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NR547 Final Exam | Latest Update |
Questions, Answers & Detailed Rationales
| Study Guide & Exam Prep
EXAM COVERAGE SUMMARY
This comprehensive exam covers the following key content areas:
Psychopharmacology & Depression Treatment
- Antidepressant classes (SSRIs, SNRIs, SDRIs, TCAs, MAOIs) - mechanisms of action, adverse effects,
prescribing pearls
- Major Depressive Disorder - diagnostic criteria (DSM-5-TR), severity levels (mild/moderate/severe),
screening tools (PHQ-9, BDI-II, HAM-D), risk factors
- Bipolar Disorder - types (Bipolar I, Bipolar II, Cyclothymia), diagnostic criteria, manic/hypomanic
features, rapid cycling
- Monoamine hypothesis and three principal neurotransmitters (NE, DA, 5HT)
- Treatment resistance strategies - dose escalation, switching, augmentation
Neurocognitive Disorders
- Dementia vs. Delirium - distinguishing features, onset, attention, fluctuation
- Alzheimer's Disease - stages (3-stage model and Reisberg scale), pathophysiology (plaques, tangles),
treatment (cholinesterase inhibitors, memantine, aducanumab)
- Vascular dementia, Lewy body dementia, Frontotemporal dementia, Parkinson's disease dementia
- Cognitive domain impairments (complex attention, executive function, learning/memory, language,
perceptual motor, social cognition)
- Screening tools (MoCA, Mini-Cog, GDS, SLUMS, MMSE)
- Diagnostic testing for cognitive deficits (labs, neuroimaging)
Personality Disorders
- Cluster A (Paranoid, Schizoid, Schizotypal) - odd/eccentric
- Cluster B (Antisocial, Borderline, Histrionic, Narcissistic) - dramatic/emotional
- Cluster C (Avoidant, Dependent, Obsessive-Compulsive) - anxious/fearful
- Diagnostic criteria, differential diagnosis, safety considerations
- Dimensional model and screening tools (PDQ-4, McLean, Zanarini)
Substance Use Disorders
- Substance use disorder diagnostic criteria and severity levels (mild/moderate/severe)
- Withdrawal syndromes and treatment protocols (CIWA-Ar, symptom-triggered therapy)
- FDA-approved medications for SUDs (alcohol: acamprosate, disulfiram, naltrexone; opioids:
buprenorphine, methadone, naltrexone; overdose: naloxone)
- Screening tools (CAGE, CIWA-Ar, SBIRT)
- Intoxication symptom patterns for various substances
- Substance-induced mental disorders
Suicide Risk Assessment
- Risk factors, screening tools (ASQ), protective factors (lithium)
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- Epidemiology and lifespan considerations
Lifespan Considerations
- Geriatric depression and bipolar disorder - atypical presentation, GDS, Cornell Scale
- Pregnancy considerations in SUD treatment
Ethics and Legal Considerations
- NAADAC/NCCAP code of ethics
- MAT and disability protections
- Safety planning
1. A 45-year-old female presents with depressed mood, anhedonia, and a 15-pound weight gain over 2
months. She reports sleeping 12 hours per night and feeling heavy in her arms and legs. Which specifier
best describes her presentation?
A) Melancholic features
B) Atypical features
C) Catatonic features
D) Mixed features
Correct Answer: B
Rationale: Atypical features include weight gain, hypersomnia, and leaden paralysis (heavy feeling in
extremities).
2. Which of the following medications is contraindicated in a client with a history of seizures?
A) Sertraline
B) Bupropion
C) Duloxetine
D) Escitalopram
Correct Answer: B
Rationale: Bupropion lowers the seizure threshold and is contraindicated in clients with a history of
seizures.
3. A 68-year-old male with Parkinson's disease develops cognitive decline with visual hallucinations and
fluctuating attention. What is the most likely diagnosis?
A) Vascular dementia
B) Frontotemporal dementia
C) Dementia with Lewy bodies
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D) Alzheimer's disease
Correct Answer: C
Rationale: Lewy body dementia features visual hallucinations, fluctuating cognition, and Parkinsonism.
4. Which medication is the first-line choice for a pregnant woman with opioid use disorder?
A) Methadone
B) Naltrexone
C) Buprenorphine
D) Naloxone
Correct Answer: C
Rationale: Buprenorphine is the recommended MAT for pregnant women with opioid use disorder.
5. A 32-year-old with borderline personality disorder presents with chronic emptiness, self-cutting, and
intense fear of abandonment. Which safety concern is most critical?
A) Harm to others
B) Substance abuse
C) Suicide and self-harm
D) Medication noncompliance
Correct Answer: C
Rationale: BPD has increased risk for suicide, self-harm, and engagement in risky behaviors.
6. Which SSRI has the longest half-life and is most likely to cause drug interactions?
A) Sertraline
B) Paroxetine
C) Fluoxetine
D) Citalopram
Correct Answer: C
Rationale: Fluoxetine has the longest half-life among SSRIs (Prozac pearl).
7. A client with alcohol use disorder has a CIWA-Ar score of 12. What is the appropriate next step?
A) Begin detoxification protocol
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B) Administer benzodiazepine
C) Discharge with referral
D) Monitor without intervention
Correct Answer: B
Rationale: CIWA-Ar score of 8 or higher indicates need for benzodiazepine administration.
8. Which medication blocks mu opioid receptors and can reduce both opioid and alcohol consumption?
A) Methadone
B) Buprenorphine
C) Naltrexone
D) Disulfiram
Correct Answer: C
Rationale: Naltrexone blocks mu opioid receptors and reduces reinforcing effects of both opioids and
alcohol.
9. A 24-year-old presents with elevated mood, decreased need for sleep, grandiosity, and racing thoughts
for 1 week. What diagnosis is most appropriate?
A) Hypomanic episode
B) Manic episode
C) Mixed episode
D) Cyclothymia
Correct Answer: B
Rationale: Mania requires symptoms for at least 1 week with significant impairment in functioning.
10. Which cognitive domain is impaired when a client cannot complete complex projects or solve
problems?
A) Learning and memory
B) Executive function
C) Language
D) Perceptual motor
Correct Answer: B
Rationale: Executive function impairment affects ability to complete complex projects and solve
problems.
NR547 Final Exam | Latest Update |
Questions, Answers & Detailed Rationales
| Study Guide & Exam Prep
EXAM COVERAGE SUMMARY
This comprehensive exam covers the following key content areas:
Psychopharmacology & Depression Treatment
- Antidepressant classes (SSRIs, SNRIs, SDRIs, TCAs, MAOIs) - mechanisms of action, adverse effects,
prescribing pearls
- Major Depressive Disorder - diagnostic criteria (DSM-5-TR), severity levels (mild/moderate/severe),
screening tools (PHQ-9, BDI-II, HAM-D), risk factors
- Bipolar Disorder - types (Bipolar I, Bipolar II, Cyclothymia), diagnostic criteria, manic/hypomanic
features, rapid cycling
- Monoamine hypothesis and three principal neurotransmitters (NE, DA, 5HT)
- Treatment resistance strategies - dose escalation, switching, augmentation
Neurocognitive Disorders
- Dementia vs. Delirium - distinguishing features, onset, attention, fluctuation
- Alzheimer's Disease - stages (3-stage model and Reisberg scale), pathophysiology (plaques, tangles),
treatment (cholinesterase inhibitors, memantine, aducanumab)
- Vascular dementia, Lewy body dementia, Frontotemporal dementia, Parkinson's disease dementia
- Cognitive domain impairments (complex attention, executive function, learning/memory, language,
perceptual motor, social cognition)
- Screening tools (MoCA, Mini-Cog, GDS, SLUMS, MMSE)
- Diagnostic testing for cognitive deficits (labs, neuroimaging)
Personality Disorders
- Cluster A (Paranoid, Schizoid, Schizotypal) - odd/eccentric
- Cluster B (Antisocial, Borderline, Histrionic, Narcissistic) - dramatic/emotional
- Cluster C (Avoidant, Dependent, Obsessive-Compulsive) - anxious/fearful
- Diagnostic criteria, differential diagnosis, safety considerations
- Dimensional model and screening tools (PDQ-4, McLean, Zanarini)
Substance Use Disorders
- Substance use disorder diagnostic criteria and severity levels (mild/moderate/severe)
- Withdrawal syndromes and treatment protocols (CIWA-Ar, symptom-triggered therapy)
- FDA-approved medications for SUDs (alcohol: acamprosate, disulfiram, naltrexone; opioids:
buprenorphine, methadone, naltrexone; overdose: naloxone)
- Screening tools (CAGE, CIWA-Ar, SBIRT)
- Intoxication symptom patterns for various substances
- Substance-induced mental disorders
Suicide Risk Assessment
- Risk factors, screening tools (ASQ), protective factors (lithium)
, Page 2 of 68
- Epidemiology and lifespan considerations
Lifespan Considerations
- Geriatric depression and bipolar disorder - atypical presentation, GDS, Cornell Scale
- Pregnancy considerations in SUD treatment
Ethics and Legal Considerations
- NAADAC/NCCAP code of ethics
- MAT and disability protections
- Safety planning
1. A 45-year-old female presents with depressed mood, anhedonia, and a 15-pound weight gain over 2
months. She reports sleeping 12 hours per night and feeling heavy in her arms and legs. Which specifier
best describes her presentation?
