1. Question 18:
Christine is a 9-year-old female who presents for care after having been placed in the local foster care system. She has been in and out of foster care for the last 4 years after her parents were killed in an automobile accident. Christine has been placed in a variety of homes and ...
NRNP 6665 Final Exam Test
1.Question 18:
Christine is a 9-year-old female who presents for care after having been placed in the local foster care system. She has been in and out of foster care
for the last 4 years after her parents were killed in an automobile accident. Christine has been placed in a variety of homes and residential care facilities. The PMHNP recognizes that Christine is at high risk for:: A. Dissociative disorders
B.Post-traumatic stress disorder
C.Impulse-control disorder
D.Attachment disorder
2.Question 7:
Caylee is a 5-year-old girl who is referred for evaluation by child protective services. She was recently removed from her biological family and placed in
foster care, as her home environment was reportedly unsafe due to conditions of extreme neglect. Her foster mother reports that Caylee is very quiet and withdrawn and always appears sad and disinterested in her surroundings; however, she becomes very irritable when anything unexpected or unplanned occurs. The foster mother became very concerned
when it appeared that Caylee was hallucinating. The PMHNP considers that::
A. Caylee is at high risk for suicide and precautions should be taken
B.The hallucinations are consistent with brief psychotic disorder or schizophrenia
C.The history and reported symptoms are typical of depressive disorder in young children
D.This is a common situation when prepubertal children are removed from the biological parents regardless of how dysfunctional they are
3.Question 2:
Debi is a 15-year-old girl who is currently being treated for depression. Her parents have been very proactive and involved in her care, and Debi has achieved remission 2 months after beginning treatment with a combination of pharmacotherapy and cognitive behavioral therapy. While counseling Debi's parents about important issues in management, the PMHNP advises that:: A. There is a > 50% likelihood that Debi's younger sibling will develop depressive symptoms
B.The mean length of major depressive episode in adolescents is 4 months
C.20 to 40% of adolescents who have major depressive disorder will develop bipolar I within 5 years
D.Adolescent-onset depression typically need long-term pharmacologic
manage- ment to prevent relapses
4.Agomelatine: Brand: Valdoxan
-Melatonin multimodal (Mel-MM) -Agonist at melatonergic 1 and melatonergic 2 receptors
-Antagonist at 5HT2C receptors
-Not FDA approved: Rx for Depression, Generalized anxiety disorder
-Initial 25 mg/day at bedtime; after 2 weeks can increase to 50 mg/day at bedtime
5.Amitriptyline (Elavil): Tricyclic antidepressant.
6.Aripiprazole (Abilify): Treatment for depression. Atypical antipsychotic.
"Dopamine stabilizer". Dopamine receptor antagonist in high concentration and also stimulates increase of dopamine in low concentrations. Side effects: insomnia, akathisia.
7.Brexpiprazole (Rexulti): Treatment for depression. Atypical antipsychotic
8.Bupropion (Wellbutrin): Antidepressant and smoking cessation aid, It
can treat depression and help people quit smoking. It can also prevent
depression caused by seasonal affective disorder (SAD).
9.Citalopram (Celexa): Antidepressant, SSRI: 20-40 mg qd.
10.Clomipramine (Anafranil): -Serotonin reuptake inhibitor (S-RI)
-Tricyclic antidepressant (TCA)
-Parent drug is a potent serotonin reuptake inhibitor
Active metabolite is a potent norepinephrine/noradrenaline reuptake
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