Psych FNP Review LEIK 3rd Edition Question and answers rated A+ An older adult male with alcohol use disorder is scheduled for a physical exam and laboratory testing. The patient's laboratory blood test results may show:
Increased serum creatinine levels and eGFR
Decreased number of platelets a...
Psych FNP Review LEIK 3rd Edition
An older adult male with alcohol use disorder is scheduled for a physical exam
and laboratory testing. The patient's laboratory blood test results may show:
Increased serum creatinine levels and eGFR
Decreased number of platelets and increased MCV
Increased serum potassium and increased triglycerides
Decreased AST and ALT levels
Decreased number of platelets and increased MCV
Chronic alcohol use affects the MCV because of reduction of folate levels
from dietary deficiency and/or impaired absorption due to excess use of
alcohol. Alcohol also interferes with the production and function of white blood
cells. Alcohol interferes with platelet production with diminished fibrinolysis
resulting in thrombocytopenia. Alcoholics are at higher risk for bleeding. It can
increase aspartate aminotransferase and alanine aminotransferase because
of liver inflammation. Alcohol affects lipid metabolism in the liver, resulting in
hypertriglyceridemia.
Which of the following individuals is at higher risk for suicide?
Obese teenager who fails an exam in high school
Black middle-aged female who is newly diagnosed with type 2 diabetes
Elderly White male whose wife of 40 years recently died
Asian adult whose mother has a chronic illness
Elderly White male whose wife of 40 years recently died
,Elderly White males who are recently widowed are at very high risk of suicide.
Whites are more likely to commit suicide compared with other racial groups.
A 56 year-old male patient with a history of depression and seeing a
psychiatrist, comes in to see the FNP and complains of being unable to
sustain an erection long enough to ejaculate. The FNP Knows when she
checks his medication list she will likely see which of the following medications
that could be causing erectile dysfunction (ED).
Out of the four medications, paroxetine (Paxil) is most likely to cause ED in a
male patient. It can also affect female orgasm. Levothyroxine (Synthroid),
penicillin, and digoxin usually do not cause ED in males.
In addition to reducing interest in sex, SSRI medications can make it difficult
to become aroused, sustain arousal, and reach orgasm. Some people taking
SSRIs aren't able to have an orgasm at all. These symptoms tend to become
more common with age.
Paroxetine is an extensively used SSRI that has been shown to impair erectile
function in patients, to induce erectile dysfunction and to inhibit nitric oxide
, synthase (NOS) activity and NO production in animal models. NO is a key
mediator of penile erection.
An elderly diabetic female with peripheral neuropathy and coronary artery
disease is recently diagnosed with major depression. The patient refuses
psychotherapy and wants medication. She denies suicidal and homicidal
ideation. Which of the following pharmacologic agents is the best choice for
this patient?
Duloxetine (Cymbalta) is an SNRI that is used for depression, chronic anxiety,
and the management of diabetic peripheral neuropathy. The patient has
diabetic peripheral neuropathy and depression. Escitalopram (Lexapro) is an
SSRI that is used for depression and generalized anxiety disorder, but it does
not have an indication for peripheral neuropathy.
The FNP who prescribes an antipsychotic medication, understand that this
medication is most likely to produce extrapyramidal effects?
Sertraline (Zoloft)
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