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NR 546 Final Exam – Advanced Pharmacology Review, Practice Questions, and Comprehensive Study Guide

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This document provides a comprehensive review for the NR 546 Final Exam, featuring practice questions and detailed explanations covering advanced pharmacology concepts. It includes key topics such as pharmacokinetics, pharmacodynamics, medication safety, drug classifications, therapeutic decision-making, adverse effects, patient education, and evidence-based prescribing principles across the lifespan. The material is designed to reinforce clinical knowledge, strengthen pharmacologic reasoning, and support successful exam preparation. It serves as a structured study resource for graduate nursing students preparing for the NR 546 final examination.

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NR 546 FINAL EXAM VERSION 1
AND VERSION 2 NEWEST 2026
ACTUAL EXAM COMPLETE
QUESTIONS AND 100% CORRECT
DETAILED ANSWERS
(GUARANTEED PASS) |ALREADY
GRADED A+
Lithium

Anticonvulsants

Second generation antipsychotics - answer-Pharmacologic Treatment of Bipolar
Disorder



major depressive disorder (MDD)

one of the most common mental disorders

-Approximately 7.1% of adults in the U.S. had episode in last year, prevalence highest
(13.1%) among individuals aged 18-25



S/S

-depressed mood

-loss of interest or pleasure in daily activities

-irritability

-withdrawal

-problems with sleep, eating, energy, concentration, or self-worth

-severe depression: may experience thoughts of suicide or psychotic symptoms. -
answer-Unipolar depression



Chronic condition characterized by extreme fluctuations in mood, energy, and ability to
function

,-Moods may be manic, hypomanic, or depressed and may include mixed mood or
psychotic features

-many have only experienced only one manic episode in their lifetime

-Mood fluctuations may be separated by periods of high stability or may cycle rapidly

-diagnosed when a client has one or more episodes of mania or hypomania with a
history of one or more major depressive episodes

-high risk for suicide - answer-Bipolar disorder (BD)



characterized by a persistently elevated, expansive, or irritable mood. Related
symptoms may include inflated self-esteem, increased goal-directed activity or energy,
including grandiosity, decreased need for sleep, excessive talkativeness, racing
thoughts, flight of ideas (FOI), distractibility, psychomotor agitation, and a propensity to
be involved in high-risk activities. Mania leads to significant functional impairment and
may include psychotic features or necessitate hospitalization - answer-mania



requires at least one episode of mania for at least one week (or any duration if
hospitalization due to symptoms is required) - answer-Bipolar Type I:



diagnosis requires a current or past hypomanic episode and a current or past major
depressive episode. Symptoms last for at least 4 days but fewer than seven.

-Hypomanic symptoms are not of sufficient duration or severity to cause significant
functional impairment, psychosis, or hospitalization.

-Anger and irritability are common.

-Clients often enjoy the elevation of mood and are reluctant to report these symptoms,
making bipolar more difficult to diagnose if the client presents in the depression phase.
- answer-Bipolar Type II:



involves the chronic presentation of hypomanic and depressive symptoms that do not
meet the diagnostic criteria for a major depressive or manic/hypomanic episode. -
answer-Cyclothymia:



antidepressant therapy may precipitate a manic episode or induce rapid-cycling bipolar
depression

,-may contribute to the increased incidence of death by suicide in children and adults
younger than 25 - answer-If bipolar depression is mistaken for MDD:



monotherapy

-Antidepressants should be combined with a mood stabilizer to prevent the onset of a
hypomanic or manic episode - answer-Antidepressants are used cautiously in clients
with bipolar disorder and never as ________________.



Decreased positive affect:

depressed mood

loss of joy

lack of interest

loss of energy

decreased alertness

decreased self-confidence

appetite changes - answer-DA, NE Dysfunction causes what mood related symptoms



Increased negative affect:

depressed mood

guilt

fear/anxiety

hostility

irritability

loneliness

appetite changes - answer-5HT, NE Dysfunction causes what mood related symptoms



-depression occurs as a result of a deficiency of one or all three monoamine
transmitters

• serotonin, norepinephrine, and dopamine

, -while mania may result from an excess - answer-monoamine hypothesis of depression



• Selective Serotonin Reuptake Inhibitors (SSRIs)

• Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)

• Norepinephrine Dopamine Reuptake Inhibitors (NDRI)

• Serotonin Antagonist and Reuptake Inhibitors (SARIs) - answer-Medication
Management for Depression, First-Line Treatment:



Mechanism of action

• inhibit 5-HT reuptake

Adverse effects

-diarrhea

-headache

-weight gain

-sexual side effects - answer-SSRI's



Mechanism of action

• inhibit 5-HT reuptake

• inhibit NE reuptake (increase energy, focus)

• increase DA in prefrontal cortex (increase cognition)

Adverse effects

-elevated blood pressure

-anxiety

-insomnia

-constipation - answer-SNRI's



Mechanism of action

• inhibit DA reuptake (increase alertness, motivation)

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