NR546 Midterm Exam Questions with Detailed
Verified Answers
What should the PMHNP consider when prescribing chemical restraints? Ans: -
allergy status
-prior med hx for adverse drug reactions r/t the meds ordered in the chemical
restraint
-state regulations regarding chemical restrains must be reviewed
Are the PMHNP and other staff liable if the client has an allergic reaction or adverse
side effects to the drugs used for chemical restraint? Ans: No.
The client has been court-ordered to take the prescribed medications and the standing
order for chemical restraints is approved. The PMHNP and other staff are not liable if
the patient has an allergic reaction or adverse side effects.
How does reviewing the genetic makeup of a client help guide the PMHNP in selecting
medication for clients? Ans: -Genetic testing can assist by providing more information
on how clients may respond to certain psychotropic medications
-provides information on how a client may break down and metabolize medications
based on the cytochrome P450 system.
Tanrıkulu and Erbaş (2020) investigated identical twins to determine the presence of
an inherited link for schizophrenia and why one twin may develop schizophrenia when
the other does not. When two people have 100% identical DNA, why don't both
persons develop the exact illnesses? Studies of identical Danish twins found that if one
twin had schizophrenia, the other twin had a 50% lifetime risk of developing
schizophrenia (Lemvigh et al., 2020). Why is there only half the risk? Ans: Both
environmental and psychosocial stressors can impact mental health. Although twins
may have identical genes, their gene expression may be different.
,There may be an environmental exposure that turned a gene "on" that should have
been "off" for one twin to develop schizophrenia and not the other.
central sulcus Ans: separates the frontal lobe from the parietal lobe
frontal lobe Ans: associated with movement, intelligence, abstract thinking
broca's area Ans: speech production
temporal lobe Ans: involves object identification and auditory signals
cerebellum Ans: coordination
wernicke's area Ans: speech comprehension
occipital lobe Ans: primary visual area
parietal lobe Ans: keeps us alert to what is going on around us
sensory cortex Ans: pain, heat, and other sensations
motor cortex Ans: movement
hippocampus Ans: involved in both memory and anxiety
nucleus accumbens Ans: involved in the reward process
thalamus Ans: involved in sensory organ and motor command processing
striatum Ans: involved in complex motor actions, also links cognition to motor
actions
limbic system Ans: includes circuits that are associated with pleasure and reward
basal ganglia Ans: group of structures involved in voluntary motor movements
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,amygdala Ans: involved in emotional regulation and perception of odors
corpus callosum Ans: controls the communication between the two brain
hemispheres
white matter Ans: contains nerve fibers that connect neurons from different regions
into functional circuits
grey matter Ans: contains nerve cells and dendrites
brain tissue Ans: made up of grey matter and white matter
dorsal striatum Ans: involved in complex motor actions and linkage of cognition to
motor actions
-main input area for basal ganglia
*activated when anticipating or engaging in pleasure
The field of epigenetics is rapidly growing and can help explain how gene expression is:
Ans: influenced by environmental factors and how epigenetics contributes to the
manifestation of mental illness
How does epigenetics impact a person's mental health? Ans: internal or external
factors activate portions of the genome that result in the manifestation of mental
health symptoms
-activation is often a result of a stressful event, which, when combined with the genetic
risk, results in the disease
-genes being on or off
-occurrence of symptoms may be the result of inheritance of an abnormal gene or of
normal genes being "on" when they should be "off."
Types of epigenetic changes: Ans: DNA Methylation
© Get it right 2025 Getaway - Stuvia US All rights reserved
, Histone modification
Non-coding RNA
The potential legal and ethical issues impacting mental health treatment must also be
taken into account, including: Ans: -informed consent
-competence to make healthcare decisions
-off-label prescribing
Informed consent Ans: Clients have the right to receive enough information to make
decisions about treatment.
-must also be informed about potential risks associated with medications.
-have the right to refuse treatment
-cannot be forcibly medicated in non-emergencies. However, clients can be forcibly
medicated if they are violent toward themselves or others and when less restrictive
methods have failed
Compliance Ans: A court order may be issued for a client to receive treatment
against their wishes if they are considered a danger to themselves or others.
-Examples: clients with schizophrenia or sex offenders
-Guardians can provide consent for clients who have limited cognitive capabilities or
are incompetent to make decisions
-PMHNPs are responsible for being knowledgeable about their state laws and abiding
by them.
Off-Label Prescribing Ans: Some clients may benefit from the unapproved use of a
drug for symptom management.