A) Melancholic features
B) Atypical features
C) Catatonic features
D) Mixed features
Correct Answer: B
Rationale: Atypical features include weight gain, hypersomnia, and leaden paralysis (heavy feeling in
extremities).
2. Which of the following medications is contraindicated in a client with a history of seizures?
A) Sertraline
B) Bupropion
C) Duloxetine
D) Escitalopram
Correct Answer: B
Rationale: Bupropion lowers the seizure threshold and is contraindicated in clients with a history of
seizures.
3. A 68-year-old male with Parkinson's disease develops cognitive decline with visual hallucinations and
fluctuating attention. What is the most likely diagnosis?
A) Vascular dementia
B) Frontotemporal dementia
C) Dementia with Lewy bodies
, Page 3 of 68
D) Alzheimer's disease
Correct Answer: C
Rationale: Lewy body dementia features visual hallucinations, fluctuating cognition, and Parkinsonism.
4. Which medication is the first-line choice for a pregnant woman with opioid use disorder?
A) Methadone
B) Naltrexone
C) Buprenorphine
D) Naloxone
Correct Answer: C
Rationale: Buprenorphine is the recommended MAT for pregnant women with opioid use disorder.
5. A 32-year-old with borderline personality disorder presents with chronic emptiness, self-cutting, and
intense fear of abandonment. Which safety concern is most critical?
A) Harm to others
B) Substance abuse
C) Suicide and self-harm
D) Medication noncompliance
Correct Answer: C
Rationale: BPD has increased risk for suicide, self-harm, and engagement in risky behaviors.
6. Which SSRI has the longest half-life and is most likely to cause drug interactions?
A) Sertraline
B) Paroxetine
C) Fluoxetine
D) Citalopram
Correct Answer: C
Rationale: Fluoxetine has the longest half-life among SSRIs (Prozac pearl).
7. A client with alcohol use disorder has a CIWA-Ar score of 12. What is the appropriate next step?
A) Begin detoxification protocol
, Page 4 of 68
B) Administer benzodiazepine
C) Discharge with referral
D) Monitor without intervention
Correct Answer: B
Rationale: CIWA-Ar score of 8 or higher indicates need for benzodiazepine administration.
8. Which medication blocks mu opioid receptors and can reduce both opioid and alcohol consumption?
A) Methadone
B) Buprenorphine
C) Naltrexone
D) Disulfiram
Correct Answer: C
Rationale: Naltrexone blocks mu opioid receptors and reduces reinforcing effects of both opioids and
alcohol.
9. A 24-year-old presents with elevated mood, decreased need for sleep, grandiosity, and racing thoughts
for 1 week. What diagnosis is most appropriate?
A) Hypomanic episode
B) Manic episode
C) Mixed episode
D) Cyclothymia
Correct Answer: B
Rationale: Mania requires symptoms for at least 1 week with significant impairment in functioning.
10. Which cognitive domain is impaired when a client cannot complete complex projects or solve
problems?
A) Learning and memory
B) Executive function
C) Language
D) Perceptual motor
Correct Answer: B
Rationale: Executive function impairment affects ability to complete complex projects and solve
problems.
