Category: Uncategorized

Which pathway is responsible for positive symptoms?

A pregnant client reports to the clinic seeking a refill on her medications she has been noncompliant with for several of month. The PMHNP should refer the client to her OBGYN/Gynecologist.

Ms. R., a 29-year-old woman recently diagnosed with Bipolar I Disorder, is started on divalproex sodium (Depakote) for mood stabilization. During medication education, she asks, “How does this medication actually work to stabilize my mood?”As her PMHNP, you explain that valproate’s mood-stabilizing effects are related to its actions on neuronal excitability and neurotransmitter regulation.Which of the following best describes the mechanism of action of valproate?

You are the Family PMHNP-BC caring for Ms. Trottier who is in the office for a follow up appointment. Ms. Tottier has a medical history of epilepsy and hypertension.  In the prior visit, the client’s Effexor XR was increased to 150 mg daily for depressive symptoms. As the Family-PMHNP-BC for this patient, which of the following would you consider. Please choose the best option. 

Ropinirole is a dopamine agonists used to treat restless leg syndrome and does not cause somnolence or nausea.

A 27-year-old man with schizophrenia presents with persistent social withdrawal, flat affect, anhedonia, avolition, and impaired executive functioning despite adequate control of hallucinations and delusions with antipsychotic therapy. He denies paranoia or auditory hallucinations but struggles to initiate activities and maintain employment.The PMHNP recognizes that these symptoms reflect dysfunction in a specific dopamine pathway, which is not effectively targeted by strong D2 receptor blockade and may worsen with high-potency antipsychotics.Which dopamine pathway is most closely associated with the negative symptoms of schizophrenia observed in this patient?

A 25 year old woman started being treated for depression 4 days ago presents with migraine, mild confusion, lethargy, diaphoresis, flushing, tremors and myoclonic jerks. The most likely diagnosis is 

A 20 year old patient presents to your office with depression, ADHD and a desire to stop smoking cigarettes. Which one of the following medications would be the  best choice for this patient?

This test consists of: (1) a multiple-choice questions and true and false. Each question in the first section is a treu or false or a multiple-choice question with four answer choices. Read each question and answer choice carefully and choose the ONE best answer

A 28-year-old female presents to the clinic with a “paralyzing” fear of public speaking that has recently begun to interfere with her career as a marketing executive. She describes episodes of heart racing, shortness of breath, and trembling whenever she is required to lead a meeting. She requests a “fast-acting pill” she can take only when she has a presentation. Upon further assessment, the PMHNP notes the patient also experiences generalized worry on most days, muscle tension, and significant avoidance of social gatherings.Which of the following represents the most appropriate pharmacological strategy for this patient, and what is the neurobiological rationale for the choice?