MSN 672 Psychopathopharmacology II at Northern Kentucky University

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Ace Your Test with MSN 627 Psychopathopharmacology II Actual Questions and Solutions - Full Set

Free MSN 672 Psychopathopharmacology II at Northern Kentucky University Questions

1.

A 28-year-old male returns to the clinic and reports worsening of nightmares after taking Trazodone for one month. The PMHNP reviewed the patient’s records and notices the patient has a chronic history of PTSD and alcoholism. What is likely the most appropriate alternative treatment for this patient?

  • A. Switch to a Benzodiazepine​
  • B. Switch to Aripiprazole​
  • C. Switch to Wellbutrin​
  • D. Switch to α1 antagonists

Explanation

Explanation
α1 antagonists, such as Prazosin, are effective in treating PTSD-related nightmares and sleep disturbances. Prazosin works by blocking adrenergic activity, reducing the excessive
noradrenergic response during sleep that contributes to vivid dreams and nightmares. Unlike
benzodiazepines or antidepressants, it has minimal risk for dependency—making it particularly
appropriate for a patient with a history of alcoholism. It improves sleep quality and decreases the
frequency and severity of trauma-related nightmares.
2.

During smoking cessation, resensitized nicotinic receptors no longer receiving nicotine, and the individual experiences cravings due to an absence of dopamine release in the nucleus accumbens. What type of antidepressant medication may the PMHNP choose to assist with boosting dopamine in the nucleus accumbens to assist with the treatment of smoking cessation?

  • A. Selective serotonin reuptake inhibitor (SSRI)
  • B. Serotonin and norepinephrine reuptake inhibitor (SNRI)
  • C. Norepinephrine and dopamine reuptake inhibitors (NDRI)
  • D. Tricyclic antidepressants (TCA)

Explanation

Explanation
Norepinephrine and dopamine reuptake inhibitors (NDRIs), such as bupropion, are effective in smoking cessation because they increase dopamine levels in the nucleus accumbens, the brain’s reward center. When nicotine is removed, dopamine release drops, leading to cravings and withdrawal. NDRIs counter this deficit by boosting dopamine and norepinephrine, reducing cravings and helping with abstinence. This mechanism makes NDRIs the preferred antidepressant class for smoking cessation.
Correct Answer Is:
C. Norepinephrine and dopamine reuptake inhibitors (NDRI)
3.

Which symptoms should be reported immediately due to severity in a 15-year-old patient prescribed valproate? Select all that apply.

  • A. Vomiting​
  • B. Severe abdominal pain​
  • C. Oily, smelly stools​
  • D. Weight gain

Explanation

Explanation
A. Vomiting​
Vomiting can be an early sign of valproate-induced hepatotoxicity or pancreatitis, both of
which are medical emergencies. Any sudden or severe vomiting in a patient taking valproate
requires immediate evaluation.
B. Severe abdominal pain​
Severe or persistent abdominal pain is a classic warning sign of acute pancreatitis, a life-threatening adverse reaction to valproate. This symptom must be reported immediately for
emergency assessment.
C. Oily, smelly stools​
Oily, foul-smelling stools (steatorrhea) may indicate pancreatic dysfunction, which can occur
in valproate-induced pancreatitis. This is a red-flag symptom requiring urgent medical attention.
4.

------ and --------------, also known as α2δ ligands since they bind to the α2δ subunit of presynaptic N- and P/Q-type VSCCs, block the release of excitatory neurotransmitters such as glutamate that occurs when neurotransmission is excessive, as postulated in the amygdala to cause fear.

  • A. Gabapentin and Pregabalin​
  • B. Serotonin and Norepinephrine reuptake inhibitors (SNRIs)​
  • C. Histamine and Serotonin​
  • D. Pregabalin and Histamine

Explanation

Explanation
Gabapentin and Pregabalin are α2δ (alpha-2-delta) ligands that bind to the α2δ subunit of
presynaptic voltage-sensitive calcium channels (VSCCs), specifically the N-type and P/Q-type.
This binding reduces calcium influx and inhibits the excessive release of excitatory
neurotransmitters like glutamate. By dampening overactive neurotransmission in regions such as
the amygdala, these drugs help reduce symptoms of anxiety and fear, making them effective in
conditions like generalized anxiety disorder and neuropathic pain.
5.

Empathogens produce an altered state of consciousness described as experiences of emotional communion, oneness, relatedness, and emotional openness. Using the options below, please select the prototype empathogen.

  • A. 3,4-methylenedioxymethamphetamine (MDMA)
  • B. Phencyclidine (PCP)
  • C. Tropane Alkaloid (TK)
  • D. Gamma-hydroxybutyrate (GHB)

Explanation

Explanation
MDMA is the prototype empathogen, known for enhancing empathy, emotional closeness, and feelings of connection with others. It increases serotonin, dopamine, and oxytocin release, creating the emotional openness and interpersonal bonding characteristic of empathogens. PCP, tropane alkaloids, and GHB belong to different substance classes and do not produce the unique empathogenic effects seen with MDMA.
Correct Answer Is:
A. 3,4-methylenedioxymethamphetamine (MDMA)
6.

