NR546 FINAL COMPREHENSIVE
EXAMINATION TEST QUESTIONS AND
SOLUTIONS FULLY VERIFIED
●● What is a key prescribing consideration for antidepressants in bipolar
disorder?
Answer: Antidepressants should not be given as monotherapy; they must
be combined with a mood stabilizer to avoid inducing mania.
●● What should be monitored when prescribing SNRIs to breastfeeding
patients?
Answer: Infant irritability.
●● What factors should be considered when prescribing antidepressants?
Answer: Client preference, prior treatment response, anticipated adverse
effects, comorbidities, half-life, interactions, and cost.
●● What should be done if the initial antidepressant does not work?
Answer: First, increase the dose; if that fails, switch to a different drug
in the same class, then try a drug in a different class, and possibly add a
second medication.
,●● What is the recommended dose adjustment for older patients taking
citalopram and escitalopram?
Answer: They should receive half the usual dose.
●● Which SSRI has the least CYP interactions?
Answer: Escitalopram (Lexapro).
●● Which SSRI is considered good for forgetful patients?
Answer: Fluoxetine, due to its 2-3 day half-life.
●● What is the longest-acting antidepressant?
Answer: Fluoxetine, with a half-life of 1-2 weeks.
●● What is discontinuation syndrome and which medication is more
likely to cause it?
Answer: Discontinuation syndrome occurs when stopping an
antidepressant, and paroxetine is more likely to cause it.
●● Which antidepressant is safe during nursing and pregnancy?
Answer: Sertraline.
●● What is serotonin syndrome?
, Answer: A condition that occurs when two serotonergic drugs are used
together, leading to symptoms such as mental status changes, autonomic
instability, neuromuscular symptoms, seizures, and gastrointestinal
symptoms.
●● What is the treatment for serotonin syndrome?
Answer: Stop the medication, provide supportive care, and use
benzodiazepines.
●● What is the black box warning for MAOIs?
Answer: They carry a warning for suicidal ideation in children,
adolescents, and young adults.
●● What is the half-life of MAOIs?
Answer: 2-4 hours.
●● What is the black box warning for SSRIs?
Answer: They carry a warning for suicidal tendencies.
●● What are MAOIs and what do they inhibit?
Answer: MAOIs (monoamine oxidase inhibitors) are antidepressants
that inhibit the enzyme that deactivates dopamine, norepinephrine, and
serotonin.
EXAMINATION TEST QUESTIONS AND
SOLUTIONS FULLY VERIFIED
●● What is a key prescribing consideration for antidepressants in bipolar
disorder?
Answer: Antidepressants should not be given as monotherapy; they must
be combined with a mood stabilizer to avoid inducing mania.
●● What should be monitored when prescribing SNRIs to breastfeeding
patients?
Answer: Infant irritability.
●● What factors should be considered when prescribing antidepressants?
Answer: Client preference, prior treatment response, anticipated adverse
effects, comorbidities, half-life, interactions, and cost.
●● What should be done if the initial antidepressant does not work?
Answer: First, increase the dose; if that fails, switch to a different drug
in the same class, then try a drug in a different class, and possibly add a
second medication.
,●● What is the recommended dose adjustment for older patients taking
citalopram and escitalopram?
Answer: They should receive half the usual dose.
●● Which SSRI has the least CYP interactions?
Answer: Escitalopram (Lexapro).
●● Which SSRI is considered good for forgetful patients?
Answer: Fluoxetine, due to its 2-3 day half-life.
●● What is the longest-acting antidepressant?
Answer: Fluoxetine, with a half-life of 1-2 weeks.
●● What is discontinuation syndrome and which medication is more
likely to cause it?
Answer: Discontinuation syndrome occurs when stopping an
antidepressant, and paroxetine is more likely to cause it.
●● Which antidepressant is safe during nursing and pregnancy?
Answer: Sertraline.
●● What is serotonin syndrome?
, Answer: A condition that occurs when two serotonergic drugs are used
together, leading to symptoms such as mental status changes, autonomic
instability, neuromuscular symptoms, seizures, and gastrointestinal
symptoms.
●● What is the treatment for serotonin syndrome?
Answer: Stop the medication, provide supportive care, and use
benzodiazepines.
●● What is the black box warning for MAOIs?
Answer: They carry a warning for suicidal ideation in children,
adolescents, and young adults.
●● What is the half-life of MAOIs?
Answer: 2-4 hours.
●● What is the black box warning for SSRIs?
Answer: They carry a warning for suicidal tendencies.
●● What are MAOIs and what do they inhibit?
Answer: MAOIs (monoamine oxidase inhibitors) are antidepressants
that inhibit the enzyme that deactivates dopamine, norepinephrine, and
serotonin.
