Exam 1: NURS660/ NURS 660 (Latest 2023/
2024) Psychopharmacology and Advanced
Mental Health Exam| Questions and Verified
Answers| Grade A – Maryville
Q: How does aripiprazole work?
Answer:
1.Partial agonism at dopamine 2 receptors
2.Reduces dopamine output when dopamine is high thus improving positive symp- toms and
mediating antipsychotic actions.
3.Increases dopamine output when dopamine levels are low thus improving cogni- tion, negative,
and mood symptoms
4.Also acts on dopamine 3 receptors
5.Blocks serotonin 2A receptors thus increasing dopamine
Q: How long does it take aripiprazole to work?
Answer:
May begin working in one week. It is best to wait 4-6 weeks to see full efficacy.
Q: How does aripiprazole cause side effects
Answer:
1.Blocking alpha 1 adrenergic receptors causing dizziness, sedation, and hypertension
2.Partial agonist at dopamine 2 receptors in the striatum can cause motor side effects such as
akathisia
3.Partial agonist at dopamine 2 receptor causing nausea, vomiting, and activation side effects
Q: Notable side effects of aripiprazole?
Answer:
1.Dizziness
2.Insomnia
3.Akathisia
4.Activation
5.Nausea and vomiting
6.Orthostatic hypotension
7.Constipation
8.Headache, asthenia (muscle weakness)
9.Theoretical risk of tardive dyskinisia
Q: What are the adverse effects (life threatening) of aripiprazole
Answer:
Impulse con- trol problems
NMS Seizures
Cerebral vascular events
Sedation and vomiting in overdose (not reported fatal)
Q: What is the dosage for aripiprazole?
Answer:
15-30 mg daily for schizophrenia
Q: What is Brexpiprazole (Rexulti)?
Answer:
Atypical antipsychotic
Dopamine partial agonist
Third generation antipsychotic
Q: What is brexpiprazole (Rexulti) prescribed for?
Answer:
Schizophrenia
Treatment resistant depression
Acute mania-(Mixed mania)
Q: How does brexpiprazole (Rexulti) work?
Answer:
1.Partial dopamine 2 receptor ag- onist (reduces dopamine output where dopamine is high, thus
reducing positive symptoms of schizophrenia).
2.Increases dopamine output where dopamine concentrations are low thus decreas- ing cognitive,
negative and mood symptoms by blocking serotonin 2A receptors.
3.Partial agonism of 5HT1A receptor which can help mood anxiety and cognition.
4.Block alpha 1B receptors reducing akathisia
5.Block alpha 2C receptors reducing depression symptoms
Q: How long until brexpiprazole (Rexulti) works?
Answer:
Some effects in 1 week and optimal results in 4-6 weeks. Most schizophrenics will have 1/3
decease in symp- toms. Super responders will have decrease of 50-60%.
Q: How does brexpiprazole (Rexulti) cause side effects?
Answer:
1.By blocking alpha
1 adrenergic receptors the medication can cause sedation, dizziness, and hypoten- sion.
2.Partial agonist actions at the dopamine 2 receptors in the striatum causes akathisia
3.Partial agonist actions at the dopamine 2 receptors and 5HT1A receptors causes nausea and
vomiting
Q: What are the side effects of brexpiprazole (Rexulti)?
Answer:
1.Weight gain
2.Akathisia
3.Sedation
Exam 2: NURS660/ NURS 660 (Latest 2023/
2024) Psychopharmacology and Advanced
Mental Health Exam| Questions and Verified
Answers| Grade A – Maryville
Q: You are doing patient teaching for Margaret, who has been prescribed amitriptyline (Elavil)
for treatment of depression. Which of the following state- ments suggest that Margaret needs
further instruction?
a. I know I might not start feeling better for a few weeks, but I’ll keep taking my medication just
as the doctor prescribed
b. I’ll keep some hard candies in my purse in case my mouth gets dry from the medicine
c. Once I start feeling better, I am looking forward to cutting down on this medication
d. I’m worried I may gain some weight, but that is the small price to pay to feeling better
Answer:
c
Q: What is the main difference between depression and dysthymic depres- sion?
a. Dysthymia is a short-term depression and major depression lasts for years
b. Dysthymia is a chronic, low-level depression that lasts for years, while major depression is
more severe
c. Dysthymia is more likely to be caused by psychological factors and major depression is caused
by neurological dysfunction
d. Dysthymia is normally treated with psychotherapy only, while major depres- sion is treated
with antidepressants and psychotherapy
Answer:
b
Q: Your depressed patient is starting a new medication called phenelzine
(Nardil). Which teaching would be most important to emphasize?
a. Educate the patient to take this medication ongoing, even as symptoms improve
b. Instruct the patient and family about the many food-drug interactions
c. Instruct the patient about interventions to relieve dry mouth
d. Inform the patient that this medication takes 4 to 6 weeks to take full effect
Answer:
b
Q: Which of the following antidepressants is a tricyclic?
a. Bupropion (Wellbutrin)
b. Sertraline (Zoloft)
c. Nortriptyline (Pamelor)
d. Venlafaxine (Effexor)
Answer:
c
Q: Which statement is most true about depression?
a. It is more common in women than men
b. It is rare to have more than one episode of major depression in one’s lifetime
c. Young children do not suffer from depression
d. As one ages, there is reduced risk of depression
Answer:
a
Q: A newly admitted client has been diagnosed with major depressive disorder. Which nursing
diagnosis takes priority?
a. Impaired social interaction
b. Self-esteem deficit
c. Hopelessness
d. Self-care deficit
Answer:
c
Q: The nurse knows that the two factors that often differentiate major depression from
dysthymia depression are
a. Amounts of mania and sadness
b. Presence or absence of anger and guilt
c. Severity and duration of symptoms
d. Patient’s gender and age
Answer:
c
Q: You are caring for an older adult who is recently widowed. She says “No one cares if I die.
Everyone I ever loved is dead.” What is the best response?
a. I am sure that you still have people who care about you
b. You sound like you are feeling alone
c. Boy, that is depressing
d. I don’t believe that
Answer:
b
Q: Your patient with major depression tells you he suffers from urinary retention. Which
medication would most likely to cause this?
a. Amitriptyline
b. Duloxetine
c. Carbamazepine
d. Ritalin
Answer:
a
Q: Which activity would be best for a depressed patient?
a. A puzzle
b. Drawing
c. Crossword puzzles
d. Television
Answer:
b
Q: Which of the following meal choices indicates the patient understands the diet restrictions
when taking an MAOI?
a. Pepperoni pizza and beer
b. Roast chicken, baked potato, and beer
c. Fried fish, rice, and cola
d. Pickled herring, eggs, and coffee
Answer:
c
Q: Your patient with major depression sits in her room for hours staring out the window. Which
of the following would be the most appropriate interven- tion?
a. Sit with the patient and gently offer your availability to help
b. Keep encouraging the patient to go to exercise class
c. Offer the class once and then let the patient decide
d. Sit with the patient and ask her to list reasons for her depression
Answer:
a
Q: Which of the following drugs is a tricyclic antidepressant?
a. Bupropion (Wellbutrin)
b. Amitriptyline (Elavil)
c. Fluoxetine (Prozac)
d. Citalopram (Celexa)
Answer:
b
Q: Some medications such as tricyclics cause blurred vision. What is the cause of this effect?
