WEEK 5 NR 546 PRACTICE ACTUAL FINAL EXAM
COMPLETE QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) |ALREADY GRADED
A+||BRAND NEW!!.
Karl, 35, complains of "brain fog" as a part of his depression symptoms.
✔✔CORRECT ANSWER✔✔Vortioxetine can improve the speed of
processing and cognitive function due to its unique mechanism of
action.
Lauren, 19, reports she sometimes forgets to take her pills on time.
✔✔CORRECT ANSWER✔✔Fluoxetine has a 2-3 days half-life, an
excellent option for forgetful people.
Edna, 62, has difficulty falling asleep most nights. ✔✔CORRECT
ANSWER✔✔The sedative effects of trazodone can assist with sleep
disturbances when given at bedtime. This medication is most
appropriate for sleep concerns. Trazadone is not first line for depression
due to the significant sedation side effect.
Serotonin Syndrome ✔✔CORRECT ANSWER✔✔potentially life-
threatening condition reported with the use of serotonergic
antidepressants, especially when they are used concomitantly with
other serotonergic drugs (such as triptans, tricyclic antidepressants,
fentanyl, lithium, tramadol, tryptophan, buspirone, and St. John's
Wort), and with drugs that impair serotonin metabolism (particularly
,MAOIs). Symptoms may include mental status changes (e.g., agitation,
hallucinations, delirium, and coma), autonomic instability (e.g.,
tachycardia, labile blood pressure, dizziness, diaphoresis, flushing,
hyperthermia), neuromuscular symptoms (e.g., tremor, rigidity,
myoclonus, hyperreflexia, incoordination), seizures, and/or
gastrointestinal symptoms (e.g., nausea, vomiting, diarrhea).
Antidepressant to avoid in pregnancy ✔✔CORRECT
ANSWER✔✔Paroxetine is contraindicated in pregnancy due to the risk
of congenital defects, including atrial septal defect.
Breast Feeding consideration with antidepressant ✔✔CORRECT
ANSWER✔✔Infant irritability should be monitored when SNRIs are
prescribed.
Older Adult consideration with antidepressant ✔✔CORRECT
ANSWER✔✔Older adults may not respond to antidepressants as
robustly as younger people if the first episode of depression occurs
after age 65.
Citalopram and escitalopram should be dosed at 1/2 dose due to risk of
QTc prolongation.
Beers Criteria recommendations: Avoid paroxetine in clients with
history of falls/fractures. Avoid tricyclic antidepressants prescribed with
other CNS depressants.
, Children consideration with antidepressant ✔✔CORRECT
ANSWER✔✔Antidepressants increase risk of death by suicide in
children and adults younger than 25.
Christina is a 34-year-old who presents to the office with complaints of
loss of energy, anxiety, and excessive sleeping. She has no past medical
history. She is diagnosed with depression. She is concerned about
starting on antidepressants because she has heard they cause weight
gain, and she isn't great at remembering to take pills "unless I can take
them in the morning." Write a prescription for Christina to treat her
depression. ✔✔CORRECT ANSWER✔✔Escitalopram 10 mg. 1 tab po at
hs.
Rationale: Escitalopram is the best-tolerated SSRI which is an excellent
choice for this medication naïve client. Escitalopram has the fewest
drug-drug interactions. This medication has a 27-32 hour half-life which
is less prone to side effects if a dose is late or forgotten. Dosage can be
increased at the next visit if medication is tolerated but efficacy is not
achieved with 10 mg.
Sertraline 50 mg. 1 tab po in AM with food.
Sertraline is also a possible medication choice and has a 27-36 hour
half-life which is less likely to cause withdrawal symptoms if a dose is
late or missed. Sertraline is taken in the morning to decrease the risk of
insomnia. This medication should be taken with food to decrease GI
effects. Dose can be increased at the next visit if medication is tolerated
but efficacy is not achieved with the initial dose.
