08 Oct The PMHNP is prescribing Aricept (donepezil) to a client with Lewy Body dementia.

The PMHNP is prescribing Aricept (donepezil) to a client with Lewy Body dementia. Which of the following should be included in his or her patient educations?

 

  This medication is FDA approved and may be taken with or without food

 

  This medication is consider off lablel use and must be taken without food

 

  This medication is FDA Approved and must be taken with food

 

  This medication is consider off label use and may be taken with or without food

 

 Question 2Which of the following medications would you want to avoid if your patient has a severe kidney impairment?

 

  Namenda (mementine)

 

  Exelon (Rivastigmine) Patch

 

  Aricept (Donepezil)

 

  Exlone (Rivastigmine) ER

 

 Question 3Which of the following is FDA approve for ADHD? SELECT ALL THAT APPLY.

 

  Modafinil

 

  Clonidine

 

  Buproprion

 

  Concerta

 

  Guanfacine

 

 Question 4The PMHNP is considering starting Strattera (atomoxetine) for a patient with a diagnosis of ADHD. Which of the following would be a reason to NOT start this medication?

 

  History of structural cardiac abnormlaities

 

  History of Major Depressive Disorder

 

  History of Renal Disease

 

  History of Generalized Anxiety Disorder

 

 Question 5A patient who is being treated for ADHD with Concerta, comes for a follow up appointment accompanied by his mother. She states the patient does not want to eat and his clothes are getting too big. Which of the following is the best response by the PMHNP?

 

  “Children with ADHD are very active, so they require increased calories.”

 

  ” Please call your PCP as it he may have a medical condition.”

 

  “This may be a side effect from the Concerata”

 

  “I am surprised to hear this, as people on Concerta generally gain weight.”

 

 

 

Question 6The PMHNP is considering treating the patient with ADHD with Ritalin. Which are the following questions would the PMHNP want to ask the patient?

 

  What medications are you currenlty taking?”

 

  Do you have a history of substance abuse?

 

  Do you have a family history sudden cardiac death?

 

  Do you have a history of Kidney Disease?

 

  Do you have a history of Liver Disease?

 

 Question 7The PMHNP has diagnosed the patient with Neurocognitive Disorder, Alzheimer’s Type Severe. Which of the following medications would be the best choice to prescribe for worsening  cognitive decline?

 

  Exlone (Rivastigmine) ER

 

  Aricept (Donepezil)

 

  Razadyne (galantamine)

 

  Depakote (valproate acid)

 

 Question 8Which of the following medications prevents over excitation of glutamate receptors thereby stabilizing the neurodegenerative process?

 

  Namenda (mementine)

 

  Aricept (Donepezil)

 

  Exelon (Rivastigmine) Patch

 

  Razadyne (galantamine)

 

 Question 9Which of the following medications are Amphetamine Based Stimulants? SELECT ALL THAT APPLY

 

  Dexedrine

 

  Vyvanse

 

  Ritalin

 

  Concerta

 

  Adderal XR

 

 Question 10Methylphenidates decrease Norepinephrine and Dopamine in the Prefrontal Cortex by blocking Reuptake pumps. True or False

 

  True

 

  False

 

 Question 11The PMHNP is rounding in the nursing home. A client is having severe behavioral outbursts. Multiple medications have been tried unsuccessfully. The PMHNP has decided to trail Seroquel (quetiapine) to treat the behavior out bursts.  Which of the following must be documented? SELECT ALL THAT APPLY

 

  Education that this is off label use.

 

  Nursing staff to monitor for sedation

 

  Education taht this medication can casue increased risk of death in older adults

 

  Nursing to monitor for anti-cholinergic side effects

 

  Nursing staff to monitor for hypertension

 

 Question 12Which of the following medications do not require lab work?

 

  No answer text provided.

 

  Depakote (valproate acid)

 

  Tegretol (Carbamazepine)

 

  Lamictal (lamotrigine)

 

 Question 13Which of the following are FDA approved for treatment of Behavioral Disturbances due to Neurocognitive Disorder. SELECT ALL THAT APPLY

 

  Seroquel (quetiapine)

 

  Depakote (valproate acid)

 

  None of the Above

 

  Risperdal (risperdone)

 

  Celexa (citalopram)

 

 Question 14Lithium is FDA approved for which of the following? SELECT ALL THAT APPLY:

 

  Pathological gambling

 

  Acute Mania, mixed states

 

  Bipolar 1

 

  Bipolar 2

 

  Suicidal Ideation

 

 Question 15Lithium is metabolized by the CYP450 System.

 

  True

 

  False

 

 Question 16The PMHNP is treating a 45 year old female with Bipolar 1, Currently Manic. He is reviewing the Lithium Level he ordered this morning. The Lithium Level is 1.0 and the patient reports she is  “starting to come down.” Which of the following is best action for the PMHNP to take?

 

  Increase the dose as the Lithium Level is sub -therapeutic

 

  Increase the dose as she is becoming depressed

 

  Continue the same dose as the Lithium Level is therapeutic

 

  Decrease the dose as she is becoming Toxic

 

 Question 17The PMHNP is starting a patient with Bipolar 2 on Lithium. Which of the following would be important to include in patient education? SELECT ALL THAT APPLY

 

  Lab work is not required with this medication

 

  Lab work to monitor level, renal function and thyroid will be done

 

  Reprot any tremors or diarrhea

 

  Be careful to avoid excessive excercise that results in perfuse sweating

 

  Take the Lithium just before the lab work

 

 Question 18___________ and _______________ have a black box warning related to serious potentially fatal rashes.

 

  Topiramate and Oxcarbamazepine

 

  Carbamazepine and Lamotrigine

 

  Lithium and Valproate

 

  Valproate and Gabapentin

 

 Question 19Which of the following could be potential side effects/complications of Depakote (Valproate)? SELECT ALL THAT APPLY

 

  Weight Gain

 

  Hepatic toxicity

 

  Neural tube defects in fetus

 

  Thrombocytopenia

 

  Weight loss

 

 Question 20Which of the following are signs of Carbamazepine toxicity? SELECT ALL THAT APPLY

 

  Involuntary movments

 

  abnormal reflexes

 

  ECG changes

 

  Hyper alertness

 

  Nausea and Vomiting

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