short.
Preganglionic fibers are short; postganglionic fibers are long.
Both preganglionic and postganglionic fibers are short.
The length of these fibers varies greatly and cannot be categorized.
Question 461
A patient currently takes drug (A), which is metabolized by CYP450. How would you change the prescription for drug (A) once the patient tells you that they are now taking St. John’s Wort?
Increase the dose of the drug (A) since St. John’s Wort is a CYP450 suicide inhibitor.
Increase the dose of the drug (A) since St. John’s Wort is a CYP450 inducer.
No need to change the dose of the drug (A) since St. John’s Wort is a CYP450 inhibitor.
Decrease the dose of the drug (A) since St. John’s Wort is a CYP450 suicide inhibitor.
Decrease the dose of the drug (A) since St. John’s Wort is a CYP450 inducer.
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Question 471
Which of the following is a major downside of using monoamine oxidase inhibitors (MAOIs) in the treatment of depression?
They result in rapid development of drug tolerance, necessitating frequent dosage increases.
They frequently cause severe allergic skin reactions.
They require avoidance of certain foods to prevent serious side effects.
They are associated with a high risk of developing type 2 diabetes.
They lead to a significant increase in serotonin levels, causing constant euphoria.
Question 481
What is the antagonist of choice to counteract the action of opioid receptor agonists?
Naloxone
Flumazenil
Endorphin
Morphine
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Question 491
TENS is considered what kind of non-pharmacological method of pain relief?
Cognitive
Cutaneous
Divergent
Sensory
Question 501
Emily becomes pale and anxious, starts sweating, and has difficulty breathing when she is the main speaker at a conference. This has happened previously in similar situations. What condition does she likely have?
Anxiety disorder
Malingering
Social anxiety
Specific phobia
Introvert
Question 511
Which of the following SSRIs is metabolized by a less common isoenzyme in the cytochrome P450 system and, thus, has fewer drug interactions?
Citalopram
Fluoxetine
Nefazodone
Paroxetine
Fluvoxamine
Question 521
A patient who is on a monoamine oxidase inhibitor (MAOI) for depression catches a viral upper respiratory infection. They start taking over-the-counter pseudoephedrine (a sympathomimetic agent) to help relieve their symptoms. What potential problem may occur?
Hypertensive crisis
Serotonin syndrome
Oversedation
Hypotension
Neuroleptic malignant syndrome
Question 531
Which statement regarding G-protein coupled receptors (GPCRs) is true?
They have 7 transmembrane domains.
They bind to ATP molecules.
They are rare in the human genome.
They bind hormones with their intracellular domain.
Question 541
A patient is prescribed an antidepressant medication that is used for both depression treatment and smoking cessation. Which of the following would NOT be a potential side effect of this medication?
Aggravation of psychosis
Seizures
Dry mouth
Orthostatic hypotension
Agitation
Question 551
A 33 year old male patient returns for follow up after starting mirtazapine (Remeron) three weeks ago. He reports sedation and grogginess in the morning. He has been taking 15mg at bedtime. He denies any other concerns or side effects. He feels the medication is Òstarting to workÓ to treat the depressive episode. Which would you recommend?
Increase the dose to 30mg
Decrease the dose to 7.5mg
Continue current dose as the sedation is related to the depressive symptoms
Add in bupropion
Question 561
A patient has a labor plan that includes music and ambulation. Which non-pharmacological methods of pain relief do these include?
Cognitive and auditory
Cognitive and sensory
Sensory and cutaneous
Cognitive and cutaneous
Question 571
An adult patient with major depressive disorder is being considered for antidepressant therapy. Which medication is a serotonin-norepinephrine reuptake inhibitor (SNRI) and can be used in both depression and neuropathic pain?
Sertraline
Trazodone
Duloxetine
Fluoxetine
Escitalopram
Question 581
You are treating a 14 year old female patient for a single episode for depression. The patient has achieved remission on fluoxetine 60mg taking it each morning with food. Her mother wonders if her daughter will have to continue this medication for the rest of her life. What is the most appropriate response to this question?
Yes, depression is a life-long chronic illness and requires medication life-long to stop the re-occurrence of a depressive episode.
Since the patient is a minor, a medication should be discontinued as soon as possible to reduce the risk of brain development abnormalities.
It is possible for the patient to taper off the medication with appropriate support and medical supervision.
Yes, and no. The patient should continue the current medication until she is pregnant, and then should stop the medication to reduce risk to the fetus.
Treatment and medication treatment should not be discussed with the patientÕs mother as it is important to limit the number of people that have access to the patientÕs treatment and illness.
Question 591
What percentage of patients with major depression will respond to antidepressant medication?
About 50%
About 10%
About 30%
About 100%
About 70%
Question 601
A middle-aged patient with major depression and a history of seizure disorder is being considered for antidepressant therapy. Which of the following medications is contraindicated in this patient?
Sertraline
Mirtazapine
Bupropion
Fluoxetine
Citalopram
Question 611
Which drug class could be used to treat both major depressive disorder and migraine disorder?
Benzodiazepines
Typical antipsychotics
Selective serotonin reuptake inhibitors (SSRIs)
Tricyclic antidepressants (TCAs)
Atypical antidepressants
Question 621
What is the main purpose of sleep according to the restorative theory?
To consolidate and store memories
To conserve energy
To release growth hormones
To escape from predators
To regulate emotional responses
Question 631
Polypharmacy is not justified in the following circumstances:
Evidence currently supports the use of the combination of medication
Provider is knowledgeable of the drug-drug interactions and pharmacodynamics and pharmacokinetic responses when using the combination
Long-term use of the medication combination and no side effects to current combination
Current combination is cost-effective even though there are other monotherapy options
Question 641
Which of the following brain abnormalities may be observed in patients with major depressive disorder?
