• Question 2

  	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 3

  	Select all the criteria for what is considered “At-Risk Drinking.” Women: > 7 drinks in any given week Men: > 4 drinks per day Women: > 4 drinks per day Men: > 14 drinks per week
  	Response Feedback: III is wrong because it’s > 3 drinks per day for women

• Question 4

  	Benzodiazepines can be withdrawn abruptly despite duration of therapy/abuse.
  	NURS 6630 Final Exam  Response Feedback: Benzodiazepines should never be stopped suddenly; Page 194 “Under no circumstances should benzodiazepines be stopped abruptly.”

• Question 5

  	If a patient suffers from a multitude of small strokes and later begins experiencing mood disturbances in an acute fashion that sometimes resolve, from what type of dementia would you think that patient may suffer?
  	Response Feedback: under the clinical features and diagnosis subtitle

• Question 6

  	Of the following neurotransmitters, which ones play a critical role in modulating attention in ADHD? Dopamine Epinephrine GABA Norepinephrine Glutamate
  	Response Feedback: “Stimulants increase intra-synaptic concentrations of dopamine (DA) and norepinephrine (NE)” NURS 6630 Final Exam

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  Question 7

  	Daytrana is the MPH transdermal system of methylphenidate approved for the treatment of ADHD in children aged 6 years and older. What is the difference in terms of the metabolism compared to the other formulations in this class?
  	Response Feedback: referring to MPH transdermal system (MTS; Daytrana): “Since the MPH is absorbed through the skin, it does not undergo first-pass metabolism by CES-1 in the liver, resulting in higher plasma MPH levels”

• Question 8

  	L. J. is a 55-year-old male who attended a funeral and found himself laughing during the service, but later that evening he was irritated with himself for what he had done. His wife said this was abnormal behavior and took him to his doctor to be evaluated. After L. J.’s MRI was reviewed, he was diagnosed with frontotemporal dementia NURS 6630 Final Exam . Which medication is recommended to help L. J. with his emotional outbursts?
  	Response Feedback: under Treatment subtitle: “The behavioral features are sometimes helped by SSRIs, and these are the best-studied treatments for these disorders.”

• Question 9

  	When can buprenorphine be initiated in a patient who is suffering from an opioid overdose?
  	Response Feedback: “To avoid this problem, the initial buprenorphine dose should not be administered until the patient demonstrates mild-to-moderate symptoms of withdrawal.”

• Question 10

  	Disorientation, tremor, hyperactivity, fever, hallucinations, marked wakefulness, and increased autonomic tone are all features that are consistent with which part of alcohol withdrawal?
  	Response Feedback: “The principal features are disorientation (to time, place, or person), tremor, hyperactivity, marked wakefulness, fever, increased autonomic tone, and hallucinations.”

• Question 11

  	The experience of pain is ALWAYS subjective
  	Response Feedback: “The experience of pain is always subjective.”

• Question 12

  	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? Butalbital Lorazepam Hydrocodone
  	Response Feedback: “Treatment should begin with an oral test dose of 200 mg of pentobarbital, a short-acting-barbiturate.”

• NURS 6630 Final Exam  Question 13

  	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. Assuming this patient will be thoroughly evaluated for the diagnosis of depression, what would you recommend as initial therapy?
  	Response Feedback: 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 14

  	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 15

  	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? Add a high-dose opioid if patient is not already on the maximum dose. Assess for a co-morbid psychiatric condition. Tell the patient you have exhausted all your options and there is nothing more you can do. 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: NURS 6630 Final Exam  If treated with opioids for more than 3 months then get a second opinion. – 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 16

  	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.?
  	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 17

  	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 39

Which medication below should be routine for all suspected cases of alcohol intoxication and dependence?

NURS 6630 Final Exam