Question 1. Jake, a forty-five-year-old patient with schizophrenia, was recently hospitalized for acute psychosis due to medication noncompliance. He was treated with intramuscular (IM) long-acting haloperidol. Besides being monitored for his schizophrenia symptoms, the patient should be assessed by his primary care provider:
For excessive weight loss
With the Abnormal Involuntary Movement Scale (AIMS) for extrapyramidal symptoms (EPS) symptoms
Monthly for tolerance to the haloperidol
Only by the mental health provider as most nurse practitioners in primary care do not care for mentally ill patients
Question 2. Sarah, a forty-two-year-old female, requests a prescription for an anorexiant to treat her obesity. A trial of phentermine is prescribed. Prescribing precautions include understanding that:
Obesity is a contraindication to prescribing phentermine.
Anorexiants may cause tolerance and should only be prescribed for six months.
Patients should be monitored for postural hypotension.
Renal function should be monitored closely while the patient is on anorexiants.
Question 3. Cara is taking levetiracetam (Keppra) to treat seizures. Routine education for levetiracetam includes reminding her:
To not abruptly discontinue levetiracetam due to the risk of withdrawal seizures
To wear a sunscreen due to photosensitivity from levetiracetam
To get an annual eye exam while on levetiracetam
To report weight loss if it occurs
Bradykinesia, akathisia, and agitation
Excessive weight gain
Potentially fatal agranulocytosis
Question 5. Prior to starting antidepressants, patients should have laboratory testing to rule out:
Low estrogen levels
Question 6. An appropriate first-line drug to try for mild to moderate generalized anxiety disorder would be:
Question 7. Monitoring for a child on methylphenidate for ADHD includes:
Routine height and weight checks
Amount of methylphenidate being used
All of the above
Increased seizure activity as this drug may auto-induce seizures
Altered renal function, including renal failure
Blood dyscrasias, which are uncommon but possible
CNS excitement, leading to insomnia
Question 9. An appropriate first-line drug for the treatment of depression with fatigue and low energy would be:
Question 11. A sixty-six-year-old male was prescribed phenelzine (Nardil) while in an acute psychiatric unit for recalcitrant depression. The nurse practitioner managing his primary healthcare needs to understand the following regarding phenelzine and other monoamine oxidase inhibitors (MAOIs):
He should not be prescribed any serotonergic drug such as sumatriptan (Imitrex).
MAOIs interact with many common foods, including yogurt, sour cream, and soy sauce.
All the above options are .
Question 12. Patients who are prescribed olanzapine (Zyprexa) should be monitored for:
Question 13. Levetiracetam has known drug interactions with:
Few, if any, drugs
Question 14. When a patient is on selective-serotonin reuptake inhibitors:
The complete blood count must be monitored every three to four months
Therapeutic blood levels must be monitored every six months after a steady state is achieved.
Blood glucose must be monitored every three to four months.
There is no laboratory monitoring required.
Question 15. In choosing a benzodiazepam to treat anxiety, the prescriber needs to be aware of the possibility of dependence. The benzodiazepam with the greatest likelihood of rapidly developing dependence is:
Question 16. Jaycee has been on escitalopram (Lexapro) for a year and is willing to try tapering off of the selective-serotonin reuptake inhibitors.What is the initial dosage adjustment when starting a taper off antidepressants?
Change the dose to every other day dosing for a week.
Reduce the dose by 50% for three to four days.
Reduce the dose by 50% every other day.
Escitalopram (Lexapro) can be stopped abruptly due to its long half-life.
Question 17. When prescribing Adderall (amphetamine and dextroamphetamine) to adults with ADHD, the nurse practitioner will need to monitor:
The blood pressure
Blood glucose levels
Urine ketone levels
Valproate is safe during all trimesters of pregnancy.
She can get pregnant while taking valproate, but she should take adequate folic acid.
Valproate is not safe at any time during pregnancy.
Valproate is a known teratogen but may be taken after the first trimester if necessary.
Question 19. Jack, eight years old, has attention deficit disorder (ADD) and is prescribed methylphenidate (Ritalin). He and his parents should be educated about the side effects of methylphenidate, which are:
Slurred speech and insomnia
Bradycardia and confusion
Dizziness and orthostatic hypotension
Insomnia and decreased appetite
Question 20. The tricyclic antidepressants should be prescribed cautiously in patients with: