NRNP 6665 Final Exam Questions with Correct
Answers
Question 18:
Christine is a 9-year-old female who presents for care after having been placed in the
local foster care system. She has been in and out of foster care for the last 4 years after
her parents were killed in an automobile accident. Christine has been placed in a
variety of homes and residential care facilities. The PMHNP recognizes that Christine is
at high risk for:
A. Dissociative disorders
B. Post-traumatic stress disorder
C. Impulse-control disorder
D. Attachment disorder
Question 7:
Caylee is a 5-year-old girl who is referred for evaluation by child protective services.
She was recently removed from her biological family and placed in foster care, as her
home environment was reportedly unsafe due to conditions of extreme neglect. Her
foster mother reports that Caylee is very quiet and withdrawn and always appears sad
and disinterested in her surroundings; however, she becomes very irritable when
anything unexpected or unplanned occurs. The foster mother became very concerned
when it appeared that Caylee was hallucinating. The PMHNP considers that:
A. Caylee is at high risk for suicide and precautions should be taken
B. The hallucinations are consistent with brief psychotic disorder or schizophrenia
C. The history and reported symptoms are typical of depressive disorder in young children
,D. This is a common situation when prepubertal children are removed from the biological
parents regardless of how dysfunctional they are
Question 2:
Debi is a 15-year-old girl who is currently being treated for depression. Her parents
have been very proactive and involved in her care, and Debi has achieved remission 2
months after beginning treatment with a combination of pharmacotherapy and
cognitive behavioral therapy. While counseling Debi's parents about important issues in
management, the PMHNP advises that:
A. There is a > 50% likelihood that Debi's younger sibling will develop depressive
symptoms
B. The mean length of major depressive episode in adolescents is 4 months
C. 20 to 40% of adolescents who have major depressive disorder will develop bipolar I within
5 years
D. Adolescent-onset depression typically need long-term pharmacologic management to
prevent relapses
Agomelatine
Brand: Valdoxan
-Melatonin multimodal (Mel-MM)
-Agonist at melatonergic 1 and melatonergic 2 receptors
-Antagonist at 5HT2C receptors
-Not FDA approved: Rx for Depression, Generalized anxiety disorder
-Initial 25 mg/day at bedtime; after 2 weeks can increase to 50 mg/day at bedtime
Amitriptyline (Elavil)
,Tricyclic antidepressant.
Aripiprazole (Abilify)
Treatment for depression. Atypical antipsychotic. "Dopamine stabilizer". Dopamine receptor
antagonist in high concentration and also stimulates increase of dopamine in low
concentrations. Side effects: insomnia, akathisia.
Brexpiprazole (Rexulti)
Treatment for depression. Atypical antipsychotic
Bupropion (Wellbutrin)
Antidepressant and smoking cessation aid, It can treat depression and help people quit
smoking. It can also prevent depression caused by seasonal affective disorder (SAD).
Citalopram (Celexa)
Antidepressant, SSRI: 20-40 mg qd.
Clomipramine (Anafranil)
-Serotonin reuptake inhibitor (S-RI)
-Tricyclic antidepressant (TCA)
-Parent drug is a potent serotonin reuptake inhibitor
Active metabolite is a potent norepinephrine/noradrenaline reuptake inhibitor
-Increases serotonergic neurotransmission by blocking the serotonin reuptake pump
(transporter), -Desensitization of serotonin receptors, especially serotonin 1A receptors
-Increases noradrenergic neurotransmission by blocking the norepinephrine reuptake pump
(transporter), -Desensitization of beta adrenergic receptors
-Dopamine is inactivated by norepinephrine reuptake in the frontal cortex
, -Lacks dopamine transporters
-Increases dopamine neurotransmission in this part of the brain
**FDA Approved for Pediatrics in tx Obsessive-compulsive disorder (OCD) (ages 10 and
older)
*Off-Label for Pediatric Use: Depression, Severe and treatment-resistant, depression,
Cataplexy syndrome, Anxiety, Insomnia,
Neuropathic pain/chronic pain
-Full therapeutic benefits may take 2-8 weeks
-Dosing: in Peds/Adolescents/Adults:
100-250mg/day
Cyamemazine (Tercian)
Treatment for depression.
-Known as cyamepromazine
-Typical antipsychotic drug of the phenothiazine class.
-Treatment for schizophrenia
and psychosis-associated
anxiety
-Behaves like an atypical
antipsychotic, due to its
potent anxiolytic effects (5-HT2C) and lack of extrapyramidal side effects (5-HT2A).
