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2023-2024 NR546 Pharmacology Midterm Exam With Answers (298 Solved Questions) - Document preview page 1

2023-2024 NR546 Pharmacology Midterm Exam With Answers (298 Solved Questions) - Page 1

Document preview content for 2023-2024 NR546 Pharmacology Midterm Exam With Answers (298 Solved Questions)

2023-2024 NR546 Pharmacology Midterm Exam With Answers (298 Solved Questions)

Get valuable insights into exam trends with 2023-2024 NR546 Pharmacology Midterm Exam With Answers, featuring past questions.

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2023-2024 NR546 Pharmacology Midterm Exam With Answers (298 Solved Questions) - Page 1 preview imageNEWLY UPDATEDNR 546 MIDTERM EXAM2023-2024WITH ANSWERSthalamus--answer-involved in sensory organ and motorcommand processingstriatum--answer-involved in complex motor actions, alsolinks cognition to motor actionslimbic system--answer-includes circuits that are associatedwith pleasure and rewardbasal ganglia--answer-group of structures involved involuntary motor movementsamygdala--answer-involved in emotional regulation andperception of odorscorpus callosum--answer-controls the communicationbetween the two brain hemisphereswhite matter--answer-contains nerve fibers that connectneurons from different regions into functional circuitsgrey matter--answer-contains nerve cells and dendritesbrain tissue--answer-made up of grey matter and whitematterdorsal striatum--answer-involved in complex motor actionsand linkage of cognition to motor actions
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2023-2024 NR546 Pharmacology Midterm Exam With Answers (298 Solved Questions) - Page 2 preview image
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2023-2024 NR546 Pharmacology Midterm Exam With Answers (298 Solved Questions) - Page 3 preview image-main input area for basal ganglia*activated when anticipating or engaging in pleasureThe field of epigenetics is rapidly growing and can helpexplainhow gene expression is:--answer-influenced byenvironmental factors and how epigenetics contributes tothe manifestation of mental illnessHow does epigenetics impact a person's mental health?--answer-internal or external factors activate portions ofthegenome that result in the manifestation of mental healthsymptoms-activation is often a result of a stressful event, which, whencombined with the genetic risk, results in the disease-genes being on or off-occurrence of symptoms may be the result ofinheritance ofan abnormal gene or of normal genes being "on" when theyshould be "off."What should the PMHNP consider when prescribing chemicalrestraints?--answer--allergy status-prior med hx for adverse drug reactions r/t the medsordered in the chemical restraint-state regulations regarding chemical restrains must bereviewedAre the PMHNP and other staff liable if the client has anallergic reaction or adverse side effects to the drugs usedfor chemical restraint?--answer-No.The client has been court-orderedto take the prescribedmedications and the standing order for chemical restraints
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2023-2024 NR546 Pharmacology Midterm Exam With Answers (298 Solved Questions) - Page 4 preview imageis approved. The PMHNP and other staff are not liable if thepatient has an allergic reaction or adverse side effects.How does reviewing the genetic makeup of a client helpguide the PMHNP in selecting medication for clients?--answer--Genetic testing can assist by providing moreinformation on how clients may respond to certainpsychotropic medications-provides information on how a client may break down andmetabolize medications based on the cytochrome P450system.Tanrıkulu and Erbaş (2020) investigated identical twins todetermine the presence of an inherited link forschizophrenia and why one twin may develop schizophreniawhen the other does not. When two people have100%identical DNA, why don't both persons develop the exactillnesses? Studies of identical Danish twins found that if onetwin had schizophrenia, the other twin had a 50% lifetimerisk of developing schizophrenia (Lemvigh et al., 2020). Whyis there only half the risk?--answer-Both environmental andpsychosocial stressors can impact mental health. Althoughtwins may have identical genes, their gene expression maybe different.There may be an environmental exposure that turned a gene"on" that shouldhave been "off" for one twin to developschizophrenia and not the other.central sulcus--answer-separates the frontal lobe from theparietal lobe
