NRNP 6667 Final Exam Test Questions
and Complete Solutions.
NRNP 6667 Final Exam Test Questions
and Complete Solutions.
Question 18:
Christine is a 9-year-old female who presents for care after having been placed in the local foster care
system. She has been in and out of foster care for the last 4 years after her parents were killed in an
automobile accident. Christine has been placed in a variety of homes and residential care facilities. The
PMHNP recognizes that Christine is at high risk for: - ANSWER A. Dissociative disorders
B. Post-traumatic stress disorder
C. Impulse-control disorder
D. Attachment disorder
Question 7:
Caylee is a 5-year-old girl who is referred for evaluation by child protective services. She was recently
removed from her biological family and placed in foster care, as her home environment was reportedly
unsafe due to conditions of extreme neglect. Her foster mother reports that Caylee is very quiet and
withdrawn and always appears sad and disinterested in her surroundings; however, she becomes very
irritable when anything unexpected or unplanned occurs. The foster mother became very concerned
when it appeared that Caylee was hallucinating. The PMHNP considers that: - ANSWER A. Caylee is at
high risk for suicide and precautions should be taken
B. The hallucinations are consistent with brief psychotic disorder or schizophrenia
C. The history and reported symptoms are typical of depressive disorder in young children
D. This is a common situation when prepubertal children are removed from the biological parents
regardless of how dysfunctional they are
Question 2:
Debi is a 15-year-old girl who is currently being treated for depression. Her parents have been very
proactive and involved in her care, and Debi has achieved remission 2 months after beginning treatment
with a combination of pharmacotherapy and cognitive behavioral therapy. While counseling Debi's
parents about important issues in management, the PMHNP advises that: - ANSWER A. There is a > 50%
likelihood that Debi's younger sibling will develop depressive symptoms
B. The mean length of major depressive episode in adolescents is 4 months
,NRNP 6667 Final Exam Test Questions
and Complete Solutions.
C. 20 to 40% of adolescents who have major depressive disorder will de velop bipolar I within 5 years
D. Adolescent-onset depression typically need long-term pharmacologic management to prevent
relapses
Agomelatine - ANSWER Brand: Valdoxan
-Melatonin multimodal (Mel-MM)
-Agonist at melatonergic 1 and melatonergic 2 receptors
-Antagonist at 5HT2C receptors
-Not FDA approved: Rx for Depression, Generalized anxiety disorder
-Initial 25 mg/day at bedtime; after 2 weeks can increase to 50 mg/day at bedtime
Amitriptyline (Elavil) - ANSWER Tricyclic antidepressant.
Aripiprazole (Abilify) - ANSWER Treatment for depression. Atypical antipsychotic. "Dopamine stabilizer".
Dopamine receptor antagonist in high concentration and also stimulates increase of dopamine in low
concentrations. Side effects: insomnia, akathisia.
Brexpiprazole (Rexulti) - ANSWER Treatment for depression. Atypical antipsychotic
Bupropion (Wellbutrin) - ANSWER Antidepressant and smoking cessation aid, It can treat depression and
help people quit smoking. It can also prevent depression caused by seasonal affective disorder (SAD).
Citalopram (Celexa) - ANSWER Antidepressant, SSRI: 20-40 mg qd.
Clomipramine (Anafranil) - ANSWER -Serotonin reuptake inhibitor (S-RI)
-Tricyclic antidepressant (TCA)
-Parent drug is a potent serotonin reuptake inhibitor
Active metabolite is a potent norepinephrine/noradrenaline reuptake inhibitor
,NRNP 6667 Final Exam Test Questions
and Complete Solutions.
-Increases serotonergic neurotransmission by blocking the serotonin reuptake pump (transporter), -
Desensitization of serotonin receptors, especially serotonin 1A receptors
-Increases noradrenergic neurotransmission by blocking the norepinephrine reuptake pump
(transporter), -Desensitization of beta adrenergic receptors
-Dopamine is inactivated by norepinephrine reuptake in the frontal cortex
-Lacks dopamine transporters
-Increases dopamine neurotransmission in this part of the brain
**FDA Approved for Pediatrics in tx Obsessive-compulsive disorder (OCD) (ages 10 and older)
*Off-Label for Pediatric Use: Depression, Severe and treatment-resistant, depression, Cataplexy
syndrome, Anxiety, Insomnia,
Neuropathic pain/chronic pain
-Full therapeutic benefits may take 2-8 weeks
-Dosing: in Peds/Adolescents/Adults:
100-250mg/day
Cyamemazine (Tercian) - ANSWER Treatment for depression.