© Get it right 2025 Getaway - Stuvia US All rights reserved
Verified Answers
What should the PMHNP consider when prescribing chemical restraints? Ans: -
allergy status
-prior med hx for adverse drug reactions r/t the meds ordered in the chemical
restraint
-state regulations regarding chemical restrains must be reviewed
Are the PMHNP and other staff liable if the client has an allergic reaction or adverse
side effects to the drugs used for chemical restraint? Ans: No.
The client has been court-ordered to take the prescribed medications and the standing
order for chemical restraints is approved. The PMHNP and other staff are not liable if
the patient has an allergic reaction or adverse side effects.
How does reviewing the genetic makeup of a client help guide the PMHNP in selecting
medication for clients? Ans: -Genetic testing can assist by providing more information
on how clients may respond to certain psychotropic medications
-provides information on how a client may break down and metabolize medications
based on the cytochrome P450 system.
Tanrıkulu and Erbaş (2020) investigated identical twins to determine the presence of
an inherited link for schizophrenia and why one twin may develop schizophrenia when
the other does not. When two people have 100% identical DNA, why don't both
persons develop the exact illnesses? Studies of identical Danish twins found that if one
twin had schizophrenia, the other twin had a 50% lifetime risk of developing
schizophrenia (Lemvigh et al., 2020). Why is there only half the risk? Ans: Both
environmental and psychosocial stressors can impact mental health. Although twins
may have identical genes, their gene expression may be different.
,There may be an environmental exposure that turned a gene "on" that should have
been "off" for one twin to develop schizophrenia and not the other.
central sulcus Ans: separates the frontal lobe from the parietal lobe
frontal lobe Ans: associated with movement, intelligence, abstract thinking
broca's area Ans: speech production
temporal lobe Ans: involves object identification and auditory signals
cerebellum Ans: coordination
wernicke's area Ans: speech comprehension
occipital lobe Ans: primary visual area
parietal lobe Ans: keeps us alert to what is going on around us
sensory cortex Ans: pain, heat, and other sensations
motor cortex Ans: movement
hippocampus Ans: involved in both memory and anxiety
nucleus accumbens Ans: involved in the reward process
thalamus Ans: involved in sensory organ and motor command processing
striatum Ans: involved in complex motor actions, also links cognition to motor
actions
limbic system Ans: includes circuits that are associated with pleasure and reward
basal ganglia Ans: group of structures involved in voluntary motor movements
© Get it right 2025 Getaway - Stuvia US All rights reserved
,amygdala Ans: involved in emotional regulation and perception of odors
corpus callosum Ans: controls the communication between the two brain
hemispheres
white matter Ans: contains nerve fibers that connect neurons from different regions
into functional circuits
grey matter Ans: contains nerve cells and dendrites
brain tissue Ans: made up of grey matter and white matter
dorsal striatum Ans: involved in complex motor actions and linkage of cognition to
motor actions
-main input area for basal ganglia
*activated when anticipating or engaging in pleasure
The field of epigenetics is rapidly growing and can help explain how gene expression is:
Ans: influenced by environmental factors and how epigenetics contributes to the
manifestation of mental illness
How does epigenetics impact a person's mental health? Ans: internal or external
factors activate portions of the genome that result in the manifestation of mental
health symptoms
-activation is often a result of a stressful event, which, when combined with the genetic
risk, results in the disease
-genes being on or off
-occurrence of symptoms may be the result of inheritance of an abnormal gene or of
normal genes being "on" when they should be "off."
Types of epigenetic changes: Ans: DNA Methylation
© Get it right 2025 Getaway - Stuvia US All rights reserved
, Histone modification
Non-coding RNA
The potential legal and ethical issues impacting mental health treatment must also be
taken into account, including: Ans: -informed consent
-competence to make healthcare decisions
-off-label prescribing
Informed consent Ans: Clients have the right to receive enough information to make
decisions about treatment.
-must also be informed about potential risks associated with medications.
-have the right to refuse treatment
-cannot be forcibly medicated in non-emergencies. However, clients can be forcibly
medicated if they are violent toward themselves or others and when less restrictive
methods have failed
Compliance Ans: A court order may be issued for a client to receive treatment
against their wishes if they are considered a danger to themselves or others.
-Examples: clients with schizophrenia or sex offenders
-Guardians can provide consent for clients who have limited cognitive capabilities or
are incompetent to make decisions
-PMHNPs are responsible for being knowledgeable about their state laws and abiding
by them.
Off-Label Prescribing Ans: Some clients may benefit from the unapproved use of a
drug for symptom management.
© Get it right 2025 Getaway - Stuvia US All rights reserved