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2023-2024 NR546 Pharmacology Midterm Exam With Answers (298 Solved Questions) - Page 5 preview imagefrontal lobe--answer-associated with movement,intelligence, abstract thinkingbroca's area--answer-speech productiontemporal lobe--answer-involves object identification andauditory signalscerebellum--answer-coordinationwernicke's area--answer-speech comprehensionoccipital lobe--answer-primary visual areaparietal lobe--answer-keeps us alert to what is going onaround ussensory cortex--answer-pain, heat, and other sensationsmotor cortex--answer-movementhippocampus--answer-involved in both memory and anxietynucleus accumbens--answer-involved in the reward processTypes of epigenetic changes:--answer-DNA MethylationHistone modificationNon-coding RNAThe potential legal and ethical issues impacting mentalhealth treatmentmust also be taken into account, including:--answer--informed consent
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2023-2024 NR546 Pharmacology Midterm Exam With Answers (298 Solved Questions) - Page 6 preview image-competence to make healthcare decisions-off-label prescribingInformed consent--answer-Clients have the right to receiveenough information to make decisions about treatment.-must also be informed about potential risks associated withmedications.-have the right to refuse treatment-cannot be forcibly medicated in non-emergencies. However,clients can be forcibly medicated if they are violent towardthemselves or others and when less restrictive methodshave failedCompliance--answer-A court order may be issued for aclient to receive treatment against their wishes if they areconsidered a danger to themselves or others.-Examples: clients with schizophrenia or sex offenders-Guardians can provide consent for clients who have limitedcognitive capabilities or are incompetent to make decisions-PMHNPs are responsible for being knowledgeable abouttheir state laws and abiding by them.Off-Label Prescribing--answer-Some clients may benefitfrom the unapproved use of a drug for symptommanagement.-Example: many SSRIs used to tx anxiety and OCD but arenot FDA approved for use in this disorder.-potentially raises ethical and legal concerns-PMHNP must remain up to date with the latestrecommendations for off-label prescribing.
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2023-2024 NR546 Pharmacology Midterm Exam With Answers (298 Solved Questions) - Page 7 preview imageIncidence of mental illness-what factors are increasing theincidence--answer-Psychological and sociological factorsLifestyle factors such as a client's smoking status, diet,exercise, history of medication adherence, or history ofaddiction should be considered when prescribingpsychotropic medicationsAdherence--answer-Persistence-taking med over intended time periodCompliance-taking med as prescribedleft hemisphere--answer--speech comprehension-word recognition-grammar-sequential processing-recognition of detail-conscious mental processingright hemisphere--answer--prosody of speech-emotional modulation-visual-spatial skills-recognition of facial expression-music-abstract mathematical skills-holistic processing-unconscious mental processingPharmacokinetics--answer-the study of what happens to adrug from the time of administration until the parent drugand all metabolites leave the body
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2023-2024 NR546 Pharmacology Midterm Exam With Answers (298 Solved Questions) - Page 8 preview imageCYP450--answer-CYP450 enzymes in the gut wall or liverconvert drug substrate into a biotransformed product in thebloodstream, responsible for degradating of a large # ofpsychotropic drugs-Not all ind. have same genetic form of CYP450 enzymes,determined with pharmacogenetic testing*Most individuals have "normal" rates of drug metabolismfrom the major CYP450 enzymes and are said to be"extensive metabolizers", most drug doses are set for theseindividuals.*genetic variants of these enzymes can make poormetabolizers or ultra rapid metabolizersFive of the most important:CYP450 1A2, 2B6, 2D6, 2C9, 2C19, and 3A4.ultra rapid metabolizers--answer-elevated enzyme activitysubtherapeutic drug levelspoor efficacy with standard dosesgenotyping--answer-the patient for pharmacogenomic use-genes for these CYP450 enzymes can now be readilymeasured and used to predict which patients might need tohave dosage adjustments-measurement of genes for drug metabolismmost common targets of psychotropic drugs--answer-G-protein receptors-Drug actions at these receptors occur in a spectrum, fromfull agonist actions, to partial agonist actions, toantagonism, and even to inverse agonism.
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2023-2024 NR546 Pharmacology Midterm Exam With Answers (298 Solved Questions) - Page 9 preview imagePharmacokinetics concepts--answer-absorptiondistributionmetabolismexcretionFlockhart Table--answer-drug interactions that aremediated by cytochrome P450 enzymescomprehensive list of drugs and the interactions related tothe cytochrome P450 systemNeurotransmitters--answer-chemicals released by neuronsto send communication across synaptic clefts to otherneurons-impact human emotion and behaviorNeurotransmission:--answer-the chemical transmission ofinformation between neurons and their target cells-the chemicals, or neurotransmitters, are released from theirtransport vesicles to bind with receptor sites to performtheir duties, which are excitatory or inhibitory-neurotransmitter then either returned and stored for futureuse (reuptake) or inactivated and dissolved by enzymes-Types: Classic, Retrograde, VolumeClassic neurotransmission--answer-neurons send electricalimpulses from one part of the cell to another part of thesame cell via their axons-one neuron hurling a chemical messenger, orneurotransmitter, at the receptors of a second neuron
