NR606 Week 1 Study Set | Questions with 100% Verified
Answers | Latest Update 2026/2027
Question: Common maternal mental health disorders
Answer: depression, anxiety, OCD, PTSD, bipolar disorder, and substance use disorder
Question: Prescribing considerations in maternal mental health
Answer: -you must consider the risks vs benefits for both mother and baby
-work with the client 6-12 months prior to a planned pregnancy
-most medications are tolerated, but in cases where the -medications are contraindicated
with pregnancy, discuss birth control and a contingency plan should the client become
pregnant
-taper drugs when possible
-physiological changes during pregnancy impact pharmacokinetics so monitor drug
levels and symptoms so dosages may be adjusted as necessary
Question: Switching medications during pregnancy
Answer: -if the client is stable on their current medication regimen, it is usually better to
continue
with the same regimen
-switching exposes the fetus to more substances and meds are tapered up and down
during the switch
Question: What to do when a mental health client informs you of
pregnancy
Answer: -schedule and appointment to discuss a treatment plan as soon as possible (the
companion may be included)
-have the client to continue to current medication regiment for now
-education her to track symptoms (mood, sleet, etc)
Question: Informed consent for maternal mental health
Answer: -initiate a discussion regarding informed consent, including risks vs benefits of
medications during pregnancy and breastfeeding
-clients who must stay on high-risk medications may benefit from a referral to a perinatal
psychiatrist who specialized in psychiatric medication administration during pregnancy
(valproic acid)
-documentation of informed consent is required and should contain a description of the
conversation with the client including a discussion of all potential serious complications
associated with treatment. (consider this...you do not want a patient to say you knowingly
gave them medication that caused congenital defects without the client's consent. You
have to make the risk and benefits clear and let them choose.)
-discuss all common and serious adverse effects, regardless of incidence
-document the informed consent with each pregnancy, no matter if the client is new or
established.
, Question: Medications for depression and anxiety during pregnancy
Answer: -SSRIs are first-line Tx for depression and anxiety during pregnancy.
-SNRIs, TCAs, and bupropion are considered safe Tx options
-SSRIs and SNRIs commonly causes neonatal withdrawal syndrome within the first 2-4
days of the neonate's life (30% of the time; S/Sx include tremors, high-pitch cry, and
disturbed sleep).
-Benzodiazepines may be taken with caution
Question: Medications for bipolar disorder during pregnancy
Answer: -lamotrigine (Lamictal) is considered safe during pregnancy for may not be effective
for
manic episodes
-lithium exposure during the 1st trimester may cause cardiac malformations, and risk
increases with higher doses.
-valproic acid and carbamazepine are considered teratogenic during the first trimester,
avoid, taper to discontinue, if the drug must be continued monitor clotting parameters
and test to detect birth defects, and consider vitamin k during the last 6 weeks of
pregnancy, encourage folic acid during 1st trimester
-atypical antipsychotics and anticonvulsants such as valproic acid may be after lithium
during the postpartum period when breastfeeding
-carbamazepine decreases the levels/efficacy of hormone contraction, the client should
use an alternative contraceptive to avoid pregnancy, especially since carbamazepine is
teratogenic during the 1st trimester
Question: Valproic acid during pregnancy
Answer: -Teratogenic effects in developing fetuses such as neural tube defects,
neurodevelopmental delay, etc.