-Known as cyamepromazine
-Typical antipsychotic drug of the phenothiazine class.
-Treatment for schizophrenia
and psychosis-associated
anxiety
-Behaves like an atypical
antipsychotic, due to its
potent anxiolytic effects (5-HT2C) and lack of extrapyramidal side effects (5-HT2A).
-Conventional antipsychotic (neuroleptic, phenothiazine, dopamine 2 antagonist, serotonin dopamine
antagonist)
-Commonly Prescribed for (not FDA approved):
-Schizophrenia
-Anxiety associated with psychosis (short-term)
, NRNP 6667 Final Exam Test Questions
and Complete Solutions.
-Anxiety associated with nonpsychotic disorders, including mood disorders and personality disorders
(short-term)
-Severe depression
-Bipolar disorder
-Other psychotic disorders
-Acute agitation/aggression (injection)
-Benzodiazepine withdrawal
Desiprimine (Norpramine) - ANSWER Treats depression
Brand: Norpramin
-TCA
-Norepinephrine noradrenaline reuptake inhibitor.
-FDA approved for treating depression.
-Off-label: Anxiety, Insomnia,
Neuropathic pain/chronic pain, Treatment-resistant depression.
-More potent inhibitor of norepinephrine reuptake pump than serotonin reuptake pump (serotonin
transporter).
-May have immediate effects in treating insomnia or anxiety.
-If it is not working within 6-8 weeks for depression, it may require a dosage increase or it may not work
at all
-100-200 mg/day (for depression)
50-150 mg/day (for chronic pain).
Desvenlafaxine (Pristiq) - ANSWER Dual serotonin and norepinephrine reuptake inhibitor-often classified
as an antidepressant.
-FDA approved to tx MDD.
-Off-label: Vasomotor sx's, fibromyalgia, GAD, Social Anx d/o, panic d/o, PTSD, PMDD
-Dopamine is inactivated by norepinephrine reuptake in frontal cortex (which lack dopamine
transporters) med can increase dopamine neurotransmission in this part of the brain
and Complete Solutions.
NRNP 6667 Final Exam Test Questions
and Complete Solutions.
Question 18:
Christine is a 9-year-old female who presents for care after having been placed in the local foster care
system. She has been in and out of foster care for the last 4 years after her parents were killed in an
automobile accident. Christine has been placed in a variety of homes and residential care facilities. The
PMHNP recognizes that Christine is at high risk for: - ANSWER A. Dissociative disorders
B. Post-traumatic stress disorder
C. Impulse-control disorder
D. Attachment disorder
Question 7:
Caylee is a 5-year-old girl who is referred for evaluation by child protective services. She was recently
removed from her biological family and placed in foster care, as her home environment was reportedly
unsafe due to conditions of extreme neglect. Her foster mother reports that Caylee is very quiet and
withdrawn and always appears sad and disinterested in her surroundings; however, she becomes very
irritable when anything unexpected or unplanned occurs. The foster mother became very concerned
when it appeared that Caylee was hallucinating. The PMHNP considers that: - ANSWER A. Caylee is at
high risk for suicide and precautions should be taken
B. The hallucinations are consistent with brief psychotic disorder or schizophrenia
C. The history and reported symptoms are typical of depressive disorder in young children
D. This is a common situation when prepubertal children are removed from the biological parents
regardless of how dysfunctional they are
Question 2:
Debi is a 15-year-old girl who is currently being treated for depression. Her parents have been very
proactive and involved in her care, and Debi has achieved remission 2 months after beginning treatment
with a combination of pharmacotherapy and cognitive behavioral therapy. While counseling Debi's
parents about important issues in management, the PMHNP advises that: - ANSWER A. There is a > 50%
likelihood that Debi's younger sibling will develop depressive symptoms
B. The mean length of major depressive episode in adolescents is 4 months
,NRNP 6667 Final Exam Test Questions
and Complete Solutions.