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2023-2024 NR546 Pharmacology Midterm Exam With Answers (298 Solved Questions) - Page 10 preview image-electrical impulse converted chemical signal at the synapsein a process known as excitation-secretion coupling, thefirst stage of chemical neurotransmission, then back intoelectrical impulse in second neuron-chemical information from the first neuron triggering acascade of further chemical messages within the secondneuron to change that neuron's molecular and geneticfunctioningRetrograde neurotransmission--answer-postsynapticneurons "talk back" to their presynaptic neurons-second neuron to the first at the synapse between them-Chemicals produced specifically as retrogradeneurotransmitters at some synapses include:endocannabinoids, gaseous neurotransmitter nitric oxide(NO), nerve growth factor (NGF).Volume neurotransmission--answer-Neurotransmissionwithout a synapse or nonsynaptic diffusionneurotransmission-Chemical messengers sent by oneneuron to another canspill over to sites distant to the synapse by diffusion-neurotransmission can occur at any compatible receptorwithin the diffusion radius of the neurotransmitter-neurotransmission occurs in chemical "puffs"-sophisticated "chemical soup."-example: dopamine action in the prefrontal cortex, at thesites of autoreceptors on monoamine neuronsExcitatory neurotransmitters:--answer-increase thelikelihood that the neuron will fire an action potential
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2023-2024 NR546 Pharmacology Midterm Exam With Answers (298 Solved Questions) - Page 11 preview imageinhibitory neurotransmitters:--answer-decrease thelikelihood that a neuron will fire an actionneurotransmitters that most impact mental health can beclassified into four major categories:--answer-cholinergics-acetylcholinemonoamines-norepinephrine, dopamine, serotonin, histamineamino acids-gamma-amino-butyric acid and glutamateneuropeptidesInhibitors: VISA CKGQ--answer-ValproateIsoniazidSulfonamidesAmiodaroneChloramphenicolKetoconazoleGrapefruit JuiceQuinidine-decrease medication metabolismInducers: CRAP GPS--answer-CarbamazepineRifampinAlcoholPhenytoinGriseofulvinPhenobarbital
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2023-2024 NR546 Pharmacology Midterm Exam With Answers (298 Solved Questions) - Page 12 preview imageSulfonylureas-increase medication metabolismneurotransmitters that may be responsible for a client'ssymptoms of depression--answer-Imbalanced levels ofacetylcholine, norepinephrine, serotonin, histamine, orglutamate can contribute to symptoms of depressionclient who is a poor metabolizer:--answer-has a lowerconcentration of the necessary enzyme to metabolize adrug, which results in higher blood concentrations of thedrug.-increase the risk of side effects and adverse reactionsWhy is trazodone not used as a front-line antidepressant--answer-Its antidepressant that has a secondary effect ofblocking histamine and adrenergic receptors-causes sedation and somnolence and as a result*often used as an adjunct in therapy when a depressedpatient has difficulty sleepingeffect on neurotransmitters and side effects: SelectiveSerotonin Reuptake Inhibitors (SSRIs)--answer-Inhibits thereuptake of serotonin, which can cause nausea, agitation,headache, and sexual dysfunctioneffect on neurotransmitters and side effects: Serotonin andNorepinephrine Reuptake Inhibitors (SNRIs)--answer-Inhibits the reuptake of serotonin and norepinephrine, whichcan cause nausea, sweating, insomnia, tremors, sexualdysfunction
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2023-2024 NR546 Pharmacology Midterm Exam With Answers (298 Solved Questions) - Page 13 preview imageeffect on neurotransmitters and side effects: TricyclicAntidepressants--answer--Inhibits the reuptake of serotoninand norepinephrine, which can cause sexual dysfunction-Blocks norepinephrine receptors, which can causehypotension and tachycardia-Blocks histamine receptors, which can cause sedation andweight gain-Blocks acetylcholine receptors, which can cause drymouth, constipation, blurred vision, and urinary retentioneffect on neurotransmitters and side effects: MonoamineOxidase Inhibitors (MAOIs)--answer-Increasesnorepinephrine and serotonin by inhibiting the enzyme thatinactivates it, which can cause sedation, dizziness, sexualdysfunction, and hypertensive crisiseffect on neurotransmitters and side effects:Benzodiazepines--answer-Increases the receptor affinity forGABA, which can cause dependence and confusioneffect on neurotransmitters and side effects: Bupropion--answer-Inhibits the reuptake of norepinephrine anddopamine, which can cause insomnia, dry mouth, tremors,and seizuresantagonist--answer-causes a conformational change thatstabilizes the receptor in the baseline state and thus is"silent."-blocks the action of a neurotransmitteragonists--answer-fully stimulate G-protein-linked receptors
