NR546 MIDTERM EXAM QUESTIONS
AND ANSWERS. VERIFIED 2025/2026.
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
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,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
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,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
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
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, *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
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
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
AND ANSWERS. VERIFIED 2025/2026.
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
1 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,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
2 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
,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
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
3 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
, *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
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
4 @COPYRIGHT 2025/2026 ALLRIGHTS RESERVED.
