NR546 NR 546 ACTUAL MIDTERM EXAM

NR546 / NR 546 ACTUAL MIDTERM EXAM

QUESTIONS AND ANSWERS (UPDATED )

A 34-year old male recently began experiencing breast secretions while receiving risperidone . Which dopamine pathway is associated with this side effect? - ✔️CORRECT ANSWER✅-tuberoinfundibular pathway

A 44-year-old woman is initiated on an atypical antipsychotic for the treatment of schizophrenia. Regarding affinity, atypical antipsychotics demonstrate which of the following most often? - ✔️CORRECT ANSWER✅-Atypical antipsychotics have equal positive symptom antipsychotic actions and low extrapyramidal symptoms.

Disorders from this lobe include dementia, affective disorders, and attention deficit hyperactivity disorders (ADHD). - ✔️CORRECT ANSWER✅-Temporal Lobe

controls visual processing. Damage to this lobe results in the inability to form visual memories. Bilateral lobe damage results in the inability to recognize items by sight even though vision is normal. - ✔️CORRECT ANSWER✅-Occipital Lobe

This separates the frontal lobe from the parietal lobe. - ✔️CORRECT ANSWER✅-Central sulcus

(BARS) Barnes Akathisia Rating Scale - ✔️CORRECT ANSWER✅-rating scale to assess the severity of drug-induced akathisia.-includes objective and subjective items such as the level of the patient's restlessness

(AIMS) Abnormal Involuntary Movement Scale - ✔️CORRECT ANSWER✅-tool used to monitor involuntary movements and tardive dyskinesia in clients who take antipsychotic medication -best practice/recommendation to document the AIMS at minimum every 6 months for patients taking an antipsychotic agent/dopamine blocker

Low-potency medications - ✔️CORRECT ANSWER✅--require higher doses to achieve efficacy -have more anticholinergic, antihistaminic, and α1- properties, can result in more sedation

Targeting mesolimbic/mesostriatal dopamine D2 receptors causes: -

✔️CORRECT ANSWER✅-antipsychotic actions

Targeting dopamine D2 receptors in Mesolimbic/mesostriatal and mesocortical

pathways causes: - ✔️CORRECT ANSWER✅-secondary negative symptoms

Targeting tuberoinfudibular dopamine D2 receptors causes: - ✔️CORRECT

ANSWER✅-elevation of prolactin -associated with gynecomastia, galactorrhea, amenorrhea

Targeting nigrostriatal dopamine D2 receptors causes: - ✔️CORRECT

ANSWER✅-motor side effects -can cause drug induced parkinsonism

overactivity of the mesolimbic dopamine system - ✔️CORRECT ANSWER✅-may mediate the positive symptoms of psychosis

any abnormal motor symptoms caused by D2 receptor blockers are lumped

together and called collectively: - ✔️CORRECT ANSWER✅-extrapyramidal

symptsom (EPS) -motor side effects of D2 antagonists

caused by chronic blockade of D2 receptors in the nigrostriatal dopamine pathway

• ✔️CORRECT ANSWER✅-tardive dyskinesia (TD)

-tx: interventions that lower dopamine neurotransmission, inhibiting the vesicular monoamine transporter type 2 (VMAT2) lowers the "go" signals - deuterated tetrabenazine (deutetrabenazine), Valbenazine (most selective and potent) ,

the most common side effect of drugs that target D2 receptors for psychosis - ✔️CORRECT ANSWER✅-Drug induced parkinsonism (DIP) -akinesia, bradykinesia, rigidity, and tremor *anticholinergics-drugs that block muscarinic cholinergic receptors

adding 5HT2A antagonism: - ✔️CORRECT ANSWER✅-improve side effects of D2

blockade and enhance the antipsychotic efficacy of D2 blockade

Sedative-hypnotic agents - ✔️CORRECT ANSWER✅-benzodiazepine &

barbiturates, clinical indications for use:

-sedation & anxiolysis -treatment of insomnia -general anesthesia -seizures -alcohol withdrawal states -as adjunctive management with neuromuscular blockage/muscle relaxation -to induce or maintain sleep