Reduced neurotransmitter levels in the frontal lobe
Hyperconvoluted cerebral cortex
Shrunken ventricles
Increased hippocampal volume
Excessive folding of the cerebellum
Question 651
Post-traumatic stress disorder (D) pharmacotherapies have generally been most effective in decreasing which of the following?
Hyperarousal
Night sweats
Sexual dysfunction
Suicidal thoughts
GI disturbances
Question 661
A father of a 13 year old male patient with major depressive disorder would like to discuss current recommendations for treatment in adolescents prior to beginning any treatment. You review the following guideline recommendations for this patient includes all of the follow except:
Fluoxetine (Prozac)
CBT (cognitive behavioral therapy)
Nefazodone (Zerzone)
ITP-A (individual therapy for adolescents)
Escitalopram (Lexapro)
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Question 671
How do benzodiazepines reduce neuronal activation?
They increase the inward flow of chloride ions through the chloride channels.
They open sodium channels.
They inhibit the binding of GABA to the receptor.
They block the voltage-dependent membrane sodium channels.
They increase the release of calcium within the synaptic cleft.
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Question 681
Which of the following models emphasizes illness over health and understands health as the lack of an obvious illness?
Psychosomatic
Religious
Social model of health
Biomedical
Public health model of prevention
Question 691
Which of the following statements is true regarding the use of selective serotonin reuptake inhibitors (SSRIs) in the second half of pregnancy?
SSRIs are recommended in the second half of pregnancy to reduce the risk of postpartum depression.
Use of SSRIs in the second half of pregnancy is associated with a decreased risk of persistent pulmonary hypertension in the newborn.
SSRIs taken during the second half of pregnancy have been associated with persistent pulmonary hypertension in the newborn.
There is no association between SSRIs taken in the second half of pregnancy and adverse neonatal outcomes.
All SSRIs should be avoided due to the potential for congenital heart abnormalities.
Question 701
A patient with D describes feeling as if the world around them is unreal or dreamlike. This symptom is known as:
Depersonalization
Dissociative amnesia
Desensitization
Derealization
Demoralization
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Question 711
A young adult patient presents with recurrent, unexpected episodes of intense fear, palpitations, and trembling. These episodes peak within minutes, and they are persistently concerned about having more of these episodes. This presentation is most consistent with which of the following diagnoses?
Generalized anxiety disorder
Social anxiety disorder
Agoraphobia
Panic disorder
Specific phobia
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Question 721
What is true about metabotropic receptors?
Most are activated by an ion
Most are ATP gated
Most are de-activated by an ion
Most are G proteins
Most are voltage dependent
Question 731
A patient comes into the office for follow up appointment. They complain of stomach upset/nausea, feeling as if their heart is racing, notes they are sweating Òa lot!,Ó and has been having loose stools. The patient reports this has been ongoing since the last appointment since the medication increase. Upon examination, you note rigidity, hypertension, tachycardia, and a fine tremor in hands.Ê What of the following medications would you expect the patient to be on to cause these symptoms?
Ziprasidone (Geodon)
Fluoxetine (Prozac)
Lamotrigine (Lamictal)
Asenapine (Saphris)
Lorazepam (Ativan)
Question 741
Which of the following describes an individual with generalized anxiety disorder?
Jane has not been sleeping well and is having nightmares after being robbed in her house 2 days ago.
Mark has extreme anxiety when he needs to give a presentation.
Mary has persistent anxiety and worry about multiple aspects of her life, including work, causing her to feel restless and have difficulty sleeping.
Drew has episodes of intense panic with sweating and difficulty breathing that last for 10–15 minutes and are triggered by specific situations.
Barry has been having flashbacks from his time in the military since he got back home 7 months ago.
Question 751
Which type of ion channel opens in response to physical stimuli, such as vibration or pressure?
Voltage-gated channels
Ligand-gated channels
Mechanically-gated channels
Leakage channels
Enzyme-activated channels
Question 761
When interviewing a patient with likely post-traumatic stress disorder (D), all of the following must be asked to assess the patient’s current mental health, EXCEPT?
Sleeping difficulties
Signs of isolation and occupational gatherings
Feelings of detachment/estrangement
Past medical illness
Flashbacks and intrusive recollection
Question 771
A patient on an SSRI presents with fever, agitation, confusion, hallucinations, and sweating. Which of the following conditions should be immediately considered?
Acute psychotic disorder
Malignant hyperthermia
Hypoglycemia
Serotonin syndrome
Neuroleptic malignant syndrome
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Question 781
What are the three ways neurotransmission can be blocked?
Degradation, excitatory, diffusion
Reuptake, inhibitory, cell modulation
Downregulation, diffusion, degradation
Diffusion, reuptake, degradation
Cell modulation, degradation, inhibitory
Question 791
Which of the following antidepressants is preferred during pregnancy due to extensive research and lower associated risks?
Paroxetine
Venlafaxine
Escitalopram
Fluoxetine
Duloxetine
Question 801
Which of the following statements about pharmacodynamic phase is correct?
Pharmacodynamic phase is concerned with drug absorption.
Pharmacodynamic phase studies the amount of drug that is excreted into breast milk.
Pharmacodynamic phase is related to the drug-receptor interaction and its biological effect.
Optimization of the pharmacodynamic phase improves drug bioavailability.
Pharmacodynamic phase is concerned with the amount of drug that is metabolized by the liver.
