The PMHNP is caring for a patient with fibromyalgia. Which second-line treatment does the PMHNP select that may be effective for managing this patient’s pain?
a) Methylphenidate (Ritalin)
b) Viloxazine (Vivalan)
c) Imipramine (Tofranil)
d) Bupropion (Wellbutrin)
The PMHNP is attempting to treat a patient’s chronic pain by having the agent bind the open channel conformation of VSCCs to block those channels with a “use-dependent” form of inhibition. Which agent will the PMHNP most likely select?
a) Pregabalin (Lyrica)
b) Duloxetine (Cymbalta)
c) Modafinil (Provigil)
d) Atomoxetine (Strattera)
A patient with irritable bowel syndrome reports chronic stomach pain. The PMHNP wants to prescribe the patient an agent that will cause irrelevant nociceptive inputs from the pain to be ignored and no longer perceived as painful. Which drug will the PMHNP prescribe?
a) Pregabalin (Lyrica)
b) Gabapentin (Neurontin)
c) Duloxetine (Cymbalta)
d) B and C
The PMHNP wants to use a symptom-based approach to treating a patient with fibromyalgia. How does the PMHNP go about treating this patient?
a) Prescribing the patient an agent that ignores the painful symptoms by initiating a reaction known as “fibro-fog”
b) Targeting the patient’s symptoms with anticonvulsants that inhibits gray matter loss in the dorsolateral prefrontal cortex
c) Mzatching the patient’s symptoms with the malfunctioning brain circuits and neurotransimitters that might mediate those symptoms
d) None of the above
The PMHNP is working with the student to care for a patient with diabetic peripheral neuropathic pain. The student asks the PMHNP why SSRIs are not consistently useful in treating this particular patient’s pain. What is the best response by the PMHNP?
a) “SSRIs only increase norepinephrine levels”
b) “SSRIs only increase serotonin levels”
c) “SSRIs only increase serotonin and norepinephrine levels”
d) “SSRIs do not increase serotonin or norepinephrine levels”
A patient with gambling disorder and no other psychiatric comorbidities is being treated with pharmacological agents. Which drug is the PMHNP most likely to prescribe?
Kevin is an adolescent who has been diagnosed with kleptomania. His parents are interested in seeking pharmacological treatment. What does the PMHNP tell the parents regarding his treatment options?
a) “Naltrexone may be an appropriate option to discuss”
b) “there are many medicine options that treat Kleptomania”
c) “Kevin may need to be prescribed antipsychotics to treat this illness”
d) “Lithium has proven effective for treating kleptomania”
Which statement best describes a pharmacological approach to treating patients for impulsive aggression?
a) Anticonvulsant mood stabilizers can eradicate limbic irritability
b) Atypical antipsychotics can increase subcortical dopaminergic stimulation
c) Stimulants can be used to decrease frontal inhibition
d) Opioid antagonists can be used to reduce drive
A patient with hypersexual disorder is being assessed for possible pharmacologic treatment. Why does the PMHNP prescribe an antiandrogen for this patient?
a) It will prevent feelings of euphoria
b) It will amplify impulse control
c) It will block testosterone
d) It will redirect the patient to think about other things
Mrs. Kenner is concerned that her teenage daughter spends too much time on the Internet. She inquires about possible treatments for her daughter’s addiction. Which response by the PMHNP demonstrates understanding of pharmacologic approaches for compulsive disorders?
a) “Compulsive internet use can be treated similarly to how we treat people with substance use disorders”
b) “internet addiction is treated with drugs that help block the tension/arousal state your daughter experiences”
c) “When it comes to internet addiction, we prefer to treat patients with pharmaceuticals rather than psychosocial methods”
d) “there are no evidence-based treatments for internet addiction, but there are behavioral therapies your daughter can try”
Mr. Peterson is meeting with the PMHNP to discuss healthier dietary habits. With a BMI of 33, Mr. Peterson is obese and needs to modify his food intake. “Sometimes I think I’m addicted to food the way some people are addicted to drugs”, he says. Which statement best describes the neurobiological parallels between food and drug addiction?
a) There is decreased activation of the prefrontal cortex
b) There is increased sensation of the reactive reward system
c) There is reduced activation of regions that process palatability
d) There are amplified reward circuits that activate upon consumption
The PMHNP is caring for a patient who reports excessive arousal at nighttime. What could the PMHNP use for a time-limited duration to shift the patient’s brain from a hyperactive state to a sleep state?
a) Histamine 2 receptor antagonist
The PMHNP is caring for a patient who experiences too much overstimulation and anxiety during daytime hours. The patient agrees to a pharmacological treatment but states, “I don’t want to feel sedated or drowsy from the medicine.” Which decision made by the PMHNP demonstrates proper knowledge of this patient’s symptoms and appropriate treatment options?
a) Avoiding prescribing the patient a drug that blocks H1 receptors
b) Prescribing the patient a drug that acts on H2 receptors
c) Stopping the patient from taking medicine that unblocks H1 receptors
d) None of the above