NR546 WEEK 5 EXAM WITH CORRECT -ANWERS
WITH RATIONALES
Pharmacologic Treatment of Major Depressive Disorder - -ANS☑️☑️--Selective
serotonin reuptake inhibitors (SSRIs)
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Norepinephrine and dopamine reuptake inhibitors (NDRIs)
Serotonin antagonists and reuptake inhibitors (SARIs)
Miscellaneous antidepressants
Monoamine oxidase (MAO)-B inhibitors
Adjunct: antipsychotics
Pharmacologic Treatment of Bipolar Disorder - -ANS☑️☑️--Lithium
Anticonvulsants
Second generation antipsychotics
Mood disorders: role of the psychiatric mental health nurse practitioner
(PMHNP) is to: - -ANS☑️☑️--determine the malfunctioning brain circuit
responsible for the client's presenting symptoms and select the appropriate
medication that targets the associated neurotransmitter(s)
Mood disorders manifest across a spectrum from: - -ANS☑️☑️--mania to
major depressive disorder (MDD)
Unipolar depression - -ANS☑️☑️--major depressive disorder (MDD)
one of the most common mental disorders
,-Approximately 7.1% of adults in the U.S. had episode in last year, prevalence
highest (13.1%) among individuals aged 18-25
S/S
-depressed mood
-loss of interest or pleasure in daily activities
-irritability
-withdrawal
-problems with sleep, eating, energy, concentration, or self-worth
-severe depression: may experience thoughts of suicide or psychotic
symptoms.
Bipolar disorder (BD) - -ANS☑️☑️--Chronic condition characterized by
extreme fluctuations in mood, energy, and ability to function
-Moods may be manic, hypomanic, or depressed and may include mixed mood
or psychotic features
-many have only experienced only one manic episode in their lifetime
-Mood fluctuations may be separated by periods of high stability or may cycle
rapidly
-diagnosed when a client has one or more episodes of mania or hypomania
with a history of one or more major depressive episodes
-high risk for suicide
mania - -ANS☑️☑️--characterized by a persistently elevated, expansive, or
irritable mood. Related symptoms may include inflated self-esteem, increased
goal-directed activity or energy, including grandiosity, decreased need for
sleep, excessive talkativeness, racing thoughts, flight of ideas (FOI),
distractibility, psychomotor agitation, and a propensity to be involved in high-
,risk activities. Mania leads to significant functional impairment and may
include psychotic features or necessitate hospitalization
Bipolar Type I: - -ANS☑️☑️--requires at least one episode of mania for at least
one week (or any duration if hospitalization due to symptoms is required)
Bipolar Type II: - -ANS☑️☑️--diagnosis requires a current or past hypomanic
episode and a current or past major depressive episode. Symptoms last for at
least 4 days but fewer than seven.
-Hypomanic symptoms are not of sufficient duration or severity to cause
significant functional impairment, psychosis, or hospitalization.
-Anger and irritability are common.
-Clients often enjoy the elevation of mood and are reluctant to report these
symptoms, making bipolar more difficult to diagnose if the client presents in
the depression phase.
Cyclothymia: - -ANS☑️☑️--involves the chronic presentation of hypomanic and
depressive symptoms that do not meet the diagnostic criteria for a major
depressive or manic/hypomanic episode.
