NSG 552 /NSG552 EXAM 3 ACTUAL EXAM QUESTIONS WITH DETAILED VERIFIED ANSWERS /A+ GRADE ASSURED

What is the mechanism of action of Naloxone?

Pure opioid antagonist that competes and displaces opioids receptor sites.

What medications treat opioid disorder?

Methadone;

Buprenorphine, buprenorphine + Naloxone

What medication for opioid use disorder is used with comorbid pain?

Buprenorphine + Naloxone

Inappropriate use of what substance may be due to uncontrolled pain?

Opioids

What are the Naltrexone delivery methods?

Tablet;

Injectable;

Implant

What is one form of Naltrexone delivery method limited to inpatient use?

Implant

What is the mechanism of action buprenorphine?

Mu receptor partial agonist for opioid withdrawal

What medication taken too soon after last opioid use increases the chances of intense withdrawal that comes on very quickly (precipitated withdrawal)?

Buprenorphine

What are symptoms of opioid intoxication?

Nausea and vomiting;

Respiratory depression;

Constipation;

Itching;

Mioisis (small pupil);

Euphoria; and

Sedation

What withdrawal symptoms of opioids?

Nausea and vomiting;

Diarrhea;

Dehydration;

Irritability;

Restlessness;

Yawning;

Twitching;

Increased heart rate and blood pressure;

Chills;

Increased temperature;

Rhinorrhea;

Lacrimation;

Dilated pupils

What medication is given for opioid intoxication during cardiac or respiratory depression is a concern?

Naloxone

What are symptoms of cocaine intoxication?

Dilated pupils;

Headache;

Tremor;

Hyper-reflexia;

Twitching;

MI;

Nausea and vomiting;

Incontinence/ARF;

Rhabdomyolysis

What is the treatment for cocaine intoxication?

Benzodiazepines;

Antipsychotics;

Management of medical problems that include hypertension, stroke, cardiac arrhythmias, hyperthermia, and seizures

What would not be the treatment for chest pain and MI from cocaine?

Beta blockers are to be avoided due to unopposed a-adrenergic stimulation.

What are the symptoms for alcohol intoxication?

Blood levels;

Decreased reaction time;

Muscle incoordination;

Ataxia;

Dysarthria;

Respiratory failure;

Coma

What are the treatments for severe alcohol intoxication?

Cardiopulmonary function maintenance;

Thiamine;

Haloperidol PRN for agitation

What medication is given to prevent Wernicke's encephalopathy?

Thiamine given intramuscular or intravenously along with intravenous fluids and a banana bag

What class of drugs are to be avoided for acute alcohol intoxication?

Benzodiazepines

What is the treatment for uncomplicated alcohol withdrawal?

Benzodiazepines for symptom triggered or flexed dose.

What kind of half-life do diazepam and chlordiazepoxide have?

Longer half-life

What medications can you give for patients with hepatic dysfunction?

Oxazepam and lorazepam

What benzodiazepines with a long half-life are used to treat AUD?

Diazepam and chlordiazepoxide

What benzodiazepines with a moderate half-life are used in AUD patients with liver disease?

Oxazepam and lorazepam

What are the treatments for alcohol withdrawal symptoms?

Diazepam intravenous;

Lorazepam intravenous or intramuscular;

Thiamine intravenous or intramuscular;

Addressing electrolyte imbalances

What are the treatments for DT?

Acute care management;

Parenteral diazepam or lorazepam;

Thiamine;

Antipsychotics if necessary

What is the mechanism of action of disulfiram?

Via negative reinforcement, where drinking is avoided due to unpleasant effects.

What is the mechanism of action of Acamprosate?

NMDA receptor antagonist

How is Acamprosate cleared?

Renally

What medication can be given to patients with AUD with hepatic dysfunction?

Acamprosate

What medication is suitable for AUD with comorbid OUD?

Naltrexone

What medication reduces consumption by decreasing reinforcement properties?

Naltrexone

What medication only deals with physical dependence, but does not address the psychological component of smoking?

NRT

What medications are oral stop-smoking aids?

Varenicline;

Bupropion;

Clonidine

"Very Bad Cancer"

What are the "Very Bad Cancer" medications?

Varenicline;

Bupropion;

Clonidine

What medication for smoking cessation treatment should be observed for neuropsychiatric symptoms that include changes in behavior, hostility, agitation, depressed mood, and suicide-related events that include ideation, behavior, and attempted suicide?

Bupropion

What is the treatment for cocaine induced chest pain or myocardial infarction?

Intravenous benzodiazepines

What medications can treat agitation in patients with dementia?

Atypical antipsychotics

What type of medications are used only for short-term and acute episodes of aggression, agitation, and psychosis in patients with dementia?

Benzodiazepines

What medical emergency can be caused with TCAs, anticholinergics, benzodiazepines, non-benzodiazepines, corticosteroids, H2 blockers, and opioids in elderly patients?

Delirium

What is Kluver-Bucy syndrome?

A type of frontotemporal degeneration (FTD) that results from bilateral lesions of the medial temporal lobe and manifests with hypersexuality and hyperorality.

What type of medications are appropriate for mild to moderate dementia?

Donepezil;

Rivastigmine;

Galantamine

"Damn, Grandma's Regressing"

What are the "Damn, Grandma's Regressing" medications?

