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NR546 Final Exam Questions with correct answers
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- Healthcare Finance MHA 706
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- Healthcare Finance MHA 706
NR546 Final Exam Questions with correct answers
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NR546 Final Exam Questions with correctanswers
Pharmacologic Treatment of Bipolar Disorder - ANSWER-Lithium
Anticonvulsants
Second generation antipsychotics
Unipolar depression - 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) - 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 - 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: - 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: - 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.
-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: - 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: - 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
________________. - 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 -
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 -
ANSWER-Increased negative affect:
depressed mood
guilt
fear/anxiety
hostility
irritability
loneliness
appetite changes
monoamine hypothesis of depression - 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
Medication Management for Depression, First-Line Treatment: - ANSWER-•
Selective Serotonin Reuptake Inhibitors (SSRIs)
• Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
• Norepinephrine Dopamine Reuptake Inhibitors (NDRI)
• Serotonin Antagonist and Reuptake Inhibitors (SARIs)
SSRI's - ANSWER-Mechanism of action
• inhibit 5-HT reuptake
Adverse effects
-diarrhea
-headache
-weight gain
-sexual side effects
, SNRI's - 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 - 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 -
ANSWER-citalopram (Celexa)
SSRI Prescribing Pearls: med with no known drug interactions -
ANSWER-escitalopram (Lexapro)
SSRI Prescribing Pearls: med with longest half-life - ANSWER-fluoxetine
(Prozac)
SSRI Prescribing Pearls: med that also treats social anxiety and insomnia -
ANSWER-paroxetine (Paxil)
SSRI Prescribing Pearls: med that treats anxious depression; smokers require an
increased dose - ANSWER-fluvoxamine (Luvox)
SSRI Prescribing Pearls: med that also treats social anxiety and
hypersomnolence - ANSWER-sertraline (Zoloft)
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