C. 20 to 40% of adolescents who have major depressive disorder will de velop bipolar I within 5 years
D. Adolescent-onset depression typically need long-term pharmacologic management to prevent
relapses
Agomelatine - ANSWER Brand: Valdoxan
-Melatonin multimodal (Mel-MM)
-Agonist at melatonergic 1 and melatonergic 2 receptors
-Antagonist at 5HT2C receptors
-Not FDA approved: Rx for Depression, Generalized anxiety disorder
-Initial 25 mg/day at bedtime; after 2 weeks can increase to 50 mg/day at bedtime
Amitriptyline (Elavil) - ANSWER Tricyclic antidepressant.
Aripiprazole (Abilify) - ANSWER Treatment for depression. Atypical antipsychotic. "Dopamine stabilizer".
Dopamine receptor antagonist in high concentration and also stimulates increase of dopamine in low
concentrations. Side effects: insomnia, akathisia.
Brexpiprazole (Rexulti) - ANSWER Treatment for depression. Atypical antipsychotic
Bupropion (Wellbutrin) - ANSWER Antidepressant and smoking cessation aid, It can treat depression and
help people quit smoking. It can also prevent depression caused by seasonal affective disorder (SAD).
Citalopram (Celexa) - ANSWER Antidepressant, SSRI: 20-40 mg qd.
Clomipramine (Anafranil) - ANSWER -Serotonin reuptake inhibitor (S-RI)
-Tricyclic antidepressant (TCA)
-Parent drug is a potent serotonin reuptake inhibitor
Active metabolite is a potent norepinephrine/noradrenaline reuptake inhibitor
,NRNP 6667 Final Exam Test Questions
and Complete Solutions.
-Increases serotonergic neurotransmission by blocking the serotonin reuptake pump (transporter), -
Desensitization of serotonin receptors, especially serotonin 1A receptors
-Increases noradrenergic neurotransmission by blocking the norepinephrine reuptake pump
(transporter), -Desensitization of beta adrenergic receptors
-Dopamine is inactivated by norepinephrine reuptake in the frontal cortex
-Lacks dopamine transporters
-Increases dopamine neurotransmission in this part of the brain
**FDA Approved for Pediatrics in tx Obsessive-compulsive disorder (OCD) (ages 10 and older)
*Off-Label for Pediatric Use: Depression, Severe and treatment-resistant, depression, Cataplexy
syndrome, Anxiety, Insomnia,
Neuropathic pain/chronic pain
-Full therapeutic benefits may take 2-8 weeks
-Dosing: in Peds/Adolescents/Adults:
100-250mg/day
Cyamemazine (Tercian) - ANSWER Treatment for depression.
-Known as cyamepromazine
-Typical antipsychotic drug of the phenothiazine class.
-Treatment for schizophrenia
and psychosis-associated
anxiety
-Behaves like an atypical
antipsychotic, due to its
potent anxiolytic effects (5-HT2C) and lack of extrapyramidal side effects (5-HT2A).
-Conventional antipsychotic (neuroleptic, phenothiazine, dopamine 2 antagonist, serotonin dopamine
antagonist)
-Commonly Prescribed for (not FDA approved):
-Schizophrenia
-Anxiety associated with psychosis (short-term)
, NRNP 6667 Final Exam Test Questions
and Complete Solutions.
-Anxiety associated with nonpsychotic disorders, including mood disorders and personality disorders
(short-term)
-Severe depression
-Bipolar disorder
-Other psychotic disorders
-Acute agitation/aggression (injection)
-Benzodiazepine withdrawal
Desiprimine (Norpramine) - ANSWER Treats depression
Brand: Norpramin
-TCA
-Norepinephrine noradrenaline reuptake inhibitor.
-FDA approved for treating depression.
-Off-label: Anxiety, Insomnia,
Neuropathic pain/chronic pain, Treatment-resistant depression.
-More potent inhibitor of norepinephrine reuptake pump than serotonin reuptake pump (serotonin
transporter).
-May have immediate effects in treating insomnia or anxiety.
-If it is not working within 6-8 weeks for depression, it may require a dosage increase or it may not work
at all
-100-200 mg/day (for depression)
50-150 mg/day (for chronic pain).
Desvenlafaxine (Pristiq) - ANSWER Dual serotonin and norepinephrine reuptake inhibitor-often classified
as an antidepressant.
-FDA approved to tx MDD.
-Off-label: Vasomotor sx's, fibromyalgia, GAD, Social Anx d/o, panic d/o, PTSD, PMDD
-Dopamine is inactivated by norepinephrine reuptake in frontal cortex (which lack dopamine
transporters) med can increase dopamine neurotransmission in this part of the brain
