FINAL EXAM TEST QUESTIONS AND RESOLVED
DETAILED ANSWERS.GRADE A+ ASSURED
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mother reports that Caylee is very quiet and withdrawn and always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%
, FINAL EXAM TEST QUESTIONS AND RESOLVED
DETAILED ANSWERS.GRADE A+ ASSURED
likelihood that Debi's younger sibling will develop depressive symptoms
B. The mean length of major depressive episode in adolescents is 4 months
, FINAL EXAM TEST QUESTIONS AND RESOLVED
DETAILED ANSWERS.GRADE A+ ASSURED
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 management 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 ettects: 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
attective 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 inhibitor
-Increases serotonergic neurotransmission by blocking the serotonin reuptake pump (transporter), -
Desensitization of serotonin receptors, especially serotonin 1A receptors
-Increases noradrenergic neurotransmission by blocking the norepinephrine reuptake pump
(transporter), -Desensi- tization of beta adrenergic receptors
-Dopamine is inactivated by norepinephrine reuptake in the frontal cortex
-Lacks dopamine transporters
-Increases dopamine neurotransmission in this part of the brain
**FDA Approved for Pediatrics in tx Obsessive-compulsive disorder (OCD) (ages 10 and older)
*Ott-Label for Pediatric Use: Depression, Severe and treatment-resistant, depression, Cataplexy syndrome,
Anxiety, Insomnia,
Neuropathic pain/chronic pain
, FINAL EXAM TEST QUESTIONS AND RESOLVED
DETAILED ANSWERS.GRADE A+ ASSURED
-Full therapeutic benefits may take 2-8 weeks
DETAILED ANSWERS.GRADE A+ ASSURED
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%
, FINAL EXAM TEST QUESTIONS AND RESOLVED
DETAILED ANSWERS.GRADE A+ ASSURED
likelihood that Debi's younger sibling will develop depressive symptoms
B. The mean length of major depressive episode in adolescents is 4 months
, FINAL EXAM TEST QUESTIONS AND RESOLVED
DETAILED ANSWERS.GRADE A+ ASSURED
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 management 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 ettects: 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
attective 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 inhibitor
-Increases serotonergic neurotransmission by blocking the serotonin reuptake pump (transporter), -
Desensitization of serotonin receptors, especially serotonin 1A receptors
-Increases noradrenergic neurotransmission by blocking the norepinephrine reuptake pump
(transporter), -Desensi- tization of beta adrenergic receptors
-Dopamine is inactivated by norepinephrine reuptake in the frontal cortex
-Lacks dopamine transporters
-Increases dopamine neurotransmission in this part of the brain
**FDA Approved for Pediatrics in tx Obsessive-compulsive disorder (OCD) (ages 10 and older)
*Ott-Label for Pediatric Use: Depression, Severe and treatment-resistant, depression, Cataplexy syndrome,
Anxiety, Insomnia,
Neuropathic pain/chronic pain
, FINAL EXAM TEST QUESTIONS AND RESOLVED
DETAILED ANSWERS.GRADE A+ ASSURED
-Full therapeutic benefits may take 2-8 weeks
