REGIS NU643 2021 January Week 15 Final Exam Latest (100% Graded)

Week 15 Final Quiz

Question 1Which of the following statements about metabolic syndrome is TRUE?

 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 2Which of the following BEST describes history of presenting illness?

 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 3Which of the following is NOT considered relevant to choosing a psychiatric medication?

 a.The patient's medication preference

 b.Past psychiatric medications

 c.The insurance formulary

 d.The patient's marital status

Question 4Which of the following BEST describes the mental status exam?

 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 5Which of the following is NOT a red flag for prescription drug misuse?

 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 6Which of the following statements is TRUE about psychotherapy and the treatment of depression?

 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 7Which of the following statements about telepsychiatry is TRUE?

 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 8Which of the following helps improve patient adherence to treatment?

 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 9Match receptor activity to its clinical side effect:

Histamine H1 receptor blockade               Answer 1 

Alpha-1 adrenergic receptor blockade    Answer 2 

Muscarinic cholinergic receptor blockade              Answer 3 

Question 10Match the following mood stabilizer to its recommended lab monitoring.

Valproic Acid     

Lithium  

Quetiapine          

Question 11Which of the following methods of drug delivery is slowest to reach the bloodstream?

 a.Sublingual formulations

 b.Oral pills

 c.IM route

 d.IV route

Question 12A 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?

 a.Pulsatile stimulation amplifies undesirable phasic dopamine and norepinephrine firing, which can lead to euphoria and abuse.

: Pulsatile delivery of stimulants can cause a frequent and rapid increase in norepinephrine and dopamine, and this amplifies phasic firing. Phasic firing is thought to be associated with reward, feelings of euphoria, and abuse potential.

 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 13Problems with selective attention associated with ADHD are hypothetically regulated by the:

 a.anterior cingulate cortex

 b.orbital frontal cortex

 c.prefrontal motor cortex

d.dorsolateral prefrontal cortex

Question 14Which of the following statements about disulfiram is true?

 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 15What pathway mediates prolactin and is involved in changes in prolactin levels?

 a.Nigrostriatal

 b.Mesocortical

 c.Mesolimbic

 d.Tuberoinfundibular

Question 16Use 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.

 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 17Which of the following statements is true about drug distribution?

 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 18Which of the following statements is TRUE about neuronal gene expression?

 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 19Which of the following statements about genetic testing for psychiatry is TRUE?

 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 20An understanding of epigenetics helps us to understand how events in the environment can alter gene expression.

 a.True

 b.False

Question 21Which of the following describes a component of pharmacodynamics?

 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 22Elimination of a drug can be impacted by all of the following scenarios EXCEPT ________.

 a.a low-fat diet

 b.metabolic acidosis, in which plasma pH is lowered

 c.concurrent use of loop diuretics

 d.dehydration

Question 23Which of the following antidepressant side effects may resolve with time?

 a.Sexual side effects

 b.Agitation

 c.Weight gain

 d.Apathy

Question 24Which of the following statements about FDA warnings and antidepressants in children and adolescents is TRUE?

 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 25A 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?

 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.

Question 26When prescribing atypical antipsychotic medications, which of the following statements is MOST true?

 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 27Which of the following statements about benzodiazepines in the treatment of bipolar disorder is TRUE?

 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 28Which of the following statements about lithium carbonate is TRUE?

 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 29Which of the following statements is TRUE about mirtazapine?

 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 30Which of the follow statements is TRUE about antidepressant side effects?

 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 longe.

 d.Patients are likely to self-report side effects.

Question 31Which of the following statements is TRUE about tardive dyskinesia?

 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 32Which of the following statements about bupropion is TRUE?

 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 33When tapering someone from long-term benzodiazepine use, which of the following is TRUE?

 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 34Which of the following is TRUE about antidepressants and bleeding?

 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 35Which of the following statements about lamotrigine is TRUE?

