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    Exam Review

    1. Which of the two following medication classes are useful in the treatment of fibromyalgia?
      (SATA)
      A)
      Tricyclic Antidepressants (TCA)
      B)
      Serotonin-norepinephrine reuptake inhibitors (SNRI)
      C)
      Bisphosphonates
      D)
      Anticholinergics
    2. The benzodiazepine among the following with the longest half-life is:
      A)
      Oxazepam (Serax)
      B)
      Diazepam (Valium)
      C)
      Lorazepam (Ativan)
      D)
      Clonazepam (Klonopin)
    3. A patient who has been taking Sertraline (Zoloft) for 12 weeks reports increased appetite and increased concentration, but continues to complain of having little interest in socializing. Which complimentary therapy would be best for this patient?
      A)
      Folate
      B)
      St. John's Wort
      C)
      SAMe
      D)
      Omega-3
    4. A patient diagnosed with major depressive disorder who has a history of non-adherence to medications presents to the outpatient clinic with complaints of feeling lightheaded, nausea, irritability and anxiety. Nurse Practitioner suspects that the patient is experiencing which of the following syndromes?
      A)
      Serotonin Syndrome
      B)
      Discontinuation syndrome
      C)
      Parasympathetic syndrome
      D)
      Neuroleptic malignant syndrome
    Page 1 of 13

    Exam Review

    1. Which of the following are rare but serious adverse reactions to Escitalopram (Lexapro) therapy?
      A)
      QTc prolongation
      B)
      Serotonin syndrome
      C)
      Suicidal thoughts
      D)
      All of the above
    2. All four patients below have classic migraine headaches. Which of the following patients can you safely prescribe Triptan therapy?
      A)
      A 40 year old who uses Ambien (Zolpidem) for insomnia
      B)
      A 26 year old who might be pregnant
      C)
      A 42 year old who takes blood pressure medicine
      D)
      A 55 year old who uses sublingual nitroglycerin
    3. What serious adverse event should be watched for when prescribing Carbamazepine (Tegretol) to a patient for generalized tonic-clonic seizures?
      A)
      Steven-Johnsons Syndrome
      B)
      Hepatitis
      C)
      Homicidal thoughts
      D)
      Megaloblastic anemia
    4. Which of the following statements concerning levodopa (Duodopa) and carbidopa (Lodosyn) for Parkinson's disease is FALSE?
      A)
      They treat only the symptoms of Parkinson's disease
      B)
      They reverse the effects of Parkinson's disease
      C)
      Carbidopa permits higher levels of levodopa to be available in the brain
      D)
      Patients eventually require more frequent dosing intervals
    Page 2 of 13

    Exam Review

    1. Benzodiazepines work predominantly by affecting:
      A)
      Serotonin reuptake
      B)
      Monoamine oxidase
      C)
      Norepinephrine
      D)
      GABA (gamma amino butyric acid)
    2. The healthcare provider is planning to prescribe Buprenorphine (Suboxone) for a patient diagnosed with an opioid use disorder. What assessment observations support the appropriateness of the intervention? SELECT 3
      (SATA)
      A)
      Patient is diaphoretic.
      B)
      Patient reports being "constipated for nearly one week."
      C)
      Patient reports a headache that has lasted 12 hours
      D)
      Erythema noted about the face, neck, and upper trunk.
    3. What are the goals of drug therapy for Alzheimer's Disease? SELECT TWO
      A)
      Significantly improve memory and forgetfulness associated with Alzheimer's Disease
      B)
      Slow progression of cognitive, behavioral, and functional domains of Alzheimer's Disease
      C)
      Stop progression of Alzheimer’s Disease
      D)
      Maintain patient's functional ability and quality of life for as long as possible
    4. A patient presents to the office with a history of hypertension and migraine headache. His blood pressure is not well controlled at 142/90. He has failed to control his headache pain with indocin. He has headaches several times per week and wants treatment to prevent headaches. Your best option from the choices below is
      A)
      Sumatriptan (Imitrex)
      B)
      Propranolol (Inderal)
      C)
      Ergotamine (Cafergot)
      D)
      Amitriptyline (Elavil)
    Page 3 of 13

