Medications Flashcards
7 cards from real Psychiatric-Mental Health Nurse Practitioner Exam practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Medications flashcards as text
A patient on bupropion reports new-onset generalized tonic-clonic seizure. Which pre-existing condition most likely increased this risk?
Answer: Bulimia nervosa
Bupropion lowers seizure threshold and is contraindicated in patients with eating disorders such as bulimia nervosa due to electrolyte imbalances that further increase seizure risk.
Which benzodiazepine is preferred in elderly patients due to its lack of active metabolites and shorter half-life?
Answer: Lorazepam
Lorazepam undergoes direct glucuronidation without active metabolites and has a shorter half-life, reducing cumulative CNS depression in elderly patients (LOT = Lorazepam, Oxazepam, Temazepam preferred).
A patient with schizophrenia on risperidone develops gynecomastia and galactorrhea. What is the most likely cause?
Answer: Tuberoinfundibular dopamine blockade causing hyperprolactinemia
Risperidone strongly blocks D2 receptors in the tuberoinfundibular pathway, removing dopamine's inhibitory tone on prolactin secretion, resulting in hyperprolactinemia.
Which mood stabilizer has the most evidence for suicide prevention in patients with bipolar disorder?
Answer: Lithium
Lithium has robust long-term evidence for reducing suicide and suicidal behavior in patients with mood disorders, likely through serotonergic and neuroprotective mechanisms.
A patient being treated with an SSRI for 6 weeks reports worsening anxiety and insomnia in the first 2 weeks but has now improved. What was the most likely early mechanism causing the initial worsening?
Answer: Initial excessive serotonergic stimulation of 5-HT2 receptors before autoreceptor desensitization
SSRIs initially overstimulate postsynaptic 5-HT2 receptors before somatodendritic 5-HT1A autoreceptors desensitize, causing transient anxiety, agitation, and insomnia.
Which of the following is a black box warning associated with atomoxetine (Strattera)?
Answer: Increased suicidal ideation in children and adolescents
Atomoxetine carries a black box warning for increased suicidal ideation in pediatric patients, requiring close monitoring especially during dose initiation and adjustment.
A patient with bipolar I disorder needs an antimanic agent but has liver disease precluding valproate use and renal disease precluding lithium. Which atypical antipsychotic is FDA-approved for acute mania with the least metabolic risk?
Answer: Ziprasidone
Ziprasidone is FDA-approved for acute manic episodes and has the lowest weight-gain and metabolic risk profile among second-generation antipsychotics, though it requires QTc monitoring.