Exam 3: NURS660/ NURS 660 (Latest 2023/
2024) Psychopharmacology and Advanced
Mental Health Exam| Questions and Verified
Answers| Grade A – Maryville
Q: Types of pain that is treated with psychiatric medication
Answer:
protracted pain
(mix of nociceptive and central pain and chronic pain (central)
Q: effect of how antidepressants migrate pain – Direct (way you think about pain)
Answer:
increase in supraspinal inhibition and decrease peripheral and central desen- sitization
Q: effect of how antidepressants migrate pain- Indirect (way you feel about pain)
Answer:
modulate limbic activity and prefrontal structures
Q: What is mincitolapram
Answer:
SNRI prescribed to treat fibromyalgia
Q: Antidote for alprazolam
Answer:
flumazenil
Q: MOA of pregabalin
Answer:
1.alter GABA metabolism
2.bind to subunit of voltage-gated Ca channel to reduce NT release
Q: What is the antagonist of caffeine
Answer:
adenosine
Q: s/s general anxiety disorder -4
Answer:
excessive worrying, increased arousal, in- creased tiredness and irritability
Q: Arears of brain that are involved with fear, anxiety and fight or flight
Answer:
amyg- dala and hippocampus
Q: MOA of modafinil
Answer:
Non-amphetamine stimulant > enhances dopaminergic sig- naling; enhances tonic dopamine
firing (1st line tx for narcolepsy)
Q: what receptors does eszopiclone target
Answer:
binds to the GABA-a receptor sub- units 1, 3, and 5
Q: first line treatment for PTSD
Answer:
SSRI – sertraline and paroxetine
Q: medication used to help cognitive and physical symptoms of firomyalgiaAnswer:
milnacipran (Savella)
Q: During a panic attack what area of the brain is related to SOB and tachy- cardia
Answer:
pararachial nucleus
Q: what non-addictive medication can be used to aide in sleep induction
Answer:
su- vorexant (belsomra)
Q: How does Suvorexant work?
Answer:
blocks the action of orexin. Orexin is a chemical in the brain that plays a role in the sleep cycle
and promotes wakefulness.
Q: what receptor does buspirone primarily act upon
Exam 4: NURS660/ NURS 660 (Latest 2023/
2024) Psychopharmacology and Advanced
Mental Health Exam| Questions and Verified
Answers| Grade A – Maryville
Q: A patient diagnosed with ADHD can’t stay focused or solve work-related problems
difficulty maintaining attention sustained and problem-solving. What area of the brain is
involved?
Answer:
Dorsal lateral prefontal cortex (CTSC loop)
Q: What part of the brain is associated with selective attention?
Answer:
Dorsal anterior singlunate
Q: What part of the brain is associated with hyperactivity?
Answer:
Prefrontal motor cortex
Q: What part of the brain is associated with impulsivity?
Answer:
Orbitofrontal cortex
Q: Atomoxetine (Strattera) lacks abuse potential because of what
Answer:
increases dopamine in the dorsal prefrontal cortex and not in the nucleus accumbens
Q: What fetal malformation does valproate cause?
Answer:
Spina bifida
Q: What region of the brain is hypothesized to cause impulsivity?
Answer:
ventral striatum
Q: What region of the brain controls compulsivity?
Answer:
Dorsal striatum
Q: What is the MOA of atomoxetine?
Answer:
Selective Norepinephrine Reuptake Inhibitor: Boosts neurotransmitter norepinephrine/
noradrenaline and may also increase dopamine in profrontal cortex • Blocks norepinephrine
reuptake pumps, also known as norepinephrine transporters •
Q: Amaloid precursor protein is first cleaved by what enzyme
Answer:
Alpha-secretase
Q: What does paroxetine do to Straterra in the body?
Answer:
increases the effect of the drug in the body
Q: If a patient is taking paroxetine and starts Straterra what should change about the Straterra
dose?
Answer:
The dose should be decreased
Q: An Alzheimer’s patient has been taking 4mg of rivastigmine what side effects might you
anticipate and why?
Answer:
GI side effects; inhibits peripheral uptake of ACH and butyrycholine
Q: Which neurotransmitters lead to eurphoria and abuse in a patient with marijuana abuse and
ADHD.
Answer:
Pulsatile delivery of stimulants can cause a frequent and rapid delivery amplifying phasic firing
of NE and DA. Phasic firing is associated with reward, euphoria, and abuse
Q: A child is diagnosed with ADHD, what symptoms continue into adulthood?