NR 546 COMPREHENSIVE TEST BANK
PRACTICE QUESTIONS AND RATIONALES
●● PFC & Amygdala Symptoms of MDD
Answer: Guilt
Suicidality
Worthlessness
●● Striatum Symptoms of MDD
Answer: Physical fatigue
●● Nucleus Accumbens Symptoms of MDD
Answer: Pleasure interests
●● Hypothalamus Symptoms of MDD
Answer: Sleep
Appetite
●● Thalamus & Hypothalamus Symptoms of Mania
Answer: Decreased sleep/arousal
●● Striatum Symptoms of Mania
,Answer: Motor/agitation
●● Prefrontal cortex (PFC) Symptoms of Mania
Answer: Risk-taking
Talkative/pressured speech
●● Nucleus Accumbens & PFC Symptoms of Mania
Answer: Racing thoughts, grandiosity
●● PFC & Amygdala Symptoms of Mania
Answer: Mood
●● Medication Management
Answer: SSRI-Selective Serotonin Reuptake Inhibitors
*Inhibit 5 HT reuptake
SNRI-Serotonin Norepinephrine Reuptake Inhibitors
*inhibit 5-HT reuptake
*inhibit NE reuptake (increase energy, focus)
*increase DA in prefrontal cortex (increase cognition)
NDRI-Norepinephrine Dopamine Reuptake inhibitors
*inhibit DA reuptake (increase alertness, motivation)
*inhibit NE reuptake (increase energy)
,SARI-Serotonin Antagonist Reuptake Inhibitors
●● Selective Serotonin Reuptake Inhibitors (SSRIs): Most adverse
effects will subside after 4-5 days once the body adjusts to increased
serotonin levels.
Answer: diarrhea
headache
weight gain
sexual side effects
●● Serotonin Norepinephrine Reuptake Inhibitors (SNRIs): Medications
should not be abruptly stopped to avoid discontinuation symptoms. NE
effects of the medication may increase anxiety in some clients. Report
worsening anxiety to the provider.
Answer: elevated blood pressure
anxiety
insomnia
constipation
●● Norepinephrine Dopamine Reuptake Inhibitors (NDRI): Take
medication in the morning. Stop taking medication if seizures occur.
Stop taking medication if anxiety is noted.
Answer: agitation
headache
, dry mouth
constipation
weight loss
●● escitalopram (Lexapro) SSRI
Answer: no known drug interactions
best tolerated SSRI
27-32 hour half-life good for forgetful prone clients
least CYP reactions
Substrate for 3A4
●● citalopram (Celexa) SSRI
Answer: mild antihistamine effects; Half-Life: 23-45 hours
Weak Inhibitor of 2D6
●● fluoxetine (Prozac) SSRI
Answer: longest half-life
Use caution in patients with comorbid anxiety due to risk for activation
and panic attacks
Half-Life: 2-3 days parent, 2 week metabolite
Inhibits 2D6 and 3A4
PRACTICE QUESTIONS AND RATIONALES
●● PFC & Amygdala Symptoms of MDD
Answer: Guilt
Suicidality
Worthlessness
●● Striatum Symptoms of MDD
Answer: Physical fatigue
●● Nucleus Accumbens Symptoms of MDD
Answer: Pleasure interests
●● Hypothalamus Symptoms of MDD
Answer: Sleep
Appetite
●● Thalamus & Hypothalamus Symptoms of Mania
Answer: Decreased sleep/arousal
●● Striatum Symptoms of Mania
,Answer: Motor/agitation
●● Prefrontal cortex (PFC) Symptoms of Mania
Answer: Risk-taking
Talkative/pressured speech
●● Nucleus Accumbens & PFC Symptoms of Mania
Answer: Racing thoughts, grandiosity
●● PFC & Amygdala Symptoms of Mania
Answer: Mood
●● Medication Management
Answer: SSRI-Selective Serotonin Reuptake Inhibitors
*Inhibit 5 HT reuptake
SNRI-Serotonin Norepinephrine Reuptake Inhibitors
*inhibit 5-HT reuptake
*inhibit NE reuptake (increase energy, focus)
*increase DA in prefrontal cortex (increase cognition)
NDRI-Norepinephrine Dopamine Reuptake inhibitors
*inhibit DA reuptake (increase alertness, motivation)
*inhibit NE reuptake (increase energy)
,SARI-Serotonin Antagonist Reuptake Inhibitors
●● Selective Serotonin Reuptake Inhibitors (SSRIs): Most adverse
effects will subside after 4-5 days once the body adjusts to increased
serotonin levels.
Answer: diarrhea
headache
weight gain
sexual side effects
●● Serotonin Norepinephrine Reuptake Inhibitors (SNRIs): Medications
should not be abruptly stopped to avoid discontinuation symptoms. NE
effects of the medication may increase anxiety in some clients. Report
worsening anxiety to the provider.
Answer: elevated blood pressure
anxiety
insomnia
constipation
●● Norepinephrine Dopamine Reuptake Inhibitors (NDRI): Take
medication in the morning. Stop taking medication if seizures occur.
Stop taking medication if anxiety is noted.
Answer: agitation
headache
, dry mouth
constipation
weight loss
●● escitalopram (Lexapro) SSRI
Answer: no known drug interactions
best tolerated SSRI
27-32 hour half-life good for forgetful prone clients
least CYP reactions
Substrate for 3A4
●● citalopram (Celexa) SSRI
Answer: mild antihistamine effects; Half-Life: 23-45 hours
Weak Inhibitor of 2D6
●● fluoxetine (Prozac) SSRI
Answer: longest half-life
Use caution in patients with comorbid anxiety due to risk for activation
and panic attacks
Half-Life: 2-3 days parent, 2 week metabolite
Inhibits 2D6 and 3A4