-It's considered safe during breastfeeding but has been found in breastmilk
-keep in mind valproic acid is teratogenic when caring for female clients of childbearing
age
Question: Medications for psychosis during the perinatal period
Answer: -atypical antipsychotic medications, particularly olanzapine and quetiapine, increases
the
risk of gestational diabetes
-Olanzapine has been found to increase the risk of musculoskeletal malformations in
infants
-risperidone and quetiapine are the most used antipsychotics during pregnancy, neither
appear to cause malformations
-antipsychotics may cause neonatal withdrawal syndrome
Question: Mental health and breastfeeding
Answer: -most psychotropic medications pass into breast milk
-some women who are taking psychopharmacologic agents, bottle feeding may be the
best option
Answers | Latest Update 2026/2027
Question: Common maternal mental health disorders
Answer: depression, anxiety, OCD, PTSD, bipolar disorder, and substance use disorder
Question: Prescribing considerations in maternal mental health
Answer: -you must consider the risks vs benefits for both mother and baby
-work with the client 6-12 months prior to a planned pregnancy
-most medications are tolerated, but in cases where the -medications are contraindicated
with pregnancy, discuss birth control and a contingency plan should the client become
pregnant
-taper drugs when possible
-physiological changes during pregnancy impact pharmacokinetics so monitor drug
levels and symptoms so dosages may be adjusted as necessary
Question: Switching medications during pregnancy
Answer: -if the client is stable on their current medication regimen, it is usually better to
continue
with the same regimen
-switching exposes the fetus to more substances and meds are tapered up and down
during the switch
Question: What to do when a mental health client informs you of
pregnancy
Answer: -schedule and appointment to discuss a treatment plan as soon as possible (the
companion may be included)
-have the client to continue to current medication regiment for now
-education her to track symptoms (mood, sleet, etc)
Question: Informed consent for maternal mental health
Answer: -initiate a discussion regarding informed consent, including risks vs benefits of
medications during pregnancy and breastfeeding
-clients who must stay on high-risk medications may benefit from a referral to a perinatal
psychiatrist who specialized in psychiatric medication administration during pregnancy
(valproic acid)
-documentation of informed consent is required and should contain a description of the
conversation with the client including a discussion of all potential serious complications
associated with treatment. (consider this...you do not want a patient to say you knowingly
gave them medication that caused congenital defects without the client's consent. You
have to make the risk and benefits clear and let them choose.)
-discuss all common and serious adverse effects, regardless of incidence
-document the informed consent with each pregnancy, no matter if the client is new or
established.
, Question: Medications for depression and anxiety during pregnancy
Answer: -SSRIs are first-line Tx for depression and anxiety during pregnancy.
-SNRIs, TCAs, and bupropion are considered safe Tx options
-SSRIs and SNRIs commonly causes neonatal withdrawal syndrome within the first 2-4
days of the neonate's life (30% of the time; S/Sx include tremors, high-pitch cry, and
disturbed sleep).
-Benzodiazepines may be taken with caution
Question: Medications for bipolar disorder during pregnancy
Answer: -lamotrigine (Lamictal) is considered safe during pregnancy for may not be effective
for
manic episodes
-lithium exposure during the 1st trimester may cause cardiac malformations, and risk
increases with higher doses.
-valproic acid and carbamazepine are considered teratogenic during the first trimester,
avoid, taper to discontinue, if the drug must be continued monitor clotting parameters
and test to detect birth defects, and consider vitamin k during the last 6 weeks of
pregnancy, encourage folic acid during 1st trimester
-atypical antipsychotics and anticonvulsants such as valproic acid may be after lithium
during the postpartum period when breastfeeding
-carbamazepine decreases the levels/efficacy of hormone contraction, the client should
use an alternative contraceptive to avoid pregnancy, especially since carbamazepine is
teratogenic during the 1st trimester
Question: Valproic acid during pregnancy
Answer: -Teratogenic effects in developing fetuses such as neural tube defects,
neurodevelopmental delay, etc.
-It's considered safe during breastfeeding but has been found in breastmilk
-keep in mind valproic acid is teratogenic when caring for female clients of childbearing
age
Question: Medications for psychosis during the perinatal period
Answer: -atypical antipsychotic medications, particularly olanzapine and quetiapine, increases
the
risk of gestational diabetes
-Olanzapine has been found to increase the risk of musculoskeletal malformations in
infants
-risperidone and quetiapine are the most used antipsychotics during pregnancy, neither
appear to cause malformations
-antipsychotics may cause neonatal withdrawal syndrome
Question: Mental health and breastfeeding
Answer: -most psychotropic medications pass into breast milk
-some women who are taking psychopharmacologic agents, bottle feeding may be the
best option