 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 36Which of the following agents is considered to have the BEST evidence for augmentation in the treatment of depression?

 a.Bupropion

 b.Lithium

 c.Methylphenidate

 d.Haloperidol

Question 37Which atypical antipsychotic carries the HIGHEST risk for EPS?

 a.Clozapine

 b.Olanzapine

 c.Risperidone

 d.Ziprasidone

Question 38The medication side effect mostly to result in aggression or violence is ________.

 a.akathisia

 b.tardive dyskinesia

 c.hyperreflexia

 d.insomnia

Question 39Which of the following is NOT a potentially serious side effect of psychostimulants?

 a.Cardiac events

 b.Hyponatremia

 c.Exacerbation of tic disorders or new-onset Tourette's

 d.Psychosis or aggression

Question 40Which of the following SSRI medications would be considered first-line treatment for generalized anxiety disorder?

 a.Clonazepam

 b.Buspirone

 c.Sertraline

 d.Hydroxyzine

Question 41Which antidepressant is LEAST likely to cause sexual side effects?

 a.Paroxetine

 b.Fluoxetine

 c.Bupropion

 d.Mirtazapine

Question 42Which of the following antipsychotics is LEAST likely to cause significant weight gain?

 a.Clozapine

 b.Olanzapine

 c.Risperidone

 d.Ziprasidone

Question 43When considering metabolic risk associated with atypical antipsychotics, which of the following statements is TRUE?

 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 44Which of the following is a potentially serious side effect of oxcarbazepine?

 a.Neuroleptic malignant syndrome

 b.Akathisia

 c.Hyponatremia

 d.Renal toxicity

Question 45 A 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?

 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 46Which of the following statements about long-acting injectable (LAI) antipsychotics is TRUE?

 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 47Which of the following is TRUE about hyponatremia and antidepressants?

 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 48Which of the following statements is TRUE about duloxetine?

 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 49According to DSM-5 criteria, what is the maximum age threshold for symptom onset when determining a diagnosis of ADHD?

 a.5

 b.7

 c.12

 d.15

Question 50When, in the course of psychiatric care, should safety be assessed?

 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 51Which of the following statements about the CIWA-Ar and COWS is TRUE?

 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 52When documenting the objective portion of a psychiatric treatment note, which if the following is included?

 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 53Carbamazepine has a half-life of approximately 12 hours. The clinical implications of this are ________.

 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 54Which of the following statements regarding suicide and antidepressant use is TRUE?

 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 55Which of the following statements about anxiety disorders and depressive disorders is TRUE?

 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 56When a patient achieves remission of depression, what is the recommended length of time that treatment should continue?

 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 57Which medication is NOT considered appropriate for the treatment of acute bipolar mania?

 a.Valproic acid

 b.Lithium carbonate

 c.Lamotrigine

 d.Olanzapine

Question 58Which of the following is NOT considered efficacious in bipolar depression?

 a.Lithium carbonate

 b.Lamotrigine

 c.Quetiapine

 d.Valproic Acid

Question 59Which of the following medications is considered second-line (second-tier) treatment for bipolar disorder?

 a.Valproic acid

 b.Carbamazepine

 c.Olanzapine

 d.Oxcarbazepine

Question 60Which of following statements is TRUE about the use of clonidine and propranolol in the treatment of anxiety?

 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 61Buspirone is indicated for which anxiety disorder?

 

 a.Generalized anxiety disorder

 b.Panic disorder

 c.Posttraumatic stress disorder

 d.Social phobia

Question 62Which of the following statements is true about behaviors in addiction?

 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 63Which ADHD symptoms most commonly present in adults?

 a.Hyperactivity

 b.Impulsivity

 c.Inattention

 d.Depressed mood

Question 64Which of the following may be helpful for treating symptoms of ADHD?

 a.Sertraline

 b.Fluoxetine

 c.Bupropion

 d.Mirtazapine

Question 65Which of the following is thought to be diagnostic for Alzheimer’s Disease:

 a.Amyloid plaque deposition in the brain

 b.Fluctuating attention

 c.Chorea

 d.Presence of Lewy bodies in the brain

Question 66Which of the following statements about managing behavioral and psychological symptoms of dementia is TRUE?

 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 67Which of the following statements about memantine is TRUE?