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Question 811
Lance received a head injury while hiking. Afterward, he has diminished fear responses, but he has no difficulty in planning or completing complex tasks. What structure most likely was injured?
Frontal lobe
Prefrontal cortex
Hippocampus
Medulla
Amygdala
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Question 821
Which of the following statements is NOT true?
The phosphate group in the molecular structure of “Fosamprenavir” enhances the aqueous solubility and greater bioavailability during anti-viral therapy.
If given in its unaltered form as an oral medication, tetracycline will effectively interfere with the protein biosynthesis process in eukaryotic cells.
The conversion of tetracycline into chlortetracycline leads to enhanced absorption and bioavailability.
The introduction of a polar group reduces the lipophilicity of the drug and renders it less prone to metabolism.
Enzymes like esterase or phosphatase play a significant role in the conversion of a prodrug into an active form.
Question 831
How many ligands need to bind to the nicotinic Ach receptor for activation?
Two sodium ions
One sodium ion
Two potassium ions
Two Ach molecules
One Ach molecule
Question 841
In which area of the brain do benzodiazepines primarily work to reduce anxiety (anxiolysis)?
Cerebral cortex
Pituitary gland
Pons
Midbrain
Limbic structures
Question 851
Which of the following areas of the brain is most important for processing visual information?
Occipital lobe
Parietal lobe
Temporal lobe
Frontal lobe
Cerebellum
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Question 861
Which medication is a P-glycoprotein inhibitor?
Carbamazepine
St John’s wort
Verapamil
Phenytoin
Rifampin
Question 871
Bioavailability is affected by which of the following factors?
Drug’s dose
Patient’s age
Patient’s weight
Drug’s solubility
Patient’s gender
Question 881
Which of the following pairs of medication and its therapeutic use is mismatched?
Selegiline for Parkinson disease
Duloxetine for chronic pain
Bupropion for neuropathy
Trazodone for sleep disturbances
Amitriptyline for chronic pain
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Question 891
A 70-year-old patient with a history of depression is started on a tricyclic antidepressant (TCA). Which of the following side effects is of particular concern in this older adult patient?
Increased appetite
Insomnia
Hypertension
Increased saliva production
Orthostatic hypotension
Question 901
Which of the following is a common anticholinergic side effect of tricyclic antidepressants (TCAs)?
Diarrhea
Excessive sweating
Dry mouth
Headache
Insomnia
Question 911
A patient on an MAOI should avoid all of the following except:
Antidepressants
Methadone
lactose
tyramine
None of the above
All of the above
Question 921
Which of the following is best defined as granules of rough endoplasmic reticulum within the neuron where protein is synthesized?
Neurofilaments
Nissl substance
Neurofibrils
Microglia
Synapses
Question 931
What is NOT a use for benzodiazepines?
Generalized anxiety disorder
Muscle spasticity
Alcohol withdrawal
Opioid overdose
Panic disorder
Question 941
Which of the following is NOT a mechanism of action for mirtazapine?
Serotonin reuptake inhibition
Alpha-2 adrenoreceptor antagonism
H1 histamine receptor antagonism
Serotonin receptor antagonism
Increased release of norepinephrine and serotonin
Question 951
Which mechanism best describes the action of monoamine oxidase inhibitors (MAOIs) on neurotransmitter levels?
Increase the synthesis of norepinephrine and serotonin
Inhibit the reuptake of norepinephrine and serotonin
Enhance the degradation of norepinephrine and serotonin
Block the postsynaptic receptors for norepinephrine and serotonin
Inhibit the breakdown of norepinephrine and serotonin in the presynaptic neuron
Question 961
What change occurs in the G-protein when a hormone binds to a G-protein coupled receptor (GPCR)?
GDP is replaced by GTP in the α subunit
GTP is replaced by GDP in the β subunit
GDP is replaced by GTP in the γ subunit
GTP is replaced by GDP in the α subunit
The β and γ subunits dissociate without any nucleotide exchange
Question 971
Which of the following is NOT a side effect of the first-line agents used to treat post-traumatic stress disorder (D)?
Decreased seizure threshold
Night sweats
GI disturbances
Mood swings
Sexual dysfunction
Question 981
Which of the following neurotransmitter systems is LEAST directly affected by the mechanism of action of tricyclic antidepressants?
Norepinephrine reuptake
Alpha-1 adrenergic transmission
Muscarinic cholinergic transmission
Dopamine transmission
Histaminergic transmission
Question 991
Ann had a dream in which she wrote an award-winning novel. Despite knowing it was a dream, she stayed in it until the alarm rang. What does this situation describe?
Lucid dreaming
Somnambulism
Daydreaming
Unconscious dreaming
Activation synthesis
Question 1001
What refers to a relatively sudden decrease in response to a drug over time, potentially due to downregulation or desensitization of receptors?
Tachyphylaxis
Reduced affinity
Prophylaxis
Potency
Suicide inhibition
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NURS6630 Midterm Exam week 5 new version 2024 Latest
Question 11
What channel in the plasma membrane of the nerve cell responds to direct changes in membrane potentials?
Mechanically gated channels
Leakage channels
Ligand-gated channels
Voltage-gated channels
Question 21
True or false: If an older adult achieves remission of depression with the current medication treatment and without side effects, the treatment should continue indefinitely
True
False
Question 31
Trazodone, commonly used as a sleep aid, acts primarily by:
Blocking norepinephrine reuptake
Blocking 5-HT2A receptors
Blocking monoamine oxidase
Stimulating postsynaptic 5-HT1A receptors
Stimulating serotonin reuptake
Question 41
In adolescents, the prevalence of depression:
Is higher in females than in males after puberty.
Is approximately 1%
Is higher in males than in females after puberty.
Is equal between males and females throughout adolescence.
Is lower than the prevalence in younger children.
Question 51
Besides treating refractory major depression, what is an additional indication for medications within the serotonin antagonist and reuptake inhibitor (SARI) drug class?
Chronic pain
Weight loss
Smoking cessation
Insomnia
Psychosis
Question 61
What is the main reason behind limited bioavailability of benzylpenicillin?
The beta-lactam ring of benzylpenicillin is highly prone to acid catalyzed intermolecular hydrolysis.
The beta-lactam ring of benzylpenicillin is highly prone to alkali catalyzed intermolecular hydrolysis.
The beta-lactam ring of benzylpenicillin is highly prone to alkali catalyzed intramolecular hydrolysis.
The beta-lactam ring of benzylpenicillin is highly prone to acid catalyzed intramolecular hydrolysis.
The beta-lactam ring of benzylpenicillin is highly prone to H2O2 catalyzed intermolecular hydrolysis.
Question 71
Amy comes to the clinic saying that she is having difficulty staying asleep and is tired during the day. What is the most effective long-term treatment for her dyssomnia?
Using stimulant medications
Drinking a glass of wine before sleeping
Improving sleep hygiene
Taking sedative medications
Watching TV in bed
Question 81
The 1st-line pharmacological treatment for depression in adolescents typically includes:
Benzodiazepines
Monoamine oxidase inhibitors (MAOIs)
Selective serotonin reuptake inhibitors (SSRIs)
Tricyclic antidepressants
Antidepressants are not recommended in children under 18 years of age.
Question 91
Which of the following is a common pharmacokinetic characteristic of tricyclic antidepressants (TCAs)?
Low volume of distribution
Rapid elimination from the body
High volume of distribution
Easily dialyzable
Insignificant first-pass metabolism
Question 101
A patient’s grandmother developed severe nutritional deficiencies during the Great Depression. The patient currently struggles with being overweight. How might the grandmother’s history contribute to the patient’s condition?
The grandmother’s nutritional deficiencies led to genetic mutations passed down to the patient, causing weight issues.
The patient’s condition is entirely due to their own lifestyle choices and is unrelated to the grandmother’s nutritional history.
Nutritional deficiencies in the grandmother caused a permanent change in the family’s DNA, affecting all subsequent generations.
The grandmother’s nutritional deficiencies directly altered her DNA sequence, which was inherited by the patient.
Epigenetic changes due to the grandmother’s nutritional deficiencies may have influenced the patient’s gene expression, such as the desire to eat.
Question 111
Which of the following is categorized as a non-selective alpha-adrenergic blocker?
Atenolol
Yohimbine
Phentolamine
Prazosin
Butaxamine
Question 121
Which of the following neurotransmitters belongs to the catecholamine class?
Acetylcholine
Dopamine
Glutamate
Serotonin
Substance P
Question 131
What is the result of an excitatory postsynaptic potential?
Subthreshold postsynaptic potential
Depolarizing postsynaptic potential
Repolarizing postsynaptic potential
Hyperpolarizing postsynaptic potential
Question 141
All the following symptoms are seen in serotonin syndrome, EXCEPT:
Mydriasis
Hypotonia
Agitation
Increased sweating
Hyperthermia
Question 151
Which symptom is NOT typically associated with a manic episode in bipolar disorder type I?
Excessive feelings of guilt
Inflated self-esteem or grandiosity
Flight of ideas
Excitability or aggression
Psychosis
Question 161
Which of the following is a first-line pharmacotherapy for long-term management of the panic disorder?
Nonsteroidal anti-inflammatory drugs
Opiates
Barbiturates
Selective serotonin reuptake inhibitors
Tetrahydrocannabinol
Question 171
Edward received a head injury while hiking. Afterward, friends note that he is easily angered and has difficulty in planning and completing complex tasks. What structure most likely was injured?
Amygdala
Cingulate gyrus
Temporal lobe
Prefrontal cortex
Postfrontal cortex
Question 181
Which area of the brain is least involved in emotional circuits?
Hippocampus
Hypothalamus
Pons
Amygdala
Prefrontal lobe
Question 191
A woman presents with a family history of breast cancer. Genetic testing reveals a single nucleotide polymorphism (SNP) commonly associated with breast cancer. This SNP is best described as:
A direct cause of breast cancer.
A causative gene that guarantees the development of breast cancer.
An unrelated genetic variation found coincidentally.
A mutation that affects the entire chromosome.
A genetic marker indicating a genetic predisposition to breast cancer.
Question 201
Which of the following is NOT risk factor for pediatric depression?
Chronic illness
High academic grades
Peer rejection
Family dysfunction
Family history of depression
Question 211
What is the most superior part of the brain stem?
Cerebrum
Pons
Midbrain
Medulla oblongata
Cerebellum
Question 231
A 50 year old patient has failed multiple trials of antidepressants, including SSRIs, NDRI, TCAs, and SNRIs. Currently, the patient is prescribed and taking duloxetine 90mg each day with minimal response. You and the patient decide to initiate an MAOI to treat depressive symptoms. How would you instruct the patient to make this change?
Initiate a cross taper-titration to reduce the risk of worsening of depression and possible hospitalization
Stop the duloxetine and wait 7 days (wash-out) and then initiate the MAOI
Taper off the duloxetine and wait 5 half-lives before starting the MAOI
An MAOI would be contraindicated for this patient and the patient should be referred to ECT or TMS
Question 221
Norepinephrine is responsible in regulating all of the following, except:
Focus
Sleep
Appetite
Cravings to use mood altering substances
Homeostasis
Question 241
Which of the following statements best differentiates dyssomnias from parasomnias?
