What will the PMHNP most likely prescribe to a patient with psychotic aggression who needs to manage the top-down cortical control and the excessive drive from striatal hyperactivity?
The PMHNP is selecting a medication treatment option for a patient who is exhibiting psychotic behaviors with poor impulse control and aggression. Of the available treatments, which can help temper some of the adverse effects or symptoms that are normally caused by D2 antagonism?
A. First-generation, conventional antipsychotics
B. First-generation, atypical antipsychotics
C. Second-generation, conventional antipsychotics
D. Second-generation, atypical antipsychotics
The PMHNP is discussing dopamine D2 receptor occupancy and its association with aggressive behaviors in patients with the student. Why does the PMHNP prescribe a standard dose of atypical antipsychotics?
A. The doses are based on achieving 100% D2 receptor occupancy.
B. The doses are based on achieving a minimum of 80% D2 receptor occupancy.
C. The doses are based on achieving 60% D2 receptor occupancy.
D. None of the above.
Why does the PMHNP avoid prescribing clozapine (Clozaril) as a first-line treatment to the patient with psychosis and aggression?
A. There is too high a risk of serious adverse side effects.
B. It can exaggerate the psychotic symptoms.
C. Clozapine (Clozaril) should not be used as high-dose monotherapy.
D. There is no documentation that clozapine (Clozaril) is effective for patients who are violent.
The PMHNP is caring for a patient on risperidone (Risperdal). Which action made by the PMHNP exhibits proper care for this patient?
A. Explaining to the patient that there are no risks of EPS
B. Prescribing the patient 12 mg/dail
C. Titrating the dose by increasing it every 5–7 days
D. Writing a prescription for a higher dose of oral risperidone (Risperdal) to achieve high D2 receptor occupancy
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