NR546 / NR 546 Midterm Exam (Latest Update 2024 / 2025): Advanced Pharmacology Psychopharmacology for the Psychiatric-Mental Health Nurse Practitioner | Complete Guide with Questions and Verified Answers| 100% Correct - Chamberlain

Midterm Exam: NR546 / NR 546 (Latest Update 2024 / 2025) Advanced Pharmacology Psychopharmacology for the Psychiatric-Mental Health Nurse Practitioner Review | Complete Guide with Questions and Verified Answers | 100% Correct - Chamberlain Q: when could the client's cognitive status create an ethical issue Answer: if the client is unable to self determine care or is a danger to self or others Q: informed consent Answer: client has the right to receive enough information to make decisions about treatment -must be informed about potential risks associated with meds -clients have the right to refuse treatment and cannot be forcibly medicated in non emergencies -clients can be forcibly medicated if they are a danger to themselves or others and less restrictive methods have failed Q: compliance Answer: a client may be court ordered to receive treatment against their will if they are a danger to themself or others Q: examples of special situations for compliance Answer: -schizophrenia -sex offenders -guardians can provide consent if client is lacks the cognitive function to do so -PMHNP be knowledgable about state laws and abide Q: example of off label prescribing Answer: SSRIs are used to treat anxiety and OCD but are not FDA approved for this. Can raise legal concerns, remain up to date with recs Q: epigenetics Answer: the study of how your behaviors and environment can cause changes that affect the way your genes work Q: in mental health, activation of a gene is often caused by Answer: a stressful event Q: when is there an increased risk for psychiatric disease? Answer: when a stressful event is combined with genetic risk (can also be due to normal genes that should not be active) Q: are epigenetic changes reversible? Answer: yes! they don't change the DNA se- quence, they change the way the body reads the DNA sequence Q: transcription factors Answer: proteins that bind to promotor sequences of DNA to turn gene expression on and off Q: epigenetic changes can be influenced by Answer: infections, cancer, nutrition during pregnancy Q: how is genetic testing useful Answer: can provide more information on how clients might respond to certain psychotropic medications by providing info on how a client metabolizes a drug based on the CYP450 system Q: incidence of mental health Answer: 30% of the world is suffering from neurologic or psychiatric disorder 20% of children and adolescents are affected Q: client factors that may affect adherence Answer: s/e, fear of addiction, misunder- standing of expected outcomes Q: clinician factors that might contribute to adherence Answer: lack of shared decision making with client, providing inadequate education about meds, lack of follow up Q: structiral factors that may contribute to adherence Answer: medication access, costs, and stigma associated with mental illness Q: CYP450 phase 1 metabolism Answer: drug is ingested orally -oxidation (most common) -reduction -hydrolysis Q: 3 possible outcomes of phase 1 metabolism Answer: becomes completely inactive becomes partially inactive by one+ metabolites remain active nal drug is not pharmacologically active, but one metabolite remains active Q: what is the relationship between CYP450 and the gut wall, liver, blood- stream Answer: CYP450 enzymes in the gut wall or liver convert drug substrate into bio- transformed product in the bloodstream. After passing through the gut wall and liver, the drug will exist partially as unchanged drug and partially as biotransformed product in the bloodstream Q: where do genetics play into CYP450 system