NURS 6630 WEEK 6 MIDTERM EXAM WINTER QTR. (COMPLETE QUESTIONS AND ANSWERS)
What is the strongest established risk factor for bipolar disorder? Family History
EXPLANATION:
“The strongest established risk factor for BPD is a family history of BPD.”
Which of the followi...
NURS 6630 WEEK 6 MIDTERM EXAM 2025-2026
WINTER QTR. (COMPLETE QUESTIONS AND ANSWERS)
• Question 1
What is the strongest established risk factor for bipolar disorder? Family History
EXPLANATION: “The strongest established risk factor for BPD is a family history of BPD.”
• Question 2
Which of the following medications are known as selective serotonin re-uptake inhibitors (SSRIs)?
• Question 3
Which disease state of a non-adherent patient is at greater risk for substance use, violence, and
victimization as well as worse overall quality of life? Schizophrenia
EXPLANATION: “Moreover, non-adherent patients with schizophrenia are at greater risk for
substance use, violence, and victimization as well as worse overall quality of
life.”
• Question 4
Patient is a 72-year-old male with a past medical history significant for atrial fibrillation and COPD
with a new diagnosis of major depression disorder. Based on his comorbid
,conditions, what antidepressant would you recommend as first-line?
EXPLANATION: (Options C & D are both TCA antidepressants and, based on the patient’s age
and comorbid conditions, a TCA would likely result in more side effects, such
as increased fall risk due to potential for orthostatic hypotension and
anticholinergic-related side effects. In addition, patient has a history for
cardiac abnormalities due to A. fib diagnosis - TCAs result in
electrocardiographic changes in susceptible individuals, therefore, would likely
avoid. Choice B is used more for ADHD purposes than as an antidepressant)
Page numbers used: Page 39 for TCA side-effect profile
• Question 5
Which of the following is an appropriate strategy for managing treatment-resistant depression?
Use both SSRI and SNRI
• Question 6
Which of the following medications is best to AVOID in maintenance treatment of bipolar disorder
and why?
EXPLANATION: “As noted previously, antidepressants may contribute to an increase in mood
episode frequency.”
• Question 7
With second-generation antipsychotics, what is the main side effect that requires frequent
monitoring?
EXPLANATION: table 7-6 & page 80, table 7-7; Page 78: “However, attention over the past
decade has focused on effect of second-generation antipsychotics on glucose
metabolism and lipids and associated metabolic syndrome.”
• Question 8
Which amino acid is involved in the synthesis of both norepinephrine and dopamine?
• Question 9
An 81-year-old male comes to your clinic today complaining of dry mouth, blurred vision, and
constipation. He has a past medical history significant for hypertension, heart failure, and
depression. Of the following medications, which one is likely contributing to these side effects?
EXPLANATION: Only TCA is listed with most anticholinergic effects; Page 39 for TCA side
effect profile: “dry mouth, blurred vision, constipation, urinary hesitancy,
tachycardia, memory difficulties, and ejaculatory difficulties”
• Question 10
Which medication has been studied and recommended in patients with a social anxiety
, disorder who also suffer from an alcohol use disorder?
EXPLANATION: “Suggested that treatment with the SSRI paroxetine decreased the anxiety and
may have reduced the alcohol use as well”
• Question 11
M. B. was just diagnosed with Generalized Anxiety Disorder and pharmacotherapy is needed. Which
of the following would be a first-line treatment option for M. B.?
Duloxetine
Quetiapine
Diazepam
Escitalopram
EXPLANATION: “As is true for panic and the other anxiety disorders, the SSRIs and SNRIS are
generally considered first-line agents for the treatment of GAD because of
their favorable side effect profile….”
• Question 12
The serotonin system is involved in many processes in psychiatry, including, most prominently,
mood, sleep, and psychosis. Of the following neurons listed, from where is serotonin synthesized?
EXPLANATION: under serotonin subheading and figure 1-18 on page 16:
Locus Coeruleus: Norepinephrine Nucleus basalis: cholinergic neurons
Substantia Nigra: dopamine Ventral Tegmental area: dopamine
• Question 13
Which of the following symptoms is NOT part of the diagnostic features for bipolar disorder?
EXPLANATION: “Psychosis is not represented in the diagnostic features for BPD.”
- “Psychosis typically resolves along with the mood symptoms, though
diagnostic criteria acknowledge that psychotic symptoms may linger beyond
the end of the episode.”
• Question 14
A 32-year-old males calls you complaining of decreased libido since starting Paroxetine 20 mg 2
weeks ago. He reported stopping the medication 1 day ago and is now experiencing extreme
irritability and nervousness. He wishes to stop this medication due to side effects. What do you
recommend?
EXPLANATION: under selective serotonin re-uptake inhibitors discontinuation syndrome
subtitle: “The risk of such adverse events occurring seems to be inversely
related to the half-life of the SSRI, with fluoxetine reported as having a
significantly lower risk than paroxetine in two studies. For more severe
discontinuation-related adverse events, re-institution of the SSRI and slow
taper may be necessary to alleviate these symptoms.”
• Question 15
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