Dyssomnias involve difficulties in the timing, quality, or amount of sleep, while parasomnias involve abnormal behaviors or physiological events occurring during sleep.
Dyssomnias are primarily treated with medication, whereas parasomnias are not.
Dyssomnias include conditions like narcolepsy and sleep apnea, whereas parasomnias include only psychological sleep disturbances.
Dyssomnias are less common than parasomnias in the general population.
Dyssomnias involve psychological events during sleep, while parasomnias involve abnormal behaviors during sleep.
Question 251
The following neurotransmitters are excitatory:
Histamine, GABA, and Norepinephrine ÊÊÊÊÊÊÊÊ
Dopamine, Serotonin, Norepinephrine
Acetylcholine, GABA, and Dopamine
Serotonin, Histamine, Glutamate
Glutamate, Norepinephrine, Dopamine
Question 261
Which of the following is a clinical feature of serotonin syndrome?
Bradycardia
Hyporeflexia
Hypothermia
Muscle paralysis
Mydriasis
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Question 271
Which of the following is considered a dyssomnia?
REM behavioral disorder
Night terrors
Somnambulism
Insomnia
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Question 281
The difference between acute stress disorder (ASD) and post-traumatic stress disorder (D) can be explained by which of the following statements?
D symptoms last > 1 week, while ASD symptoms last no longer than a month.
D symptoms last > 1 month, while ASD symptoms last no longer than a week.
D symptoms last > 1 month, while ASD symptoms last no longer than a month.
D symptoms last > 1 week, while ASD symptoms last no longer than 2 days.
D symptoms last > 1 year, while ASD symptoms last no longer than 6 months.
Question 291
What best describes EC50?
The dose required to achieve 50% mortality from toxicity.
The dose that is required to achieve 50% of the desired response in 50% of the population.
The effective concentration of a drug that produces 50% of the minimum effect.
The dose required to get 50% of the population reporting toxic side effects.
The effective concentration of a drug produces 50% of the maximal effect.
Question 301
Which of the following mechanisms of action are associated with tricyclic antidepressants (TCAs)?
Inhibits reuptake of serotonin only at the presynaptic cleft
Nonselectively inhibits monoamine oxidase
Stimulates release of norepinephrine and dopamine in the presynaptic cleft
Inhibits reuptake of serotonin and norepinephrine at the presynaptic cleft
Acts as an antagonist at dopamine and serotonin receptors
Question 311
Which of the following beta blockers is known for its combined alpha and beta receptor activity and is particularly used in cardiac failure?
Propranolol
Atenolol
Carvedilol
Nadolol
Timolol
Question 321
Which of the following neurotransmitters is most often affected in depression?
Histamine
Acetylcholine
GABA
Epinephrine
Serotonin
Question 331
Considering that Drug X has a dissociation constant (Kd) of 700 pg/mL and an effective dose 50 (ED50) of 700 pg/mL, which of the following statements is most accurate?
Drug X requires that all receptors be bound to produce 50% of the maximal effect.
ED50 represents the point at which 50% of the population will experience a toxic effect from the drug.
Drug X produces 100% of the maximal effect when 50% of the receptors are bound.
Kd represents the concentration at which 50% of the drug is metabolized.
if the Kd value for drug X were 200 pg/mL, that would indicate a higher binding affinity compared to its current Kd of 700 pg/mL.
Question 341
Which of the following statements regarding the management of post-traumatic stress disorder (D) is FALSE?
Early treatment may prevent chronicity.
SSRIs and other drugs are most effective in improving hyperarousal and mood.
An SSRI should be started at its lowest dose and gradually titrated.
Prazosin should be started with a dose of 3-15 mg to increase its efficacy.
TCAs and MAOIs are used as second-line agents
Question 351
A patient who is being treated with a monoamine oxidase inhibitor (MAOI) for major depressive disorder presents with a hypertensive crisis. This most likely resulted from ingestion of which of the following?
A banana
White bread
Red wine
Grilled chicken
A garden salad
Question 361
A nurse practitioner should recognize the importance of dreaming in:
Reducing sleep latency
Promoting physical healing
Improving motor skills
Regulating body temperature
Facilitating learning and problem-solving
Question 371
Which of the following is NOT associated with positive symptoms of schizophrenia?
Increased dopamine
Increased dopamine receptor sensitivity
Abnormal temporal lobe
Decreased brain size
Question 381
An adult man with a BMI of 32 kg/m2 presents with daytime sleepiness and fatigue despite getting 7-8 hours of sleep nightly. His wife reports loud snoring and periods where he seems to stop breathing for short durations. Which of the following treatments is most appropriate for this patient?
Cognitive behavioral therapy (CBT)
Continuous positive airway pressure (CPAP) machine
Scheduled daytime naps
Stimulant medications
Sedative hypnotic medications
Question 391
What is NOT an indication for beta-blocker therapy?
Rate control in atrial fibrillation
Social/performance anxiety
Supraventricular tachycardia management
Hypertension in pregnancy
Unstable heart failure
Question 401
Which of the following is NOT an indication for monoamine oxidase inhibitor (MAOI) therapy?
Bulimia nervosa
Depression
Obsessive-compulsive disorder
Psychosis
Panic attacks
Question 411
What is the antidote for a benzodiazepine overdose?
Naloxone
Flumazenil
Atropine
Naltrexone
Ethanol
Question 421
Which of the following phases is most concerned with drug absorption and metabolism?
