NU643 Advance Psychopharmacology
Week 15 Quiz
Question 1 A 28 y.o. male presents with a severe alcohol abuse problem and you are discussing pharmacotherapy as part of his treatment plan. You advise naltrexone and use which of the following statements to help with you explanation?
Select one:
a.Naltrexone blocks mu-opioid receptors to reduce the euphoria you might normally experience with heavy drinking.
b.Naltrexone blocks metabotropic glutamate receptors to reduce the euphoria you might normally experience with heavy drinking.
c.Naltrexone stimulates mu-opioid receptors to the euphoria you might normally experience with heavy drinking.
d.Naltrexone stimulates metabotropic glutamate receptors to the euphoria you might normally experience with heavy drinking.
: Blocking the mu-opioid receptors is thought to reduce the desire to engage in heavy drinking activity, because doing so will be associated with a reduced reward.
Question 2A 73-year-old male presents as a new patient with a history of long-term use of clonazepam 1mg QID. Which of the following actions is appropriate in the first visit?
Select one:
a.Continue with treatment plan already established by previous provider.
b.Initiate an immediate benzodiazepine taper.
c.Begin cross taper from clonazepam to dose equivalent diazepam.
d.Assess for safety, educate about the associated risks of benzodiazepines, begin discussion about tapering the medication, obtain and document informed consent.
Question 3A clinician is considering treatment options for a 28-year-old female with ADHD who has a history of alcohol and marijuana abuse. Which of the following statements accurately explains the effects of different stimulant formulations on neuronal firing?
Select one:
a.Pulsatile stimulation amplifies undesirable phasic dopamine and norepinephrine firing, which can lead to euphoria and abuse.
b.Immediate-release stimulants lead to tonic firing, which can lead to euphoria and abuse.
c.Tonic firing is the result of rapid receptor occupancy and fast onset of action as see with extended-release formulations
d.Extended-release formulations result in phasic stimulation of norepinephrine and dopamine signals, but this does not result in euphoria and abuse.
Question 4According to DSM-5 criteria, what is the maximum age threshold for symptom onset when determining a diagnosis of ADHD?
Select one:
a.5
b.7
c.12
d.15
Question 5 Based on the Carlat reading, "Diet and Mental Health," what dietary recommendations would be most useful for mental health patients?
Select one:
a.Recommendations to eliminate dietary fat.
b.Recommendations that patients choose foods that are labeled sugar free or fat free.
c.Recommendations that patients eliminate carbohydrates.
d.Specific suggestions for following a whole-food diet.
Question 6Buspirone is indicated for which anxiety disorder?
Select one:
a.Generalized anxiety disorder
b.Panic disorder
c.Posttraumatic stress disorder
d.Social phobia
Question 7Carbamazepine has a half-life of approximately 12 hours. The clinical implications of this are ________.
Select one:
a.Carbamazepine will be 50% less effective 12 hours after taking the medication.
b.Carbamazepine requires once daily dosing.
c.therapeutic blood monitoring of carbamazepine should not occur before 2½ days of starting the medication.
d.one-half of the dose of carbamazepine will be excreted from the kidneys in 12 hours.
Question 8Elimination of a drug can be impacted by all of the following scenarios EXCEPT ________.
Select one:
a.a low-fat diet
b.metabolic acidosis, in which plasma pH is lowered
c.concurrent use of loop diuretics
d.dehydration
Question 9Nootropics are best described as ________.
Select one:
a.supplements that are believed to inhibit glutamate and be neuroprotective
b.supplements that are believed to enhance cognition
c.supplements that are used illicitly for their euphoric effects
d.supplements that newly developed without problematic side effects
Question 10Problems with selective attention associated with ADHD are hypothetically regulated by the:
Select one:
a.anterior cingulate cortex
b.orbital frontal cortex
c.prefrontal motor cortex
d.dorsolateral prefrontal cortex
Question 11The medication side effect mostly to result in aggression or violence is ________.
Select one:
a.akathisia
b.tardive dyskinesia
c.hyperreflexia
d.insomnia
Question 12The psychiatric disorder(s) most likely to result in aggression or violence is (are) ________.
