Assignment: Inhibition Of Pain To Patient

Assignment: Inhibition Of Pain To Patient
Assignment: Inhibition Of Pain To Patient
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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?
Venlafaxine (Effexor)
Duloxetine (Cymbalta)
Clozapine (Clozaril)
Phenytoin (Dilantin)
QUESTION 27
The PMHNP prescribes gabapentin (Neurontin) for a patient’s chronic pain. How does the PMHNP anticipate the drug to work?
A. It will bind to the alpha-2-delta ligand subunit of voltage-sensitive calcium channels. B. It will induce synaptic changes, including sprouting. C. It will act on the presynaptic neuron to trigger sodium influx. D. It will inhibit activity of dorsal horn neurons to suppress body input from reaching the brain.
QUESTION 28
Mrs. Rosen is a 49-year-old patient who is experiencing fibro-fog. What does the PMHNP prescribe for Mrs. Rosen to improve this condition? A. Venlafaxine (Effexor) B. Armodafinil (Nuvigil) C. Bupropion (Wellbutrin) D. All of the above
QUESTION 29
The PMHNP is caring for a patient with fibromyalgia. Which second-line treatment does the PMHNP select that may be effective for managing this patient’s pain?
A. Methylphenidate (Ritalin) B. Viloxazine (Vivalan) C. Imipramine (Tofranil) D. Bupropion (Wellbutrin
QUESTION 30
The PMHNP is attempting to treat a patient’s chronic pain by having the agent bind the open channel conformation of VSCCs to block those channels with a “use-dependent” form of inhibition. Which agent will the PMHNP most likely select?
A. Pregabalin (Lyrica) B. Duloxetine (Cymbalta) C. Modafinil (Provigil) D. Atomoxetine (Strattera)
QUESTION 31
A patient with irritable bowel syndrome reports chronic stomach pain. The PMHNP wants to prescribe the patient an agent that will cause irrelevant nociceptive inputs from the pain to be ignored and no longer perceived as painful. Which drug will the PMHNP prescribe?
A. Pregabalin (Lyrica) B. Gabapentin (Neurontin) C. Duloxetine (Cymbalta) D. B and C
QUESTION 32
The PMHNP wants to use a symptom-based approach to treating a patient with fibromyalgia. How does the PMHNP go about treating this patient?
A. Prescribing the patient an agent that ignores the painful symptoms by initiating a reaction known as “fibro-fog” B. Targeting the patient’s symptoms with anticonvulsants that inhibit gray matter loss in the dorsolateral prefrontal cortex C. Matching the patient’s symptoms with the malfunctioning brain circuits and neurotransmitters that might mediate those symptoms D. None of the above
QUESTION 33
The PMHNP is working with the student to care for a patient with diabetic peripheral neuropathic pain. The student asks the PMHNP why SSRIs are not consistently useful in treating this particular patient’s pain. What is the best response by the PMHNP?
A. “SSRIs only increase norepinephrine levels.” B. “SSRIs only increase serotonin levels.” C. “SSRIs increase serotonin and norepinephrine levels.” D. “SSRIs do not increase serotonin or norepinephrine levels.”
QUESTION 34
A patient with gambling disorder and no other psychiatric comorbidities is being treated with pharmacological agents. Which drug is the PMHNP most likely to prescribe?
A. Antipsychotics B. Lithium C. SSRI D. Naltrexone
QUESTION 35
Kevin is an adolescent who has been diagnosed with kleptomania. His parents are interested in seeking pharmacological treatment. What does the PMHNP tell the parents regarding his treatment options?
A. “Naltrexone may be an appropriate option to discuss.” B. “There are many medicine options that treat kleptomania.” C. “Kevin may need to be prescribed antipsychotics to treat this illness.” D. “Lithium has proven effective for treating kleptomania.”