If bipolar depression is mistaken for MDD: - -ANS☑️☑️--antidepressant
therapy may precipitate a manic episode or induce rapid-cycling bipolar
depression
-may contribute to the increased incidence of death by suicide in children and
adults younger than 25
Antidepressants are used cautiously in clients with bipolar disorder and never
as ________________. - -ANS☑️☑️--monotherapy
-Antidepressants should be combined with a mood stabilizer to prevent the
onset of a hypomanic or manic episode
, DA, NE Dysfunction causes what mood related symptoms - -ANS☑️☑️--
Decreased positive affect:
depressed mood
loss of joy
lack of interest
loss of energy
decreased alertness
decreased self-confidence
appetite changes
5HT, NE Dysfunction causes what mood related symptoms - -ANS☑️☑️--
Increased negative affect:
depressed mood
guilt
fear/anxiety
hostility
irritability
loneliness
appetite changes
neurobiological factors that contribute to mood and mood disorders: Genetics
- -ANS☑️☑️--MDD and BD are heritable disorders
-genetic factors 31-42% of the disease risk in MDD and 59-85% in BD
-causes of mood disorders complex, likely involve interactions between
genetic/epigenetic, biological, psychological, and social factors including:
• dysfunctions in brain
WITH RATIONALES
Pharmacologic Treatment of Major Depressive Disorder - -ANS☑️☑️--Selective
serotonin reuptake inhibitors (SSRIs)
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Norepinephrine and dopamine reuptake inhibitors (NDRIs)
Serotonin antagonists and reuptake inhibitors (SARIs)
Miscellaneous antidepressants
Monoamine oxidase (MAO)-B inhibitors
Adjunct: antipsychotics
Pharmacologic Treatment of Bipolar Disorder - -ANS☑️☑️--Lithium
Anticonvulsants
Second generation antipsychotics
Mood disorders: role of the psychiatric mental health nurse practitioner
(PMHNP) is to: - -ANS☑️☑️--determine the malfunctioning brain circuit
responsible for the client's presenting symptoms and select the appropriate
medication that targets the associated neurotransmitter(s)
Mood disorders manifest across a spectrum from: - -ANS☑️☑️--mania to
major depressive disorder (MDD)
Unipolar depression - -ANS☑️☑️--major depressive disorder (MDD)
one of the most common mental disorders
,-Approximately 7.1% of adults in the U.S. had episode in last year, prevalence
highest (13.1%) among individuals aged 18-25
S/S
-depressed mood
-loss of interest or pleasure in daily activities
-irritability
-withdrawal
-problems with sleep, eating, energy, concentration, or self-worth
-severe depression: may experience thoughts of suicide or psychotic
symptoms.
Bipolar disorder (BD) - -ANS☑️☑️--Chronic condition characterized by
extreme fluctuations in mood, energy, and ability to function
-Moods may be manic, hypomanic, or depressed and may include mixed mood
or psychotic features
-many have only experienced only one manic episode in their lifetime
-Mood fluctuations may be separated by periods of high stability or may cycle
rapidly
-diagnosed when a client has one or more episodes of mania or hypomania
with a history of one or more major depressive episodes
-high risk for suicide
mania - -ANS☑️☑️--characterized by a persistently elevated, expansive, or
irritable mood. Related symptoms may include inflated self-esteem, increased
goal-directed activity or energy, including grandiosity, decreased need for
sleep, excessive talkativeness, racing thoughts, flight of ideas (FOI),
distractibility, psychomotor agitation, and a propensity to be involved in high-
,risk activities. Mania leads to significant functional impairment and may
include psychotic features or necessitate hospitalization
Bipolar Type I: - -ANS☑️☑️--requires at least one episode of mania for at least
one week (or any duration if hospitalization due to symptoms is required)
Bipolar Type II: - -ANS☑️☑️--diagnosis requires a current or past hypomanic
episode and a current or past major depressive episode. Symptoms last for at
least 4 days but fewer than seven.
-Hypomanic symptoms are not of sufficient duration or severity to cause
significant functional impairment, psychosis, or hospitalization.
-Anger and irritability are common.
-Clients often enjoy the elevation of mood and are reluctant to report these
symptoms, making bipolar more difficult to diagnose if the client presents in
the depression phase.
Cyclothymia: - -ANS☑️☑️--involves the chronic presentation of hypomanic and
depressive symptoms that do not meet the diagnostic criteria for a major
depressive or manic/hypomanic episode.
If bipolar depression is mistaken for MDD: - -ANS☑️☑️--antidepressant
therapy may precipitate a manic episode or induce rapid-cycling bipolar
depression
-may contribute to the increased incidence of death by suicide in children and
adults younger than 25
Antidepressants are used cautiously in clients with bipolar disorder and never
as ________________. - -ANS☑️☑️--monotherapy
-Antidepressants should be combined with a mood stabilizer to prevent the
onset of a hypomanic or manic episode
, DA, NE Dysfunction causes what mood related symptoms - -ANS☑️☑️--
Decreased positive affect:
depressed mood
loss of joy
lack of interest
loss of energy
decreased alertness
decreased self-confidence
appetite changes
5HT, NE Dysfunction causes what mood related symptoms - -ANS☑️☑️--
Increased negative affect:
depressed mood
guilt
fear/anxiety
hostility
irritability
loneliness
appetite changes
neurobiological factors that contribute to mood and mood disorders: Genetics
- -ANS☑️☑️--MDD and BD are heritable disorders
-genetic factors 31-42% of the disease risk in MDD and 59-85% in BD
-causes of mood disorders complex, likely involve interactions between
genetic/epigenetic, biological, psychological, and social factors including:
• dysfunctions in brain