Select one:
a.psychotic disorders
b.substance use disorders
c.personality disorders
d.bipolar disorder
Question 13Use the following CYP450 table to hypothesize drug interactions and their clinical significance for a patient on sertraline who begins regularly taking over-the-counter ibuprofen.
Select one:
a.Sertraline levels would decrease, placing the patient at risk for re-emergence of depressive symptoms.
b.Sertraline levels would increase, placing the patient at risk for worsening side effects.
c.Ibuprofen levels would decrease, decreasing the amount of pain relief.
d.Ibuprofen levels would increase, placing the patient at the risk for side effects.
e.There is no theoretical interaction between these two medications.
Question 14What pathway mediates prolactin and is involved in changes in prolactin levels?
Select one:
a.Nigrostriatal
b.Mesocortical
c.Mesolimbic
d.Tuberoinfundibular
Question 15When a patient achieves remission of depression, what is the recommended length of time that treatment should continue?
Select one:
a.The recommended length of treatment depends on the number of depressive episodes that a patient has had.
b.A patient should continue treatment for a minimum of six months.
c.A patient should continue treatment for a minimum of one year.
d.A patient should continue treatment indefinitely.
Question 16When comparing naltrexone with acamprosate for alcohol dependence, which of the following statements is TRUE?
Select one:
a.Acamprosate is preferred for patients with renal disease.
b.Acamprosate is preferred for patients with co-occurring opiate use.
c.Naltrexone is preferred for patients with low alcohol use.
d.Acamprosate and naltrexone are equally effective with similar side effect profiles.
Question 17When comparing serotonin syndrome to hypertensive crisis, which of the follow statements is TRUE?
Select one:
a.Only serotonin syndrome involves hypertension.
b.Only hypertensive crisis is considered life threatening.
c.Both syndromes can be managed with outpatient treatment.
d.Although both syndromes have muscular symptoms, only serotonin syndrome has hyperreflexia and myoclonus.
Question 18When considering length of action of benzodiazepines, which of the following statements is TRUE?
Select one:
a.The length of action of a benzodiazepine is a direct relationship to its half-life.
b.Long-acting benzodiazepines are more habituating and put patients at greater risk for dependence than short-acting benzodiazepines.
c.Short-acting benzodiazepines are preferred over long-acting benzodiazepines for scheduled use.
d.Both short-acting and long-acting benzodiazepines have been associated with increased risk for the development of dementia.
Question 19When considering metabolic risk associated with atypical antipsychotics, which of the following statements is TRUE?
Select one:
a.Metabolic risk is due to weight gain which is secondary to increased appetite and caloric intake.
b.Patients taking atypical antipsychotics are at increased risk for diabetes and cardiovascular disease.
c.Metabolic syndrome is a rare side effect of atypical antipsychotics.
d.If a patient does not have metabolic risk factors at the initiation of an atypical antipsychotic, they are unlikely to develop metabolic syndrome later in treatment.
Question 20When considering the neuroscience of addiction, which of the following statements is true?
Select one:
a.Most addiction is the result of stimulation of serotonergic pathways in the brain.
b. Compulsive behaviors in the dorsal regions of the brain often precede impulsivity in the ventral regions of the brain.
c.Dopamine pathways are implicated in all substances of abuse.
d.Glutamate pathways are associated with the reward aspects of substance abuse.
Question 21When documenting the objective portion of a psychiatric treatment note, which if the following is included?
Select one:
a.Statements made by the patient
b.Behaviors witnessed by the clinician
c.Collateral information obtained from family members
d.Collateral information obtained from chart review
Question 22When monitoring patients on psychostimulants, which of the following is NOT a consideration?
Select one:
a.Glucose
b.Weight
c.Blood pressure
d.EKG
Question 23When prescribing atypical antipsychotic medications, which of the following statements is MOST true?
Select one:
a.There is elevated risk of cerebrovascular events for all patient populations.
b.The FDA has issued a black box warning for metabolic syndrome on all atypical antipsychotics.
c.Atypical antipsychotics are not approved for the treatment of geriatric dementia-related psychosis and carry increased risk of mortality in this population.
d.Atypical antipsychotics do not require monitoring for tardive dyskinesia.
Question 24When prescribing for preschool-aged children, which of the following statements is TRUE?
Select one:
a.Research on the very young has led to several FDA-approved medications for psychiatric disorders.
b.SSRIs are first-line treatment for depression in very young children
c.SSRIs are first-line treatment for anxiety disorders in very young children.
d.Behavioral and psychotherapeutic interventions are first-line treatment for all psychiatric disorders in preschool-aged children.
Question 25When prescribing guanfacine, the clinician should consider which of the following?
Select one:
a.Guanfacine can worsen motor tics.
b.Rebound hypertension can occur when abruptly stopping Guanfacine.
c.If a patient forgets to take their medication for a few days, they should resume their previous dose.
d.Patients should be advised to take the guanfacine in the morning, because it may contribute to insomnia with qHS dosing.
Question 26When tapering someone from long-term benzodiazepine use, which of the following is TRUE?
Select one:
a.The clinician should present as a firm and directive authority when initiating benzodiazepine tapers.
b.Patients who resist benzodiazepine tapers are likely misusing the medication.
c.It is best begin a benzodiazepine taper with a long-acting benzodiazepine for increased tolerance to the taper.
d.Most benzodiazepine tapers can be achieved quickly, by reducing dose 25% per week over the course of a month.
Question 27When treating acute aggression, which of the following medication combinations is a suggested treatment:
Select one:
a.Sertraline + quetiapine
b.Propranolol + buspirone
c.Paroxetine + buspirone
d.Haldol +lorazepam
Question 28When, in the course of psychiatric care, should safety be assessed?
Select one:
a.At the beginning of treatment
b.Once a therapeutic alliance is formed
c.At every appointment
d.Safety is best addressed by case managers and therapists
Question 29Which ADHD symptoms most commonly present in adults?
Select one:
a.Hyperactivity
b.Impulsivity
c.Inattention
d.Depressed mood
Question 30Which antidepressant is LEAST likely to cause sexual side effects?
Select one:
a.Paroxetine
b.Fluoxetine
c.Bupropion
d.Mirtazapine
Question 31Which antipsychotic carries the HIGHEST risk of QTc prolongation?
Select one:
a.Clozapine
b.Olanzapine
c.Ziprasidone
d.Perphenazine
Question 32Which atypical antipsychotic carries the HIGHEST risk for EPS?
Select one:
a.Clozapine
b.Olanzapine
c.Risperidone
d.Ziprasidone
Question 33Which medication is NOT considered appropriate for the treatment of acute bipolar mania?
Select one:
a.Valproic acid
b.Lithium carbonate
c.Lamotrigine
d.Olanzapine
Question 34Which of following statements is TRUE about the use of clonidine and propranolol in the treatment of anxiety?
Select one:
a.Clonidine and propranolol should be scheduled twice daily to be effective anti-anxiety agents.
b.Clonidine and propranolol target the physiologic symptoms associated with anxiety.
c.Clonidine and propranolol are effective for the treatment of worry associated with anxiety.
d.Clonidine and propranolol are well tolerated in individuals with a history of hypotension.
Question 35Which of the follow statements is TRUE about antidepressant side effects?
Select one:
a.Side effects rarely resolve on their own.
b.The most common side effects are also the most bothersome to patients.
c.Discussing possible side effects before starting medication is associated with patients staying on medications longer.
d.Patients are likely to self-report side effects.
Question 36Which of the follow foods would be considered safe when consumed concurrently with a monoamine oxidase inhibitor?
Select one:
a.A pint of craft beer
b.A platter of aged cheese
c.A bowl of ice cream
d.A ham sandwich
Question 37Which of the following statements about metabolic syndrome is TRUE?
Select one:
a.Diagnosis of metabolic syndrome is determined by change in BMI.
b.Elevated fasting blood glucose is rarely an indicator of the development of metabolic syndrome.
c.Thyroid (TSH/T4) monitoring should occur at baseline and every six months.
d.Diet and lifestyle education should be included as a strategy for reducing risk of metabolic syndrome.
Question 38Which of the following BEST describes history of presenting illness?
Select one:
a.Current symptoms and the environment in which they present
b.A quote from the patient describing the reason for seeking treatment
c.A comprehensive review of the patient’s psychiatric history
d.Current laboratory and diagnostic findings
Question 39Which of the following is NOT considered relevant to choosing a psychiatric medication?
Select one:
a.The patient's medication preference
b.Past psychiatric medications
c.The insurance formulary
d.The patient's marital status
Question 40Which of the following BEST describes the mental status exam?
Select one:
a.The mental status exam is a clinical snapshot of the patient's presentation at the time of assessment.
b.The mental status exam is a formalized cognition test.
c.The mental status exam is only recorded on initial assessments.
d.The mental status exam assesses fixed features of a patient's personality and behaviors.
Question 41Which of the following is NOT a red flag for prescription drug misuse?
Select one:
a.The Prescription Monitoring Program shows a patient has prescriptions filled at multiple pharmacies.
b.A patient requests to decrease the dose of his controlled substance.
c.A patient reports that her prescription has been stolen and requests an early refill.
d.A patient requesting a controlled substance reports having two previous providers in the past year.
Question 42Which of the following statements is TRUE about psychotherapy and the treatment of depression?
Select one:
a.Psychotherapies do not create epigenetic changes in the brain.
b.Psychotherapy can work synergistically with psychotropic medication.
c.CBT has poor evidence as an adjunctive treatment for depression.
d.Evidence for psychotherapy in depression is limited to mild depression.
Question 43Which of the following statements about telepsychiatry is TRUE?
Select one:
a.Research evidence has shown that telepsychiatry is less effective than face-to-face visits.
b.Insurance is required to reimburse telepsychiatry visits.
c.State practice laws regarding telepsychiatry vary.
d.Video conferencing applications such as Skype and Google Hangout are verified as HIPPA compatible.
Question 44Which of the following helps improve patient adherence to treatment?
Select one:
a.Prescribing a medication regimen that requires frequent daily doses.
b.Brief, simplified patient instruction.
c.Involving the patient in the plan of care.
d.Avoiding discussions about adherence.
Question 45Which of the following methods of drug delivery is slowest to reach the bloodstream?
Select one:
a.Sublingual formulations
b.Oral pills
c.IM route
d.IV route
Question 46Which of the following statements about disulfiram is true?
Select one:
a.Disulfiram works by blocking the action of acetaldehyde dehydrogenase.
b.Disulfiram increases abstinence rates when compared to placebo.
c.Disulfiram decreases alcohol craving when compared to placebo.
d.Disulfiram is considered a safe medication with few contraindications.
Question 47Which of the following statements is true about drug distribution?
Select one:
a.Most psychotropic medications are lipophobic and water soluble.
b.Psychotropic medications are most highly concentrated in plasma.
c.Body composition does not impact drug distribution.
d.Protein binding of psychotropic drugs can impact their availability at receptor sites.
Question 48Which of the following statements is TRUE about neuronal gene expression?
Select one:
a.Environmental factors can alter a neuron's gene expression.
b.Gene expression is determined in development.
c.Inactive genes remain inactive throughout a neuron's lifetime.
d.Only active genes can be targets of psychotropic medications.
Question 49Which of the following statements about genetic testing for psychiatry is TRUE?
Select one:
a.Gene expression and pharmacokinetics are consistent between individuals with a given gene.
b.Genetic testing is proven effective in predicting response to antidepressant treatment.
c.Genetic testing has shown modest benefit in predicting response to antidepressant treatment.
d.Genetic testing has been shown to be no better than treatment as usual in predicting response to antidepressants.
Question 50Which of the following describes a component of pharmacodynamics?
Select one:
a.The effects of taking a medication with an antacid
b.The percent fat content in the body
c.The receptor binding site of the drug
d.Kidney function
Question 51Which of the following statements is TRUE about mirtazapine?
Select one:
a.Mirtazapine is a serotonin and norepinephrine reuptake inhibitor.
b.Mirtazapine is a poor choice for patients with comorbid anxiety.
c.Mirtazapine has side effects of weight gain and sedation.
d.Mirtazapine carries risks for hepatotoxicity and should be avoided in patients with liver disease.
Question 52Which of the following antipsychotics is LEAST likely to cause significant weight gain?
Select one:
a.Clozapine
b.Olanzapine
c.Risperidone
d.Ziprasidone
Question 53Which of the following statements is TRUE about tardive dyskinesia?
Select one:
a.Tardive dyskinesia is a movement disorder characterized by slow, shuffling gait.
b.Tardive dyskinesia is an acute (short duration) side effect of antipsychotic medication.
c.Elderly patients may develop tardive dyskinesia sooner in treatment than younger patients.
d.The FDA-approved drug, Valbenazine, is an affordable treatment option for most patients.
Question 54Which of the following is TRUE about antidepressants and bleeding?
Select one:
a.Serotonin reuptake inhibition increases serotonin in the platelets.
b.Bleeding is a common adverse side effect of antidepressant treatment.
c.All antidepressants can cause bleeding.
d.Concurrent use of antidepressants and NSAIDS can increase risk of bleeding.
Question 55Which of the following is TRUE about hyponatremia and antidepressants?
Select one:
a.Hyponatremia is common throughout the course of antidepressant treatment.
b.Symptoms of hyponatremia include lethargy, delirium, and nausea.
c.Once present, hyponatremia is unlikely to resolve.
d.Hyponatremia occurs with equal incidence across the lifespan.
Question 56Which of the following antidepressant side effects may resolve with time?
Select one:
a.Sexual side effects
b.Agitation
c.Weight gain
d.Apathy
Question 57Which of the following statements about FDA warnings and antidepressants in children and adolescents is TRUE?
Select one:
a.Antidepressant use has been shown to lead to an increase in completed suicides in children and adolescents.
b.Antidepressants are contraindicated with the treatment of child and adolescent depression and anxiety.
c.For moderate to severe anxiety and depression, antidepressant benefit may outweigh risks.
d.Untreated depression in children and adolescents rarely has adverse long-term consequences.
Question 58Which of the following statements about bupropion is TRUE?
Select one:
a.Bupropion may help with symptoms of attention and focus in patients with ADHD.
b.Bupropion is a preferred antidepressant for patients with comorbid seizure history.
c.Bupropion is recommended for patients with eating disorder.
d.Bupropion is a preferred antidepressant for patients with intermittent explosive disorder.
Question 59Which of the following SSRI medications would be considered first-line treatment for generalized anxiety disorder?
Select one:
a.Clonazepam
b.Buspirone
c.Sertraline
d.Hydroxyzine
Question 60Which of the following statements about long-acting injectable (LAI) antipsychotics is TRUE?
Select one:
a.There is strong evidence for the efficacy of LAIs in nonadherent patients.
b.LAIs are often an affordable alternative for patients stable on oral antipsychotics.
c.LAI antipsychotics have a short half-life and reach clinical efficacy quickly.
d.Patients with a history of neuroleptic malignant syndrome should not be initiated on LAI antipsychotics.
Question 61Which of the following is a potentially serious side effect of oxcarbazepine?
Select one:
a.Neuroleptic malignant syndrome
b.Akathisia
c.Hyponatremia
d.Renal toxicity
Question 62Which of the following agents is considered to have the BEST evidence for augmentation in the treatment of depression?
Select one:
a.Bupropion
b.Lithium
c.Methylphenidate
d.Haloperidol
Question 63Which of the following statements about lithium carbonate is TRUE?
Select one:
a.Lithium carbonate should be considered a second-line treatment for bipolar disorder.
b.There is increased risk of suicidality in patients taking lithium carbonate.
c.Kidney impairment after long-term lithium treatment is a common adverse side effect.
d.Hepatotoxicity increases when lithium is combined with an atypical antipsychotic.
Question 64Which of the following statements about lamotrigine is TRUE?
Select one:
a.Lamotrigine is FDA approved for bipolar mania.
b.Lamotrigine is FDA approved for bipolar depression.
c.Lamotrigine carries a black box warning for potentially life-threatening rash.
d.When initiating lamotrigine, it is best to start at full therapeutic dose.
Question 65Which of the following statements is TRUE about psychostimulants?
Select one:
a.They are schedule IV medications.
b.Prescriptions can be written for 30 days with one refill only.
c.A patient must provide the pharmacy with a hard copy of the prescription or an electronic transmission.
d.Psychostimulants are rarely misused or abused.
Question 66Which of the following is NOT a potentially serious side effect of psychostimulants?
Select one:
a.Cardiac events
b.Hyponatremia
c.Exacerbation of tic disorders or new-onset Tourette's
d.Psychosis or aggression
Question 67Which of the following statements about benzodiazepines in the treatment of bipolar disorder is TRUE?
Select one:
a.Benzodiazepines are effective mood-stabilizing agents.
b.Benzodiazepine monotherapy is a second-line treatment for bipolar disorder.
c.Adjunctive use of benzodiazepines with mood stabilizers is useful for agitation and insomnia.
d.Adjunctive use of benzodiazepines boosts the antidepressant effects of other mood stabilizers.
Question 68Which of the following statements about benzodiazepines is TRUE?
Select one:
a.Treatment guidelines recommend benzodiazepines as first-line treatment for anxiety disorders.
b.When used as prescribed, tolerance to benzodiazepines is unlikely to develop.
c.Seizure risk is high with abrupt cessation from long-term benzodiazepine use.
d.Patients in full sustained remission from alcohol-use disorders are at no greater risk on benzodiazepines than the general population.
Question 69Which of the following statements is TRUE about duloxetine?
Select one:
a.Duloxetine is a SSRI.
b.Duloxetine is FDA approved for migraines.
c.Duloxetine carries risks for heptaotoxicity and should be avoided in patients with liver disease.
d.Duloxetine is associated with unexplained weight gain.
Question 70Which of the following statements about the CIWA-Ar and COWS is TRUE?
Select one:
a.The CIWA-Ar and COWS evaluate the severity of an individual's addiction.
b.The CIWA-Ar grades the severity of alcohol intoxication and COWS grades the severity of opiate intoxication.
c.The CIWA-Ar and COWS can guide treatment decisions for withdrawal states.
d.The CIWA-Ar and COWS are research instruments without significant clinical application.
Question 71Which of the following statements regarding suicide and antidepressant use is TRUE?
Select one:
a.Antidepressant use lowers the incidence of suicide in patients over 65.
b.Antidepressant use increases incidence of completed suicides in young adults (ages 18Ð24).
c.The incidence of suicide in young adults on antidepressants is statistically significant.
d.There is no correlation between antidepressant use and suicidality.
Question 72Which of the following statements about anxiety disorders and depressive disorders is TRUE?
Select one:
a.It is important to have a clear diagnosis before making treatment decisions for either anxiety or depressive disorders.
b.Symptoms of fear and worry are hallmarks of both anxiety and depressive disorders.
c.Concentration impairments differentiate depressive disorders from anxiety disorders.
d.Overlapping symptoms of depression and anxiety suggest that both disorders can be targeted with the same first-line agents.
Question 73Which of the following is NOT considered efficacious in bipolar depression?
Select one:
a.Lithium carbonate
b.Lamotrigine
c.Quetiapine
d.Valproic Acid
Question 74Which of the following medications is considered second-line (second-tier) treatment for bipolar disorder?
Select one:
a.Valproic acid
b.Carbamazepine
c.Olanzapine
d.Oxcarbazepine
Question 75Which of the following statements is true about behaviors in addiction?
Select one:
a.Addiction is always driven by the associated pleasurable effects of using a substance.
b.Dopaminergic neurons begin responding to environmental reminders of use through conditioned responses.
c.Drug seeking behavior is modulated by acetylcholine.
d.Up-regulation of dopamine signaling in prefrontal brain regions impair executive processes (self-regulation, decision making, etc.).
Question 76Which of the following may be helpful for treating symptoms of ADHD?
Select one:
a.Sertraline
b.Fluoxetine
c.Bupropion
d.Mirtazapine
Question 77Which of the following is thought to be diagnostic for Alzheimer’s Disease:
Select one:
a.Amyloid plaque deposition in the brain
b.Fluctuating attention
c.Chorea
d.Presence of Lewy bodies in the brain
Question 78Which of the following statements about managing behavioral and psychological symptoms of dementia is TRUE?
Select one:
a.Conventional antipsychotics are considered first-line treatment for behavioral and psychological symptoms of dementia.
b.Long-acting scheduled use of benzodiazepines is second-line treatment for behavioral and psychological symptoms of dementia.
c.Habilitation therapy, the practice of understanding problematic behaviors as communications of a need and then finding ways to meet that need, has been shown to reduce agitation.
d.Directive language that seeks to explain the present is the preferred communication for de-escalation.
Question 79Which of the following statements about memantine is TRUE?
Select one:
a.Memantine is FDA approved for treatment of mild dementia.
b.Memantine is a NMDA receptor antagonist and is hypothesized to reduce abnormal activation of glutamate.
c.Memantine has been shown to reduce agitation in dementia.
d.Memantine has been shown to result in robust improvement in cognition.
Question 80
Which of the following statements about substance dependence is TRUE?
Select one:
a.Persons with a history of substance dependence should never be prescribed psychoactive substances.
b.Persons with a history of substance dependence are vulnerable to craving or relapse following exposure to any psychoactive substance.
c.Persons with a history of substance dependence are vulnerable to craving or relapse following exposure ONLY TO their substance of addiction.
d.Vulnerability to craving or relapse following exposure to a psychoactive substance diminishes the longer an individual is abstinent.
Question 81Which of the following statements about opioid withdrawal is TRUE?
Select one:
a.Left untreated, opioid withdrawal can be fatal.
b.Patients who experience discomfort in opioid withdrawal are less likely to relapse on opiates in the future.
c.Clonidine treats myalgias, insomnia, and craving.
d.Buprenorphine should not be administered until a patient is in moderate opioid withdrawal.
Question 82Which of the following conditions is considered PHYSIOLOGICALLY safe?
Select one:
a.Alcohol intoxication
b.Benzodiazepine withdrawal
c.Opioid intoxication
d.Opioid withdrawal
Question 83Which of the following statements about preventing and recognizing prescription drug misuse is TRUE?
Select one:
a.Scheduled urine drug screens are recommended for patients on controlled substances.
b.A urine drug screen that is NEGATIVE for a prescribed controlled substance is common and acceptable.
c.Patients with active substance use should not be prescribed controlled substances.
d.Short-acting formulations of controlled substances are less likely to be abused.
Question 84Which of the following is TRUE about medications for nicotine dependence?
Select one:
a.Nicotine replacement is treatment of choice of nicotine withdrawal symptoms.
b.Bupropion can be used adjunctively to treat symptoms of nicotine withdrawal.
c.Varenicline and bupropion should be initiated on a patient's nicotine quit date.
d.Varenicline is a safe alternative for patients with a history of seizures or alcohol dependence.
Question 85Which of the following should be monitored in children who are prescribed psychostimulants?
Select one:
a.Sodium
b.Weight
c. Glucose
d.Lipids
Question 86Which of the following statements about pediatric psychiatry is TRUE?
Select one:
a.Behavioral and psychological strategies should be included in all treatment plans.
b.Psychiatric disorders in children usually resolve without intervention.
c.There are no significant drawbacks to withholding treatment until adulthood for most disorders.
d.When dosing psychiatric medication in a pediatric patient, body weight is the primary consideration.
Question 87Which of the following medications is FDA approved for the treatment of depression in children?
Select one:
a.Fluoxetine
b.Paroxetine
c.Venlafaxine
d.Mirtazapine
Question 88Which of the following statements is TRUE when prescribing for pediatric populations?
Select one:
a.Adherence is generally high in pediatric populations.
b.It is important to address parent/caregiver's perception of psychiatric medication.
c.The meaning of taking medication is usually irrelevant to children.
d.It is inappropriate to seek information about the patient from adults other than the parent.
Question 89Which of the following statements about antipsychotic use in the elderly is TRUE?
Select one:
a.Antipsychotic use in patients with dementia is associated with increased risk of CVA and of mortality.
b.Antipsychotic use is considered appropriate treatment for patients with Lewy Body dementia.
cAntipsychotic use is considered appropriate treatment for mild aggression or agitation in the elderly.
d.Antipsychotic use in elderly patients with dementia is never appropriate.
Question 90Which of the following statements about psychotropic use in pregnancy is TRUE?
Select one:
a.Clinicians should discuss psychotropic risks in pregnancy when a patient announces that they are pregnant.
b.Pregnancy is protective of mental illness, and most women can stop medications during pregnancy.
c.Clinicians should only choose agents that are FDA approved for use in pregnancy.
d.All medications cross the placenta and pose a potential risk to the fetus.
Question 91Which of the following statements is TRUE about teratogenicity in pregnancy?
Select one:
a.The greatest risk of teratogenicity often occurs before a patient is aware that they are pregnant.
b.Psychostimulants carry a high risk of teratogenicity.
c.Atypical antipsychotics carry a high risk of teratogenicity.
d.Most teratogenic risk has been determined by placebo-controlled, blinded studies.
Question 92Which of the following statements about anticonvulsant use in pregnancy is TRUE?
Select one:
a.As a class, anticonvulsants carry the highest risk of major congenital malformations.
b.Among anticonvulsants, lithium poses the greatest risk.
c.Among anticonvulsant, depakote is believed to be safest in pregnancy.
d.Serious rash among neonates is a common occurrence with exposure to lamotrigine.
Question 93Which of the following statements is TRUE about psychotropic use during lactation?
Select one:
a.Most medications are not secreted in breast milk.
b.The postpartum period is considered a vulnerable time for onset, relapse, and recurrence of mental disorders.
c.Infant rate of metabolism is generally similar to metabolism rates in adults.
d.Fluoxetine and citalopram are favorable for use during lactation.
Question 94Which of the following statements about antipsychotic use in pregnancy is TRUE?
Select one:
a.Conventional antipsychotic use for the treatment of psychosis in pregnancy is well studied.
b.Atypical antipsychotic use in pregnancy does not appear to be associated with major congenital malformations.
c.Atypical antipsychotic use in pregnancy does not appear to be associated with withdrawal syndromes.
d.Atypical antipsychotic use in pregnancy does not appear to be associated with increased birth weights.
Question 95Which of the following statements about SSRI discontinuation syndrome in neonates is TRUE?
Select one:
a.SSRI discontinuation syndrome is a relatively uncommon phenomenon in newborns exposed to antidepressant medication.
b.Seizures and convulsions are common in SSRI discontinuation syndrome.
c.SSRI discontinuation syndrome is time-limited and usually resolves within two weeks.
d.SSRI discontinuation syndrome has lasting deleterious effects on maternal-infant bonding.
Question 96Which of the following statements about complementary treatments is FALSE?
Select one:
a.Folic acid may be as effective as l-methylfolate for depression.
b.St. John's Wort is recommended as an adjunct medication to SSRIs.
c.Melatonin should be dosed in the early evening for the treatment of insomnia.
d.S-Adenosyl-L-Methionine (SAMe) has been demonstrated to be more effective than placebo in the treatment of depression.
Question 97Which of the following statements about herbal treatments in depression is TRUE?
Select one:
a.SAMe may be an effective monotherapy for depression.
b.Omega-3 Fatty acids may be an effective monotherapy for depression.
c.Herbal treatments do not carry risk of precipitating mania or hypomania.
d.L-methyl folate has been shown to be more effective than folic acid for depression.
Question 98Which of the following statements about the nootropic, cannabidiol, is TRUE?
Select one:
a.Cannabidiol can precipitate psychosis in vulnerable individuals.
b.Cannabidiol has psychoactive properties.
c.Cannabidiol is believed to be neuroprotective through antioxidant and acetylcholine-elevating mechanisms.
d.Cannabidiol levels are consistent between marijuana strains.
Question 99Which of the following herbal formulas may be safe and effective for anxiety?
Select one:
a.St John's Wort
b.Rodiola Rosea
c.Valerian
d.Kava
Question 100An understanding of epigenetics helps us to understand how events in the environment can alter gene expression.
Select one:
True
False