Distribution phase
Pharmacokinetic phase
Storage phase
Pharmaceutical phase
Pharmacodynamic phase
Question 431
A patient undergoing a sleep study is found to be acting out their dreams during REM sleep. This behavior is most consistent with which sleep disorder?
Sleepwalking
Night terrors
Narcolepsy
REM behavior disorder
Sleep apnea
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Question 441
Which of the following medications is NOT classified as a selective serotonin reuptake inhibitor (SSRI)?
Escitalopram
Fluvoxamine
Paroxetine
Venlafaxine
Sertraline
Question 451
Which of the following correctly describes the relative length of preganglionic and postganglionic fibers in the sympathetic nervous system?
Both preganglionic and postganglionic fibers are long.
Preganglionic fibers are long; postganglionic fibers are short.
Preganglionic fibers are short; postganglionic fibers are long.
Both preganglionic and postganglionic fibers are short.
The length of these fibers varies greatly and cannot be categorized.
Question 461
A patient currently takes drug (A), which is metabolized by CYP450. How would you change the prescription for drug (A) once the patient tells you that they are now taking St. John’s Wort?
Increase the dose of the drug (A) since St. John’s Wort is a CYP450 suicide inhibitor.
Increase the dose of the drug (A) since St. John’s Wort is a CYP450 inducer.
No need to change the dose of the drug (A) since St. John’s Wort is a CYP450 inhibitor.
Decrease the dose of the drug (A) since St. John’s Wort is a CYP450 suicide inhibitor.
Decrease the dose of the drug (A) since St. John’s Wort is a CYP450 inducer.
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Question 471
Which of the following is a major downside of using monoamine oxidase inhibitors (MAOIs) in the treatment of depression?
They result in rapid development of drug tolerance, necessitating frequent dosage increases.
They frequently cause severe allergic skin reactions.
They require avoidance of certain foods to prevent serious side effects.
They are associated with a high risk of developing type 2 diabetes.
They lead to a significant increase in serotonin levels, causing constant euphoria.
Question 481
What is the antagonist of choice to counteract the action of opioid receptor agonists?
Naloxone
Flumazenil
Endorphin
Morphine
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Question 491
TENS is considered what kind of non-pharmacological method of pain relief?
Cognitive
Cutaneous
Divergent
Sensory
Question 501
Emily becomes pale and anxious, starts sweating, and has difficulty breathing when she is the main speaker at a conference. This has happened previously in similar situations. What condition does she likely have?
Anxiety disorder
Malingering
Social anxiety
Specific phobia
Introvert
Question 511
Which of the following SSRIs is metabolized by a less common isoenzyme in the cytochrome P450 system and, thus, has fewer drug interactions?
Citalopram
Fluoxetine
Nefazodone
Paroxetine
Fluvoxamine
Question 521
A patient who is on a monoamine oxidase inhibitor (MAOI) for depression catches a viral upper respiratory infection. They start taking over-the-counter pseudoephedrine (a sympathomimetic agent) to help relieve their symptoms. What potential problem may occur?
Hypertensive crisis
Serotonin syndrome
Oversedation
Hypotension
Neuroleptic malignant syndrome
Question 531
Which statement regarding G-protein coupled receptors (GPCRs) is true?
They have 7 transmembrane domains.
They bind to ATP molecules.
They are rare in the human genome.
They bind hormones with their intracellular domain.
Question 541
A patient is prescribed an antidepressant medication that is used for both depression treatment and smoking cessation. Which of the following would NOT be a potential side effect of this medication?
Aggravation of psychosis
Seizures
Dry mouth
Orthostatic hypotension
Agitation
Question 551
A 33 year old male patient returns for follow up after starting mirtazapine (Remeron) three weeks ago. He reports sedation and grogginess in the morning. He has been taking 15mg at bedtime. He denies any other concerns or side effects. He feels the medication is Òstarting to workÓ to treat the depressive episode. Which would you recommend?
Increase the dose to 30mg
Decrease the dose to 7.5mg
Continue current dose as the sedation is related to the depressive symptoms
Add in bupropion
Question 561
A patient has a labor plan that includes music and ambulation. Which non-pharmacological methods of pain relief do these include?
Cognitive and auditory
Cognitive and sensory
Sensory and cutaneous
Cognitive and cutaneous
Question 571
An adult patient with major depressive disorder is being considered for antidepressant therapy. Which medication is a serotonin-norepinephrine reuptake inhibitor (SNRI) and can be used in both depression and neuropathic pain?
Sertraline
Trazodone
Duloxetine
Fluoxetine
Escitalopram
Question 581
You are treating a 14 year old female patient for a single episode for depression. The patient has achieved remission on fluoxetine 60mg taking it each morning with food. Her mother wonders if her daughter will have to continue this medication for the rest of her life. What is the most appropriate response to this question?
Yes, depression is a life-long chronic illness and requires medication life-long to stop the re-occurrence of a depressive episode.
Since the patient is a minor, a medication should be discontinued as soon as possible to reduce the risk of brain development abnormalities.
It is possible for the patient to taper off the medication with appropriate support and medical supervision.
Yes, and no. The patient should continue the current medication until she is pregnant, and then should stop the medication to reduce risk to the fetus.
Treatment and medication treatment should not be discussed with the patientÕs mother as it is important to limit the number of people that have access to the patientÕs treatment and illness.
Question 591
What percentage of patients with major depression will respond to antidepressant medication?
About 50%
About 10%
About 30%
About 100%
About 70%
Question 601
A middle-aged patient with major depression and a history of seizure disorder is being considered for antidepressant therapy. Which of the following medications is contraindicated in this patient?