 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 68When treating acute aggression, which of the following medication combinations is a suggested treatment:

 a.Sertraline + quetiapine

 b.Propranolol + buspirone

 c.Paroxetine + buspirone

 d.Haldol +lorazepam

Question 69Which of the following statements about substance dependence is TRUE?

 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 70Which of the following statements about opioid withdrawal is TRUE?

 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 71Which of the following conditions is considered PHYSIOLOGICALLY safe?

 a.Alcohol intoxication

 b.Benzodiazepine withdrawal

 c.Opioid intoxication

 d.Opioid withdrawal

Question 72When monitoring patients on psychostimulants, which of the following is NOT a consideration?

 a.Glucose

 b.Weight

 c.Blood pressure

 d.EKG

Question 73Which of the following statements about preventing and recognizing prescription drug misuse is TRUE?

 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 74Which of the following is TRUE about medications for nicotine dependence?

 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 75When comparing naltrexone with acamprosate for alcohol dependence, which of the following statements is TRUE?

 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 76The psychiatric disorder(s) most likely to result in aggression or violence is (are) ________.

 a.psychotic disorders

 b.substance use disorders

 c.personality disorders

 d.bipolar disorder

Question 77When considering the neuroscience of addiction, which of the following statements is true?

 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 78When prescribing for preschool-aged children, which of the following statements is TRUE?

 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 79Which of the following should be monitored in children who are prescribed psychostimulants?

 a.Sodium

 b.Weight

 c.Glucose

 d.Lipids

Question 80Which of the following statements about pediatric psychiatry is TRUE?

 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 81Which of the following medications is FDA approved for the treatment of depression in children?

 a.Fluoxetine

 b.Paroxetine

 c.Venlafaxine

 d.Mirtazapine

Question 82Which of the following statements is TRUE when prescribing for pediatric populations?

 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 83Which of the following statements about antipsychotic use in the elderly is TRUE?

 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.

 c.Antipsychotic 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 84Which of the following statements about psychotropic use in pregnancy is TRUE?

 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 85Which of the following statements is TRUE about teratogenicity in pregnancy?

 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 86Which of the following statements about anticonvulsant use in pregnancy is TRUE?

 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 87Which of the following statements is TRUE about psychotropic use during lactation?

 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 88Which of the following statements about antipsychotic use in pregnancy is TRUE?

 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 89Which of the following statements about SSRI discontinuation syndrome in neonates is TRUE?

 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 90Which of the following statements about complementary treatments is FALSE?

 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 91Which of the following statements about herbal treatments in depression is TRUE?

 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 92Based on the Carlat reading, "Diet and Mental Health," what dietary recommendations would be most useful for mental health patients?

 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 93Nootropics are best described as ________.

 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 94Which of the following statements about the nootropic, cannabidiol, is TRUE?

 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 95Which of the following herbal formulas may be safe and effective for anxiety?

 a.St John's Wort

 b.Rodiola Rosea

 c.Valerian

 d.Kava

Question 96Which of the following statements about complementary treatments in psychiatry is TRUE?

 a.There is robust evidence for their effectiveness in psychiatry.

 b.FDA regulates herbal formulations similarly to prescription medications.

 c.Herbal formulations can interact adversely with psychiatric medications.

 d.Most natural formulations are well tolerated and without safety concerns.

Question 97Which of the following statements about herbal and complementary treatments is TRUE?

 a.Most herbal and complementary treatments in psychiatry have FDA approval.

 b.Most herbal and complementary treatments have had double-blind treatment trials.

 c.Quality of herbal and complementary treatments are often inconsistent between brands.

 d.Herbal treatments do not have drug-drug interactions.

Question 98Which of the following medications may worsen tics?

 a.Methylphenidate

 b.Guanfacine

 c.Atomoxetine

 d.Clonidine

Question 99Which medication might be a good choice for a shift worker with excessive daytime sleepiness?

 a.Melatonin

 b.Diphenhydramine

 c.Modafinil

 d.Temazepam

Question 100All of the following are important aspects of sleep hygiene practices EXCEPT ________.

 a.limit exposure to blue light 90 minutes before bedtime.

 b.avoid caffeine, nicotine, and large meals before bedtime

 c.set a regular rising time

 d.if unable to fall asleep, stay in bed