Donepezil;

Rivastigmine;

Galantamine

What is the mechanism of action of memantine?

NMDA receptor antagonist that promotes synaptic plasticity.

What medication is used for moderate to severe dementia?

Memantine

What TCA has the fewest anticholinergic effects?

Nortriptyline

What TCA is the most appropriate in the elderly?

Nortriptyline

What type of medications are preferred in the elderly?

SSRIs

What medication is the most appropriate for elderly patients with MDD, insomnia, and decreased appetite?

Mirtazapine

What medication may be used as an adjunct to antidepressants for sever depression or psychomotor retardation in low doses?

Methylphenidate

What medication is the best alternative to sedative-hypnotic use for insomnia in the elderly as it is less likely to cause memory impairment, paradoxical excitement, or rebound insomnia?

Trazadone

What is a reversible condition that may be caused by drugs, electrolyte imbalance, low O2 saturation, infection, reduced sensory input, intracranial events, urinary retention, or myocardial issues?

Delirium

What are the 4 stimulants for treating ADHD?

Methylphenidate;

Amphetamine salts;

Dexmethylphenidate;

Dextroamphetamine

What are the "Man, ADHD Does Damage" medications?

Methylphenidate;

Amphetamine salts;

Dexmethylphenidate;

Dextroamphetamine

What are the 5 non-stimulants for treating ADHD?

TCAs;

Clonidine;

Guanfacine;

Bupropion;

Atomoxetine

What are the "Calm Teens Give Better Answers" medications?

TCAs;

Clonidine;

Guanfacine;

Bupropion;

Atomoxetine

What baseline measurements are needed prior to starting treatment for ADHD?

Height;

Weight;

Blood pressure;

Heart rate;

EKG

What medication is second-line treatment, a non-stimulant, used in patients with history of SUD, or when family prefers a non-stimulant?

Atomoxetine

What types of stimulants are use when patient needs a duration of action longer than 4 hours, improves adherence, and is less likely to be abused?

Intermediate or long acting

What are common adverse effects of stimulants?

Dizziness;

Poor growth;

Decreased appetite;

Insomnia;

Mood lability

What are "Dizzy Patients Demand Immediate Monitoring" symptoms?

Dizziness;

Poor growth;

Decreased appetite;

Insomnia;

Mood lability

What symptom do children exhibit that requires blood pressure and heart rate monitoring?

Dizziness

If dizziness in children occurs at peak, what should the patient be switched to?

A longer acting formula

If a patient exhibits this stimulant associated symptom, they should be switched to a shorter acting formula?

Insomnia

Prior to starting a stimulant, the patient history, family history, and exam should be conducted with a focus on what?

Cardiovascular

What stimulant side effect may require discontinuation of medication?

Tics

What condition is pharmacological treatment initiated as first-line therapy after careful assessment and targets co-occurring disorders?

Intellectual disability

What medications should not be combined with stimulants?

SNRIs;

Mood stabilizers;

MAOIs;

Antipsychotics;

TCAs

What medications are "Stimulants Make Me Act Tense?"

SNRIs;

Mood stabilizers;

MAOIs;

Antipsychotics;

TCAs

What non-stimulant ADHD medication is most appropriate in a patient with co-occurring depression?

Bupropion

What type of medication class is considered a "reasonable choice" in a patient with co-occurring depression and anxiety?

TCA

What 2 medications are approved by the FDA to treat severe behavioral issues in ASD, specifically tantrums, self-injury, and aggression?

Risperidone;

Ariprazole

What is the on-demand treatment for premature ejaculation?

Clomipramine

What medication, if combined with nitrates, can cause an unsafe drop in blood pressure, headaches, flushing, and dizziness?

Sildenafil

What condition may be caused by physiological (medications), psychological (depression), or hormonal (abnormal levels)?

Sexual dysfunction

What is the most appropriate medication for a female with depression and hyperarousal?

Bupropion

What SSRI is most likely to cause sexual dysfunction?

Paroxetine

What SSRI may be used to treat premature ejaculation?

Paroxetine

What can be done to reduce sexual side effects caused by psychotropic medications?

Dose reduction

What is hypogonadism?

Hypoactive sexual desire in males.

Life-long rather than an acquired condition.

What is a Cluster B personality disorder that begins as a conduct disorder in childhood?

Antisocial

What is the gold-standard treatment for borderline disorder?

DBT

What class of medications are strongly discouraged in treating BPD due to risks of worsening impulsivity and suicidality?

Benzodiazepines

What type of treatment is not recommended when treating the primary traits of antisocial personality disorder?

Pharmacological

What is the treatment for male hypoactive sexual desire disorder and female sexual interest/arousal disorder?

Hormone replacement therapy

What medication is an alpha 2 agonist?

Guanfacine

What is the first-line medication for tic disoder?

Guanfacine

What are the first-line treatments options for enuresis?

Desmopressin;

Imipramine

What is the management of IDD deficits?

Behavioral therapy

What stimulant medication is FDA approved for children 6+ that should not be used in patients with pre-existing cardiac conditions?

Methylphenidate

What FDA stimulant is approved for children 3+?

Dextromethylphenidate

What non-stimulant is approved for children aged 6-17?

Guanfacine