NR 546 Exam Questions and Verified Answers Graded A+ 2026/27
Lithium
Anticonvulsants
Second generation antipsychotics - Pharmacologic Treatment of Bipolar Disorder
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. -
Unipolar depression
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 - Bipolar disorder (BD)
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 - mania
requires at least one episode of mania for at least one week (or any duration if hospitalization due
to symptoms is required) - Bipolar Type I:
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. - Bipolar
Type II:
,involves the chronic presentation of hypomanic and depressive symptoms that do not meet the
diagnostic criteria for a major depressive or manic/hypomanic episode. - Cyclothymia:
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 - If bipolar depression is mistaken for MDD:
monotherapy
-Antidepressants should be combined with a mood stabilizer to prevent the onset of a hypomanic
or manic episode - Antidepressants are used cautiously in clients with bipolar disorder and
never as ________________.
Decreased positive affect:
depressed mood
loss of joy
lack of interest
loss of energy
decreased alertness
decreased self-confidence
appetite changes - DA, NE Dysfunction causes what mood related symptoms
Increased negative affect:
depressed mood
, guilt
fear/anxiety
hostility
irritability
loneliness
appetite changes - 5HT, NE Dysfunction causes what mood related symptoms
-depression occurs as a result of a deficiency of one or all three monoamine transmitters
• serotonin, norepinephrine, and dopamine
-while mania may result from an excess - monoamine hypothesis of depression
• Selective Serotonin Reuptake Inhibitors (SSRIs)
• Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
• Norepinephrine Dopamine Reuptake Inhibitors (NDRI)
• Serotonin Antagonist and Reuptake Inhibitors (SARIs) - Medication Management for
Depression, First-Line Treatment:
Mechanism of action
• inhibit 5-HT reuptake
Adverse effects
-diarrhea
-headache
-weight gain
Lithium
Anticonvulsants
Second generation antipsychotics - Pharmacologic Treatment of Bipolar Disorder
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. -
Unipolar depression
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 - Bipolar disorder (BD)
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 - mania
requires at least one episode of mania for at least one week (or any duration if hospitalization due
to symptoms is required) - Bipolar Type I:
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. - Bipolar
Type II:
,involves the chronic presentation of hypomanic and depressive symptoms that do not meet the
diagnostic criteria for a major depressive or manic/hypomanic episode. - Cyclothymia:
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 - If bipolar depression is mistaken for MDD:
monotherapy
-Antidepressants should be combined with a mood stabilizer to prevent the onset of a hypomanic
or manic episode - Antidepressants are used cautiously in clients with bipolar disorder and
never as ________________.
Decreased positive affect:
depressed mood
loss of joy
lack of interest
loss of energy
decreased alertness
decreased self-confidence
appetite changes - DA, NE Dysfunction causes what mood related symptoms
Increased negative affect:
depressed mood
, guilt
fear/anxiety
hostility
irritability
loneliness
appetite changes - 5HT, NE Dysfunction causes what mood related symptoms
-depression occurs as a result of a deficiency of one or all three monoamine transmitters
• serotonin, norepinephrine, and dopamine
-while mania may result from an excess - monoamine hypothesis of depression
• Selective Serotonin Reuptake Inhibitors (SSRIs)
• Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
• Norepinephrine Dopamine Reuptake Inhibitors (NDRI)
• Serotonin Antagonist and Reuptake Inhibitors (SARIs) - Medication Management for
Depression, First-Line Treatment:
Mechanism of action
• inhibit 5-HT reuptake
Adverse effects
-diarrhea
-headache
-weight gain
