NR 668 Week 4 Quiz 4 Psychopharmacology

Quiz 4 Psychopharmacology Which of the following would help the PMHNP differentiate between NMS and serotonin syndrome? Clonus Temp of 101.7 Muscle Rigidity Low Vitamin B12 A febrile patient with muscle rigidity may have either NMS or serotonin syndrome. Clonus is associated with serotonin syndrome. Low Vitamin B12 does not help narrow the differential diagnosis in this clinical scenario. Which of the following psychoactive medications is most likely to be associated with fetal risk? Valproate Buspirone Bupropion Trazodone Valproate may produce congenital malformations, lower IQ and greater risk for autism spectrum disorder in children. A patient was recently started on a dopamine antagonist, and complains of breast tenderness and milky discharge. What is the most likely explanation for the symptoms? Dopamine transmission in the tuberoinfundibular pathway Dopamine transmission in the mesolimbic pathway Dopamine transmission in the nigrostriatal pathway Dopamine increases throughout the basal ganglia Pharmacogenetic testing shows that a 26 year old female with MDD is a CYP450 2D6 slow metabolizer. This may require reduced dosing or awareness of drug-drug interactions to minimize potential drug toxicity. Which of the following medications is the theoretical safest choice for treating MDD in this patient given the test results? Citalopram Vortioxetine Venlafaxine Paroxetine Venlafaxine, Vortioxetine and Paroxetine are primarily substrates for CYP2D6. Citalopram is metabolized by CYP3A4 and CYP2C19. A CYP2D6 slow metabolizer phenotype would not affect the metabolism of Citalopram. Kerry is a 19-year-old female with Bipolar disorder about to start on Lithium. Several lab values are recommended prior to the initiation of Lithium. Which of the following listed below are part of the lab panel the PMHNP would order? Pregnancy test LFT's Lithium level Full body skin exam to document pre-existing rashes. Pregnancy test. Lithium is a known teratogen. A patient is started on lamotrigine for bipolar depression. The patient complained of a rash comprised of blistering skin and mouth sores after a dose increase. The blood work reveals normal renal and liver function. Which type of drug rash is most likely? Stevens-Johnson syndrome Atopic dermatitis Psoriasis DRESS syndrome The PMHNP in the ED is evaluating a 68-year-old woman who was recently diagnosed with mild cognitive impairment and cannot remember the name of the medication that she has recently started 1 week ago. The patient is complaining of increased heart rate, sweating, and muscle spasms progressively worsening for the last 3 days. Which neurotransmitter is associated with this adverse effect? Acetylcholine Gamma-aminobenzoic acid (GABA) Serotonin Dopamine Sunny is a 50-year -old female who presents to the clinic with a recent ECG tracing. Her QTC is recorded at 327 ms. Mary is on Citalopram 40 mg daily x 3 years secondary to generalized anxiety disorder. Given this information, you decide to do what? Do nothing Repeat the ECG in 1 month to monitor for prolonged QTC Decrease the citalopram to 20mg daily Switch to the bioequivalent of Escitalopram at 40mg daily A QTC of 388 ms is considered normal. Persons over 60 are limited to a daily dose of Citalopram 20mg given