A+ NR546 FINAL EXAM QUESTIONS AND ANSWERS LATEST
UPDATE
lab tests required for: Atypical antipsychotic medications
CBC
HbA1C
Rationale: Atypical antipsychotics can cause increased blood glucose and an increased
risk of developing diabetes mellitus (DM) II. Measure HbA1C every 3 months for 1 year
and then annually. Certain medications, such as Clozapine, may cause blood
dyscrasias and CBC should be monitored closely.
Medications for Bipolar Disorder Lifespan Considerations: Pregnancy
-Lithium, valproic acid, and carbamazepine are teratogenic and are contraindicated
during pregnancy.
-Lurasidone has been used in pregnancy without teratogenic effects.
Medications for Bipolar Disorder Lifespan Considerations: Breast Feeding
Avoid breastfeeding for clients prescribed carbamazepine, lithium, and lamotrigine.
Medications for Bipolar Disorder Lifespan Considerations: Older Adult
Use caution. Reduced renal and hepatic function may impact metabolism and
elimination. Reduce dose as necessary.
2019 American Geriatric Society (AGS) Beers Criteria include the following
recommendations:
-Avoid carbamazepine (may cause syndrome of inappropriate antidiuretic hormone
secretion [SIADH]).
-Use caution with antipsychotic medications (may increase the risk of falls).
-Antipsychotic medications may increase the risk of stroke, cognitive decline, and death
in dementia clients.
-Avoid lithium in clients taking ACE inhibitors or loop diuretics.
Medications for Bipolar Disorder Lifespan Considerations: Children
Medications approved for children are limited.
Age 10 +:
-lurasidone (bipolar depression)
, -aripiprazole (acute and mixed mania)
-quetiapine (monotherapy and adjunct for acute mania)
-asenapine (acute and mixed mania)
-risperidone (monotherapy and adjunct for acute and mixed mania)
Age 13 +:
-olanzapine (acute and mixed mania)
match the client scenario with the best prescribing choice:
Jade, 24, is newly diagnosed with bipolar I with acute mania. She has an
intrauterine device (IUD).
lithium
first-line treatment for new onset bipolar with acute mania. Lithium is teratogenic; an
IUD will prevent pregnancy. If the client does not want long-term contraception or
decides to get pregnant, you can prescribe lurasidone as it is nonteratogenic and is
monotherapy for acute mania and mixed mania.
match the client scenario with the best prescribing choice:
Michelle, 30, has been taking valproic acid for bipolar I disorder. She and her
partner are discussing getting pregnant in the next few months.
lurasidone
Valproic acid is contraindicated during pregnancy. The client should be switched to an
atypical antipsychotic prior to trying to conceive.
match the client scenario with the best prescribing choice:
Adam, 22, has been diagnosed with bipolar I disorder for 3 years. He presents
with an acute episode of mania. His mother states she isn't sure how carefully he
has been taking his medications.
aripiprazole intramuscular (IM) after an oral trial establishes tolerability.
Long-acting injectable antipsychotic medications, such as aripiprazole, may be
appropriate for clients who struggle with medication adherence after a successful oral
trial.
With consideration of tolerability and low side effect profile, the first-line
medication selection for the treatment of severe depression includes:
UPDATE
lab tests required for: Atypical antipsychotic medications
CBC
HbA1C
Rationale: Atypical antipsychotics can cause increased blood glucose and an increased
risk of developing diabetes mellitus (DM) II. Measure HbA1C every 3 months for 1 year
and then annually. Certain medications, such as Clozapine, may cause blood
dyscrasias and CBC should be monitored closely.
Medications for Bipolar Disorder Lifespan Considerations: Pregnancy
-Lithium, valproic acid, and carbamazepine are teratogenic and are contraindicated
during pregnancy.
-Lurasidone has been used in pregnancy without teratogenic effects.
Medications for Bipolar Disorder Lifespan Considerations: Breast Feeding
Avoid breastfeeding for clients prescribed carbamazepine, lithium, and lamotrigine.
Medications for Bipolar Disorder Lifespan Considerations: Older Adult
Use caution. Reduced renal and hepatic function may impact metabolism and
elimination. Reduce dose as necessary.
2019 American Geriatric Society (AGS) Beers Criteria include the following
recommendations:
-Avoid carbamazepine (may cause syndrome of inappropriate antidiuretic hormone
secretion [SIADH]).
-Use caution with antipsychotic medications (may increase the risk of falls).
-Antipsychotic medications may increase the risk of stroke, cognitive decline, and death
in dementia clients.
-Avoid lithium in clients taking ACE inhibitors or loop diuretics.
Medications for Bipolar Disorder Lifespan Considerations: Children
Medications approved for children are limited.
Age 10 +:
-lurasidone (bipolar depression)
, -aripiprazole (acute and mixed mania)
-quetiapine (monotherapy and adjunct for acute mania)
-asenapine (acute and mixed mania)
-risperidone (monotherapy and adjunct for acute and mixed mania)
Age 13 +:
-olanzapine (acute and mixed mania)
match the client scenario with the best prescribing choice:
Jade, 24, is newly diagnosed with bipolar I with acute mania. She has an
intrauterine device (IUD).
lithium
first-line treatment for new onset bipolar with acute mania. Lithium is teratogenic; an
IUD will prevent pregnancy. If the client does not want long-term contraception or
decides to get pregnant, you can prescribe lurasidone as it is nonteratogenic and is
monotherapy for acute mania and mixed mania.
match the client scenario with the best prescribing choice:
Michelle, 30, has been taking valproic acid for bipolar I disorder. She and her
partner are discussing getting pregnant in the next few months.
lurasidone
Valproic acid is contraindicated during pregnancy. The client should be switched to an
atypical antipsychotic prior to trying to conceive.
match the client scenario with the best prescribing choice:
Adam, 22, has been diagnosed with bipolar I disorder for 3 years. He presents
with an acute episode of mania. His mother states she isn't sure how carefully he
has been taking his medications.
aripiprazole intramuscular (IM) after an oral trial establishes tolerability.
Long-acting injectable antipsychotic medications, such as aripiprazole, may be
appropriate for clients who struggle with medication adherence after a successful oral
trial.
With consideration of tolerability and low side effect profile, the first-line
medication selection for the treatment of severe depression includes:
