Administration of serotonin-norepinephrine

Administration of serotonin-norepinephrine
Administration of serotonin-norepinephrine
Administration of serotonin-norepinephrine reuptake inhibitor (SNRI) Assignment
Question 23
The PMHNP is assessing a 49-year-old male with a history of depression, post-traumatic stress disorder (PTSD), alcoholism with malnutrition, diabetes mellitus type 2, and hypertension. His physical assessment is unremarkable with the exception of peripheral edema bilaterally to his lower extremities and a chief complaint of pain with numbness and tingling to each leg 5/10. The PMHNP starts this patient on a low dose of doxepin (Sinequan). What is the next action that must be taken by the PMHNP?
a) Orders liver function tests
b) Educate the patient on avoiding grapefruits when taking this medication
c) Encourage this patient to keep fluids to 1500ml/day until the swelling subside
d) Order BUN/Creatinine test
Question 24
The PMHNP is evaluating a 30-year-old female patient who states that she notices pain and a drastic change in mood before the start of her menstrual cycle. The patient states that she has tried diet and lifestyle changes but nothing has worked. What will the PMHNP most likely do?
a) Prescribe estrin FE 24 birth control
b) Prescribe Ibuprofen 800mg every 8 hours as needed for pain
c) Prescribe desvenlafaxine (Pristiq) 50mg daily
d) Prescribe Risperdal 2mg TID
Question 25
A patient with chronic back pain has been prescribed a serotonin-norepinephrine reuptake inhibitor (SNRI). How does the PMHNP describe the action of SNRIs on the inhibition of pain to the patient?
a) “the SNRI can increase noradrenergic neurotransmission in the descending spinal pathway to the dorsal horn”
b) “the SNRI can decrease noradrenergic neurotransmission in the descending spinal pathway to the dorsal horn”
c) “the SNRI can reduce brain atrophy by slowing the gray matter loss in the dorsolateral prefrontal cortex”
d) “the SNRI can increase neurotransmission to descending neurons”
Question 26
A patient with fibromyalgia and major depression needs to be treated for symptoms of pain. Which is the PMHNP most likely to prescribe for this patient?
a) Venlafaxine (Effexor)
b) Duloxetine (Cymbalta)
c) Clozapine (Clozaril)
d) Phenytoin (Dilantin)

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