-Conventional antipsychotic (neuroleptic, phenothiazine, dopamine 2 antagonist, serotonin
dopamine antagonist)
Answers
Question 18:
Christine is a 9-year-old female who presents for care after having been placed in the
local foster care system. She has been in and out of foster care for the last 4 years after
her parents were killed in an automobile accident. Christine has been placed in a
variety of homes and residential care facilities. The PMHNP recognizes that Christine is
at high risk for:
A. Dissociative disorders
B. Post-traumatic stress disorder
C. Impulse-control disorder
D. Attachment disorder
Question 7:
Caylee is a 5-year-old girl who is referred for evaluation by child protective services.
She was recently removed from her biological family and placed in foster care, as her
home environment was reportedly unsafe due to conditions of extreme neglect. Her
foster mother reports that Caylee is very quiet and withdrawn and always appears sad
and disinterested in her surroundings; however, she becomes very irritable when
anything unexpected or unplanned occurs. The foster mother became very concerned
when it appeared that Caylee was hallucinating. The PMHNP considers that:
A. Caylee is at high risk for suicide and precautions should be taken
B. The hallucinations are consistent with brief psychotic disorder or schizophrenia
C. The history and reported symptoms are typical of depressive disorder in young children
,D. This is a common situation when prepubertal children are removed from the biological
parents regardless of how dysfunctional they are
Question 2:
Debi is a 15-year-old girl who is currently being treated for depression. Her parents
have been very proactive and involved in her care, and Debi has achieved remission 2
months after beginning treatment with a combination of pharmacotherapy and
cognitive behavioral therapy. While counseling Debi's parents about important issues in
management, the PMHNP advises that:
A. There is a > 50% likelihood that Debi's younger sibling will develop depressive
symptoms
B. The mean length of major depressive episode in adolescents is 4 months
C. 20 to 40% of adolescents who have major depressive disorder will develop bipolar I within
5 years
D. Adolescent-onset depression typically need long-term pharmacologic management to
prevent relapses
Agomelatine
Brand: Valdoxan
-Melatonin multimodal (Mel-MM)
-Agonist at melatonergic 1 and melatonergic 2 receptors
-Antagonist at 5HT2C receptors
-Not FDA approved: Rx for Depression, Generalized anxiety disorder
-Initial 25 mg/day at bedtime; after 2 weeks can increase to 50 mg/day at bedtime
Amitriptyline (Elavil)
,Tricyclic antidepressant.
Aripiprazole (Abilify)
Treatment for depression. Atypical antipsychotic. "Dopamine stabilizer". Dopamine receptor
antagonist in high concentration and also stimulates increase of dopamine in low
concentrations. Side effects: insomnia, akathisia.
Brexpiprazole (Rexulti)
Treatment for depression. Atypical antipsychotic
Bupropion (Wellbutrin)
Antidepressant and smoking cessation aid, It can treat depression and help people quit
smoking. It can also prevent depression caused by seasonal affective disorder (SAD).
Citalopram (Celexa)
Antidepressant, SSRI: 20-40 mg qd.
Clomipramine (Anafranil)
-Serotonin reuptake inhibitor (S-RI)
-Tricyclic antidepressant (TCA)
-Parent drug is a potent serotonin reuptake inhibitor
Active metabolite is a potent norepinephrine/noradrenaline reuptake inhibitor
-Increases serotonergic neurotransmission by blocking the serotonin reuptake pump
(transporter), -Desensitization of serotonin receptors, especially serotonin 1A receptors
-Increases noradrenergic neurotransmission by blocking the norepinephrine reuptake pump
(transporter), -Desensitization of beta adrenergic receptors
-Dopamine is inactivated by norepinephrine reuptake in the frontal cortex
, -Lacks dopamine transporters
-Increases dopamine neurotransmission in this part of the brain
**FDA Approved for Pediatrics in tx Obsessive-compulsive disorder (OCD) (ages 10 and
older)
*Off-Label for Pediatric Use: Depression, Severe and treatment-resistant, depression,
Cataplexy syndrome, Anxiety, Insomnia,
Neuropathic pain/chronic pain
-Full therapeutic benefits may take 2-8 weeks
-Dosing: in Peds/Adolescents/Adults:
100-250mg/day
Cyamemazine (Tercian)
Treatment for depression.
-Known as cyamepromazine
-Typical antipsychotic drug of the phenothiazine class.
-Treatment for schizophrenia
and psychosis-associated
anxiety
-Behaves like an atypical
antipsychotic, due to its
potent anxiolytic effects (5-HT2C) and lack of extrapyramidal side effects (5-HT2A).
-Conventional antipsychotic (neuroleptic, phenothiazine, dopamine 2 antagonist, serotonin
dopamine antagonist)
