NURS 663 EXAM 1 PSYCHIATRIC
NURSING NEWEST ACTUAL EXAM 2025
QUESTIONS AND DETAILED CORRECT
ANSWERS | MARYVILLE UNIVERSITY
A+ STUDYGUIDE
Case: 26 year old woman without a psychiatric history who
presents for treatment of depression after her mother died.
It has been over a year but she is still struggling with
frequent bouts of sadness, has lost 15 lbs in the last four
months, is unable to sleep past 4am, and is getting poor
performance reviews at work due to impaired
concentration and memory. She feels like nothing in life is
enjoyable anymore.
diagnosis and medications to consider? Correct Answer
MDD
-Sertraline
-Escitalopram
-Fluoxetine
-Mirtazapine
case: 35 year old woman with a history of major
depressive disorder who presents complaining of
persistent depression despite treatment with maximum
dose sertraline and escitalopram in the past. She has
been depressed for over eight months, and spends up to
,16 hours per day lying in bed. She reports that she doesn't
have the energy to get up in the morning, and that there is
nothing that she enjoys doing, anyway. She has gained 35
lbs in the last eight months, reports feeling like she has
failed everyone in her life, and states that she only leaves
the house about once a week to shop for groceries.
Recently, she has begun hearing vague voices when she
feels especially badly, although she cannot make out
specific words.
diagnosis and medications? Correct Answer MDD
-Bupropion
-Venlafaxine
-Duloxetine
-Maybe fluoxetine
case: 39 year old man with a history of PTSD and
depression who presents after returning from a recent
deployment to Afghanistan. He is having trouble sleeping
because of nightmares about combat, is unable to tolerate
being in crowded places, and visibly jumps at small noises
during your interview. His unwillingness to leave the house
is exacerbated by a lower spinal injury that has left him
with chronic leg pain and a limp that he thinks makes him
look "like an easy target." He also reports that he has
difficulty sleeping through the night, is having trouble
enjoying doing anything with his family, feels extremely
guilty for the time that he was away from them while
deployed, has low energy and concentration, but
adamantly denies suicidal thoughts. He has tried
,maximum dose sertraline and venlafaxine, but neither
were helpful. He also tried mirtazapine, but it was far too
sedating and didn't work either.
diagnosis Correct Answer PTSD, MDD, Chronic Pain
-Nortriptyline or another TCA
-Duloxetine
-Escitalopram
-Prazosin
all antidepressants carry what 5 warnings? Correct
Answer - increased risk of suicide (especially in children
and young adults)
- mania activation
- serotonin syndrome
-discontinuation syndrome
- bleeding risk
What antidepressants are more activating? Correct
Answer Wellbutrin, Prozac, Effexor, Pristiq, Viibryd
what antidepressants are more sedating? Correct Answer
Paxil, Remeron, TCAs
which antidepressants increase appetite? Correct Answer
Paxil, Remeron, TCAs, Nardil
, which antidepressants decrease appetite? Correct Answer
Wellbutrin, Prozac, Effexor, Pristiq, Fetzima, Parnate
what strategies should be considered for augmentation?
Correct Answer •Lithium
•Atypical Antipsychotics
•Thyroid Hormone
•Buspirone
•Pindolol
•Omega-3 Fatty Acids (Lovaza)
•SAMe (S-adenosyl-l-methionine)
•L-methylfolate (Deplin)
•Modafinil
•Stimulants
•Light Therapy
behavioral therapy Correct Answer focuses on changing
behavior by identifying problem behaviors, replacing them
with appropriate behaviors, and using rewards or other
consequences to make the changes
•Behavioural therapy is based on the concept that a deficit
of 'reinforcers', such as pleasant activities and positive
interpersonal contacts, leaves patients vulnerable to
depression
•Sample interventions: increase activity level, structured
goal setting, interpersonal skills training