Sertraline
Mirtazapine
Bupropion
Fluoxetine
Citalopram
Question 611
Which drug class could be used to treat both major depressive disorder and migraine disorder?
Benzodiazepines
Typical antipsychotics
Selective serotonin reuptake inhibitors (SSRIs)
Tricyclic antidepressants (TCAs)
Atypical antidepressants
Question 621
What is the main purpose of sleep according to the restorative theory?
To consolidate and store memories
To conserve energy
To release growth hormones
To escape from predators
To regulate emotional responses
Question 631
Polypharmacy is not justified in the following circumstances:
Evidence currently supports the use of the combination of medication
Provider is knowledgeable of the drug-drug interactions and pharmacodynamics and pharmacokinetic responses when using the combination
Long-term use of the medication combination and no side effects to current combination
Current combination is cost-effective even though there are other monotherapy options
Question 641
Which of the following brain abnormalities may be observed in patients with major depressive disorder?
Reduced neurotransmitter levels in the frontal lobe
Hyperconvoluted cerebral cortex
Shrunken ventricles
Increased hippocampal volume
Excessive folding of the cerebellum
Question 651
Post-traumatic stress disorder (D) pharmacotherapies have generally been most effective in decreasing which of the following?
Hyperarousal
Night sweats
Sexual dysfunction
Suicidal thoughts
GI disturbances
Question 661
A father of a 13 year old male patient with major depressive disorder would like to discuss current recommendations for treatment in adolescents prior to beginning any treatment. You review the following guideline recommendations for this patient includes all of the follow except:
Fluoxetine (Prozac)
CBT (cognitive behavioral therapy)
Nefazodone (Zerzone)
ITP-A (individual therapy for adolescents)
Escitalopram (Lexapro)
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Question 671
How do benzodiazepines reduce neuronal activation?
They increase the inward flow of chloride ions through the chloride channels.
They open sodium channels.
They inhibit the binding of GABA to the receptor.
They block the voltage-dependent membrane sodium channels.
They increase the release of calcium within the synaptic cleft.
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Question 681
Which of the following models emphasizes illness over health and understands health as the lack of an obvious illness?
Psychosomatic
Religious
Social model of health
Biomedical
Public health model of prevention
Question 691
Which of the following statements is true regarding the use of selective serotonin reuptake inhibitors (SSRIs) in the second half of pregnancy?
SSRIs are recommended in the second half of pregnancy to reduce the risk of postpartum depression.
Use of SSRIs in the second half of pregnancy is associated with a decreased risk of persistent pulmonary hypertension in the newborn.
SSRIs taken during the second half of pregnancy have been associated with persistent pulmonary hypertension in the newborn.
There is no association between SSRIs taken in the second half of pregnancy and adverse neonatal outcomes.
All SSRIs should be avoided due to the potential for congenital heart abnormalities.
Question 701
A patient with D describes feeling as if the world around them is unreal or dreamlike. This symptom is known as:
Depersonalization
Dissociative amnesia
Desensitization
Derealization
Demoralization
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Question 711
A young adult patient presents with recurrent, unexpected episodes of intense fear, palpitations, and trembling. These episodes peak within minutes, and they are persistently concerned about having more of these episodes. This presentation is most consistent with which of the following diagnoses?
Generalized anxiety disorder
Social anxiety disorder
Agoraphobia
Panic disorder
Specific phobia
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Question 721
What is true about metabotropic receptors?
Most are activated by an ion
Most are ATP gated
Most are de-activated by an ion
Most are G proteins
Most are voltage dependent
Question 731
A patient comes into the office for follow up appointment. They complain of stomach upset/nausea, feeling as if their heart is racing, notes they are sweating Òa lot!,Ó and has been having loose stools. The patient reports this has been ongoing since the last appointment since the medication increase. Upon examination, you note rigidity, hypertension, tachycardia, and a fine tremor in hands.Ê What of the following medications would you expect the patient to be on to cause these symptoms?
Ziprasidone (Geodon)
Fluoxetine (Prozac)
Lamotrigine (Lamictal)
Asenapine (Saphris)
Lorazepam (Ativan)
Question 741
Which of the following describes an individual with generalized anxiety disorder?
Jane has not been sleeping well and is having nightmares after being robbed in her house 2 days ago.
Mark has extreme anxiety when he needs to give a presentation.
Mary has persistent anxiety and worry about multiple aspects of her life, including work, causing her to feel restless and have difficulty sleeping.
Drew has episodes of intense panic with sweating and difficulty breathing that last for 10–15 minutes and are triggered by specific situations.
Barry has been having flashbacks from his time in the military since he got back home 7 months ago.
Question 751
Which type of ion channel opens in response to physical stimuli, such as vibration or pressure?
Voltage-gated channels
Ligand-gated channels
Mechanically-gated channels
Leakage channels
Enzyme-activated channels
Question 761
When interviewing a patient with likely post-traumatic stress disorder (D), all of the following must be asked to assess the patient’s current mental health, EXCEPT?
Sleeping difficulties
Signs of isolation and occupational gatherings
Feelings of detachment/estrangement
Past medical illness
Flashbacks and intrusive recollection
Question 771
A patient on an SSRI presents with fever, agitation, confusion, hallucinations, and sweating. Which of the following conditions should be immediately considered?
Acute psychotic disorder
Malignant hyperthermia
Hypoglycemia
Serotonin syndrome
Neuroleptic malignant syndrome
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Question 781
What are the three ways neurotransmission can be blocked?