Which of the following neurotransmitters are considered part of the ascending reticular activating system in the brain that works together to regulate arousal? (Select all that apply.)

  • A. Histamine​
  • B. Dopamine​
  • C. Orexin​
  • D. Methylation

Explanation

Explanation
The ascending reticular activating system (ARAS) is responsible for regulating arousal,
wakefulness, and attention. Several neurotransmitters play a central role in this process:
A. Histamine​
Histamine is produced in the tuberomammillary nucleus of the hypothalamus and promotes
alertness and wakefulness. Antihistamine medications that cross the blood-brain barrier often
cause drowsiness due to histamine inhibition.
B. Dopamine​
Dopamine, released from the ventral tegmental area (VTA) and other midbrain regions, is
essential for maintaining arousal, motivation, and cognitive alertness. It supports the brain’s
reward and activation pathways that sustain wakefulness.
C. Orexin​
Orexin (also known as hypocretin), produced in the lateral hypothalamus, stabilizes
wakefulness by stimulating other arousal-promoting systems. Deficiency in orexin is associated
with narcolepsy.
7.

The PMHNP does patient education with a 24-year-old female who is prescribed a mood stabilizer. The PMHNP informed the patient that she could experience the following side effects: weight gain, hair loss, acne, tremor, sedation, decrease in kidney function, and hypothyroidism. What medication is the PMHNP most likely prescribing that is congruent with this side-effect profile?

  • A. Olanzapine​
  • B. Lithium​
  • C. Valproate​
  • D. Fluoxetine

Explanation

Explanation
B. Lithium​
This side-effect profile matches lithium more closely than any other option. Lithium commonly
causes weight gain, acne, hair loss (alopecia), tremor, and sedation. It can also lead to
decreased kidney function (nephrogenic diabetes insipidus) and hypothyroidism, both
hallmark long-term adverse effects requiring routine monitoring of renal and thyroid labs. These
combined features distinctly point toward lithium therapy.
8.

A 44-year-old unemployed male with a 20-year debilitating history of alcoholism "heavy drinker" presents to the clinic. The patient has a history of Bipolar Disorder and is currently taking lithium. The patient has not experienced withdrawal; his longest period of sobriety recently has been one week. The patient fears that he may start drinking again due to “stress.” Which of the following medications below would be most appropriate for the PMHNP to prescribe for the treatment of alcoholism for this patient?

  • A. Disulfiram
  • B. Naloxone
  • C. Acamprosate
  • D. Naltrexone

Explanation

Explanation
Acamprosate is the safest option for this patient because it does not interact with lithium, does not affect mood stability in bipolar disorder, and is indicated to help maintain abstinence in patients who have recently stopped drinking. It works by modulating glutamate and GABA balance disrupted by chronic alcohol use. Disulfiram is risky in patients with poor adherence and can worsen mood instability. Naltrexone is contraindicated in bipolar patients on lithium due to increased risk of mood destabilization and possible hepatotoxicity. Naloxone is not a treatment for alcohol use disorder.
Correct Answer Is:
C. Acamprosate
9.

A 42-year-old police officer presents to the clinic with complaints of "sleep disturbances." After sufficient consultation, you prescribe the patient eszopiclone. Which receptors are primarily being targeted by this treatment, producing the desired effect of sedation?

  • A. GABAA receptors that contain the α1 subunit/subtype​
  • B. Serotonin receptor that contains the β1 subtype/subunit​
  • C. Histamine1 receptor that contains an α2 subunit/subtype​
  • D. Histamine2 receptor that contains β2 subunits/subtypes

Explanation

Explanation
Eszopiclone, a non-benzodiazepine hypnotic (commonly known as a “Z-drug”), selectively
binds to the GABAA receptor complex containing the α1 subunit. This subunit is primarily
responsible for the sedative and hypnotic effects of GABAergic medications. When eszopiclone
enhances GABA’s action at these receptors, it increases chloride ion flow, hyperpolarizing
neurons and inducing sleep without significant muscle relaxation or anticonvulsant properties.
This selective binding explains its efficacy in treating insomnia with minimal next-day sedation.
10.

A 35-year-old man Army veteran presents with a chief complaint of excessive crying, which he notes is often triggered by thoughts of dying prior to seeing his family again. His wife reports that he is often tense and “flies off the handle,” followed by episodes of difficulty breathing and increased heart rate. The patient’s symptom of difficulty breathing is related to activation of what part of the brain?

  • A. Hippocampus​
  • B. Hypothalamus​
  • C. Parabrachial nucleus​
  • D. Periaqueductal gray

Explanation

Explanation
The parabrachial nucleus, located in the pons, plays a key role in autonomic and respiratory
regulation. It integrates input from emotional centers such as the amygdala and hypothalamus
and translates those emotional signals into physiological responses—including changes in
breathing and heart rate. In emotionally charged states such as anxiety or panic, activation of
this area can cause the sensation of difficulty breathing and hyperventilation.

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