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2023-2024 NR546 Pharmacology Midterm Exam With Answers (298 Solved Questions) - Page 14 preview imagepartial agonists--answer-stimulate receptors to a lesserdegree than an agonist or natural neurotransmitterSSRIs, SNRIs, and tricyclic antidepressants increase ________levels.___________ do not impact serotonin levels.--answer-increaseserotonin levels.Benzodiazepines do not impact serotonin levels.Is nicotine an inducer or an inhibitor of the CYP 1A2enzyme?--answer-inducerNicotine is an inducer of the CYP 1A2 enzyme. Does thePMHNPanticipate Joshua may need a higher or lower doseof olanzapine to achieve a therapeutic response?--answer-Higher-Nicotine is an inducer of the CYP 1A2 enzyme, so it lowersthe concentration of drugs. Therefore, a higher dose ofolanzapine may be needed to control his symptoms.Ernesto, a 60-year-old, presents to the PMHNP with report ofhaving anxiety, frequent occurrences of feeling frozen inplace and like his heart is pounding out of his chest, as wellas having difficulty sleeping.The PMHNP suspects the client has an elevated level ofwhich neurotransmitter?--answer-Norepinephrine-responsible for the regulation of fight or flight responsesand can impact mood and sleep.Which of the following is the best medication class for thePMHNP to prescribe for Ernesto to address his elevated
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2023-2024 NR546 Pharmacology Midterm Exam With Answers (298 Solved Questions) - Page 15 preview imagenorepinephrine levels?--answer-selective serotoninreuptake inhibitor would block the reuptake of serotonin,leaving a larger amount of serotonin available. Increasingthe amount of serotonin would help regulate the feelings offear and anxiety. Reducing the occurrence of fear wouldhelp reduce the release of norepinephrine.A serotonin and norepinephrine reuptake inhibitor wouldprevent the reuptake of norepinephrine, which would notreduce the level of norepinephrine as needed.Benzodiazepines increase the levels of GABA and do notimpact norepinephrine. A monoamine oxidase inhibitorwould increase levels of norepinephrine.During a follow up appointment after 4 weeks, the PMHNPshould assess for the need to add which medication toErnesto's treatment plan?--answer-The nurse should assessfor sexual dysfunction and anticipate the potential need fora phosphodiesterase inhibitor such as sildenafil (Viagra).-After 4 to 6 weeks, the client should be experiencing fulleffects of the SSRI, so the need for a short-term medicationlike a benzodiazepine or a beta blocker are not anticipated.St. John's Wort is contraindicated withan SSRI and cancause serotonin syndrome.Glu--answer-Glutamate-amino acid-excitatory neurotransmitter-"workhorse" of the brain-can affect almost every neuron inthe brain-affects: energy, memory, learning, neural plasticity-relay sensory info. and regulate spinal and motor reflexes-too much: schizophrenia, epilepsy, mania
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2023-2024 NR546 Pharmacology Midterm Exam With Answers (298 Solved Questions) - Page 16 preview image-receptors: NMDA, AMPAGABA--answer-inhibitory neurotransmitter-decrease neuroexcitability across the brain-"chill", take the edge off stress, help people calm down,relax, destress, sleep-to little: may experience anxiety or schizophrenia-slows down everything, even breathing-affect executive function and motor coordination, increaserisk for accidents-Increased levels of gamma-aminobutyric acid have acalming effect.5HT--answer-Serotonin-help regulate mood-makes relaxed, comfortable, decreases stress, regulatesleep, arousal, libido, aggression, pain perceptionNE--answer-norepinephrine-monoamine neurotransmitter-focus and productivity-too much due to stress, meds, caffein, stimulants cancause: nervous, antsy, affect focusDA--answer-dopamine-monoamine neurotransmitter-regulate mood-associated with executive function, ability to perform well,be organized, emotional intelligence-movement and coordination-to little: lose pleasure, interest, alertness, self-confidence,parkinson's disease
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Document Details

University
Chamberlain College of Nursing
Course
NR 546
Subject
Pharmacology

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