Degradation, excitatory, diffusion
Reuptake, inhibitory, cell modulation
Downregulation, diffusion, degradation
Diffusion, reuptake, degradation
Cell modulation, degradation, inhibitory
Question 791
Which of the following antidepressants is preferred during pregnancy due to extensive research and lower associated risks?
Paroxetine
Venlafaxine
Escitalopram
Fluoxetine
Duloxetine
Question 801
Which of the following statements about pharmacodynamic phase is correct?
Pharmacodynamic phase is concerned with drug absorption.
Pharmacodynamic phase studies the amount of drug that is excreted into breast milk.
Pharmacodynamic phase is related to the drug-receptor interaction and its biological effect.
Optimization of the pharmacodynamic phase improves drug bioavailability.
Pharmacodynamic phase is concerned with the amount of drug that is metabolized by the liver.
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Question 811
Lance received a head injury while hiking. Afterward, he has diminished fear responses, but he has no difficulty in planning or completing complex tasks. What structure most likely was injured?
Frontal lobe
Prefrontal cortex
Hippocampus
Medulla
Amygdala
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Question 821
Which of the following statements is NOT true?
The phosphate group in the molecular structure of “Fosamprenavir” enhances the aqueous solubility and greater bioavailability during anti-viral therapy.
If given in its unaltered form as an oral medication, tetracycline will effectively interfere with the protein biosynthesis process in eukaryotic cells.
The conversion of tetracycline into chlortetracycline leads to enhanced absorption and bioavailability.
The introduction of a polar group reduces the lipophilicity of the drug and renders it less prone to metabolism.
Enzymes like esterase or phosphatase play a significant role in the conversion of a prodrug into an active form.
Question 831
How many ligands need to bind to the nicotinic Ach receptor for activation?
Two sodium ions
One sodium ion
Two potassium ions
Two Ach molecules
One Ach molecule
Question 841
In which area of the brain do benzodiazepines primarily work to reduce anxiety (anxiolysis)?
Cerebral cortex
Pituitary gland
Pons
Midbrain
Limbic structures
Question 851
Which of the following areas of the brain is most important for processing visual information?
Occipital lobe
Parietal lobe
Temporal lobe
Frontal lobe
Cerebellum
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Question 861
Which medication is a P-glycoprotein inhibitor?
Carbamazepine
St John’s wort
Verapamil
Phenytoin
Rifampin
Question 871
Bioavailability is affected by which of the following factors?
Drug’s dose
Patient’s age
Patient’s weight
Drug’s solubility
Patient’s gender
Question 881
Which of the following pairs of medication and its therapeutic use is mismatched?
Selegiline for Parkinson disease
Duloxetine for chronic pain
Bupropion for neuropathy
Trazodone for sleep disturbances
Amitriptyline for chronic pain
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Question 891
A 70-year-old patient with a history of depression is started on a tricyclic antidepressant (TCA). Which of the following side effects is of particular concern in this older adult patient?
Increased appetite
Insomnia
Hypertension
Increased saliva production
Orthostatic hypotension
Question 901
Which of the following is a common anticholinergic side effect of tricyclic antidepressants (TCAs)?
Diarrhea
Excessive sweating
Dry mouth
Headache
Insomnia
Question 911
A patient on an MAOI should avoid all of the following except:
Antidepressants
Methadone
lactose
tyramine
None of the above
All of the above
Question 921
Which of the following is best defined as granules of rough endoplasmic reticulum within the neuron where protein is synthesized?
Neurofilaments
Nissl substance
Neurofibrils
Microglia
Synapses
Question 931
What is NOT a use for benzodiazepines?
Generalized anxiety disorder
Muscle spasticity
Alcohol withdrawal
Opioid overdose
Panic disorder
Question 941
Which of the following is NOT a mechanism of action for mirtazapine?
Serotonin reuptake inhibition
Alpha-2 adrenoreceptor antagonism
H1 histamine receptor antagonism
Serotonin receptor antagonism
Increased release of norepinephrine and serotonin
Question 951
Which mechanism best describes the action of monoamine oxidase inhibitors (MAOIs) on neurotransmitter levels?
Increase the synthesis of norepinephrine and serotonin
Inhibit the reuptake of norepinephrine and serotonin
Enhance the degradation of norepinephrine and serotonin
Block the postsynaptic receptors for norepinephrine and serotonin
Inhibit the breakdown of norepinephrine and serotonin in the presynaptic neuron
Question 961
What change occurs in the G-protein when a hormone binds to a G-protein coupled receptor (GPCR)?
GDP is replaced by GTP in the α subunit
GTP is replaced by GDP in the β subunit
GDP is replaced by GTP in the γ subunit
GTP is replaced by GDP in the α subunit
The β and γ subunits dissociate without any nucleotide exchange
Question 971
Which of the following is NOT a side effect of the first-line agents used to treat post-traumatic stress disorder (D)?
Decreased seizure threshold
Night sweats
GI disturbances
Mood swings
Sexual dysfunction
Question 981
Which of the following neurotransmitter systems is LEAST directly affected by the mechanism of action of tricyclic antidepressants?
Norepinephrine reuptake
Alpha-1 adrenergic transmission
Muscarinic cholinergic transmission
Dopamine transmission
Histaminergic transmission
Question 991
Ann had a dream in which she wrote an award-winning novel. Despite knowing it was a dream, she stayed in it until the alarm rang. What does this situation describe?
Lucid dreaming
Somnambulism
Daydreaming
Unconscious dreaming
Activation synthesis
Question 1001
What refers to a relatively sudden decrease in response to a drug over time, potentially due to downregulation or desensitization of receptors?
Tachyphylaxis
Reduced affinity
Prophylaxis
Potency
Suicide inhibition
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