    Exam Review

    1. Mu receptors are the target of opioids. Opioids have various side effects, many of which are due to Mu receptors found in all below EXCEPT.
      A)
      Peripheral neurons
      B)
      Brain and spinal cord
      C)
      Gastrointestinal tract
      D)
      Renal arteries
    2. What type of benzodiazepine is best for a patient who has difficulty with falling asleep?
      A)
      Short-acting
      B)
      Long-acting
      C)
      Intermediate-acting
      D)
      Transitional-acting
    3. Why does cannabis overdose NOT result in fatal respiratory depression?
      A)
      Cannabis users do not consume opioids.
      B)
      Cannabinoid receptors increase respiratory drive.
      C)
      Cannabinoids have no psychoactive effect
      D)
      Cannabinoid receptors are effectively absent in the brainstem and cardiorespiratory centers.
    4. Which class of drugs is considered first-line treatment for Restless Leg Syndrome/Willis-Ekbom disease?
      A)
      Dopamine agonists
      B)
      Benzodiazepines
      C)
      Psychostimulants
      D)
      Opioids
    Page 4 of 13

    Exam Review

    1. Patients taking a norepinephrine-dopamine reuptake inhibitor such as Wellbutrin (bupropion) are at risk for:
      A)
      Circulatory disorder
      B)
      Seizures
      C)
      Sedation
      D)
      Vomiting
    2. A patient diagnosed with Parkinson disease (PD) has been prescribed benztropine (Cogentin). What information will the healthcare provider prescribing the medication share with the patient?
      A)
      "This medication may help your narrow-angle glaucoma.
      B)
      "You may experience mild improvement in both your short- and long-term memory."
      C)
      “The medication may trigger temporary drooling."
      D)
      "You will feel the effects of the medication in about one hour."
    3. Which of the following is true about Levodopa? SELECT TWO
      A)
      It cannot cross the blood brain barrier unless given with Dopamine.
      B)
      It should not be given in patients with history of hypertension.
      C)
      It is the most effective treatment for symptomatic relief of Parkinson's Disease
      D)
      It is given with Carbidopa to limit peripheral breakdown of levodopa.
    4. Dronabinol (Marinol, Syndros) is an example of what type of cannabinoid?
      A)
      Phytocannabinoid.
      B)
      Endocannabinoid
      C)
      Synthetic cannabinoid.
      D)
      Illegal cannabinoid.
    Page 5 of 13

    Exam Review

    1. The Nurse Practitioner prescribes a patient Escitalopram (Lexapro) for Major Depressive Disorder. How long does it take for the medication to show efficacy?
      A)
      Five to ten days.
      B)
      Six to twelve hours
      C)
      Two to four hours
      D)
      Four to six weeks.
    2. Which of the following is an example of a drug that blocks the reuptake of both serotonin and norepinephrine into cells in the brain?
      A)
      Venlafaxine (Effexor)
      B)
      Diazepam (Valium)
      C)
      Phenelzine (Nardil)
      D)
      Citalopram (Celexa)
    3. The Advanced Practice Provider knows which of the following scenarios is consistent with a neuropathic pain presentation?
      A)
      A 23-year-old man with mechanical low back pain after moving boxes.
      B)
      A 76-year-old woman post-operative for acute appendicitis
      C)
      A 70-year-old woman with mucosal ulcerations from chemotherapy
      D)
      A 56-year-old with diffuse pain after a cerebrovascular accident (CVA)
    4. A patient returns to the clinic for migraine follow up. They were started on Topiramate (Topamax) 6 weeks ago, however headache days have not decreased, partly because the patient has not been taking medication consistently due to busy work and life schedule. What is an appropriate 2nd line agent to start on this patient given their lifestyle?
      A)
      Verapamil (Calcium Channel Blocker)
      B)
      Botox (Neuromuscular blocker)
      C)
      Ajovy (CGRP inhibitor)
      D)
      Dexamethasone (Corticosteriod)
    Page 6 of 13