NR546 Final Exam
NR546 Final Exam Questions and
Answers Top Graded 2025
Pharmacologic Treatment of Bipolar Disorder -Correct Answer ✔Lithium
Anticonvulsants
Second generation antipsychotics
Unipolar depression -Correct Answer ✔major depressive disorder (MDD)
one of the most common mental disorders
-Approximately 7.1% of adults in the U.S. had episode in last year, prevalence highest
(13.1%) among individuals aged 18-25
S/S
-depressed mood
-loss of interest or pleasure in daily activities
-irritability
-withdrawal
-problems with sleep, eating, energy, concentration, or self-worth
-severe depression: may experience thoughts of suicide or psychotic symptoms.
Bipolar disorder (BD) -Correct Answer ✔Chronic condition characterized by extreme
fluctuations in mood, energy, and ability to function
-Moods may be manic, hypomanic, or depressed and may include mixed mood or
psychotic features
-many have only experienced only one manic episode in their lifetime
-Mood fluctuations may be separated by periods of high stability or may cycle rapidly
-diagnosed when a client has one or more episodes of mania or hypomania with a
history of one or more major depressive episodes
-high risk for suicide
mania -Correct Answer ✔characterized by a persistently elevated, expansive, or irritable
mood. Related symptoms may include inflated self-esteem, increased goal-directed
activity or energy, including grandiosity, decreased need for sleep, excessive
talkativeness, racing thoughts, flight of ideas (FOI), distractibility, psychomotor agitation,
and a propensity to be involved in high-risk activities. Mania leads to significant
functional impairment and may include psychotic features or necessitate hospitalization
Bipolar Type I: -Correct Answer ✔requires at least one episode of mania for at least one
week (or any duration if hospitalization due to symptoms is required)
Bipolar Type II: -Correct Answer ✔diagnosis requires a current or past hypomanic
episode and a current or past major depressive episode. Symptoms last for at least 4
days but fewer than seven.
NR546 Final Exam
,NR546 Final Exam
-Hypomanic symptoms are not of sufficient duration or severity to cause significant
functional impairment, psychosis, or hospitalization.
-Anger and irritability are common.
-Clients often enjoy the elevation of mood and are reluctant to report these symptoms,
making bipolar more difficult to diagnose if the client presents in the depression phase.
Cyclothymia: -Correct Answer ✔involves the chronic presentation of hypomanic and
depressive symptoms that do not meet the diagnostic criteria for a major depressive or
manic/hypomanic episode.
If bipolar depression is mistaken for MDD: -Correct Answer ✔antidepressant therapy
may precipitate a manic episode or induce rapid-cycling bipolar depression
-may contribute to the increased incidence of death by suicide in children and adults
younger than 25
Antidepressants are used cautiously in clients with bipolar disorder and never as
________________. -Correct Answer ✔monotherapy
-Antidepressants should be combined with a mood stabilizer to prevent the onset of a
hypomanic or manic episode
DA, NE Dysfunction causes what mood related symptoms -Correct Answer
✔Decreased positive affect:
depressed mood
loss of joy
lack of interest
loss of energy
decreased alertness
decreased self-confidence
appetite changes
5HT, NE Dysfunction causes what mood related symptoms -Correct Answer
✔Increased negative affect:
depressed mood
guilt
fear/anxiety
hostility
irritability
loneliness
appetite changes
monoamine hypothesis of depression -Correct Answer ✔-depression occurs as a result
of a deficiency of one or all three monoamine transmitters
• serotonin, norepinephrine, and dopamine
-while mania may result from an excess
NR546 Final Exam
,NR546 Final Exam
Medication Management for Depression, First-Line Treatment: -Correct Answer ✔•
Selective Serotonin Reuptake Inhibitors (SSRIs)
• Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
• Norepinephrine Dopamine Reuptake Inhibitors (NDRI)
• Serotonin Antagonist and Reuptake Inhibitors (SARIs)
SSRI's -Correct Answer ✔Mechanism of action
• inhibit 5-HT reuptake
Adverse effects
-diarrhea
-headache
-weight gain
-sexual side effects
SNRI's -Correct Answer ✔Mechanism of action
• inhibit 5-HT reuptake
• inhibit NE reuptake (increase energy, focus)
• increase DA in prefrontal cortex (increase cognition)
Adverse effects
-elevated blood pressure
-anxiety
-insomnia
-constipation
NDRI's -Correct Answer ✔Mechanism of action
• inhibit DA reuptake (increase alertness, motivation)
• inhibit NE reuptake (increase energy)
Adverse effects
-agitation
-headache
-dry mouth
-constipation
-weight loss
SSRI Prescribing Pearls: med with mild antihistamine effects -Correct Answer
✔citalopram (Celexa)
SSRI Prescribing Pearls: med with no known drug interactions -Correct Answer
✔escitalopram (Lexapro)
SSRI Prescribing Pearls: med with longest half-life -Correct Answer ✔fluoxetine
(Prozac)
SSRI Prescribing Pearls: med that also treats social anxiety and insomnia -Correct
Answer ✔paroxetine (Paxil)
NR546 Final Exam
, NR546 Final Exam
SSRI Prescribing Pearls: med that treats anxious depression; smokers require an
increased dose -Correct Answer ✔fluvoxamine (Luvox)
SSRI Prescribing Pearls: med that also treats social anxiety and hypersomnolence -
Correct Answer ✔sertraline (Zoloft)
venlafaxine (Effexor) -Correct Answer ✔INDICATION
-Depression
-GAD
-Social anxiety disorder
-Panic disorder
Mechanism of Action
-SNRI (dual serotonin and norepinephrine reuptake inhibitor), Boosts neurotransmitters
serotonin, norepinephrine/noradrenaline, and dopamine.
TESTS
-Check bp before initiating tx & regularly during tx
Starting Dose
-Initial 37.5 mg daily (extended-release) or 25-50 mg divided into 2-3 doses (immediate-
release)
Adverse Effects
-H/A, nervousness, insomnia, sedation, nausea, diarrhea, decreased appetite, sexual
dysfunction, asthenia, sweating, SIADH, hyponatremia, increase BP
PEARLS
-treats both depression and anxiety disorders, ensure trial of higher dose before
switching to a different medication
-preferred treatments for treatment-resistant depression
desvenlafaxine (Pristiq) -Correct Answer ✔INDICATION
-MDD
Mechanism of Action
-SNRI (dual serotonin and norepinephrine reuptake inhibitor), Boosts neurotransmitters
serotonin, norepinephrine/noradrenaline, and dopamine
TESTS
-Monitor BP before and during treatment.
Starting Dose
-50 mg/day
NR546 Final Exam
