NR546 Final Exam Questions with Correct Answer

NR546 Final Exam Questions with Correct Answer -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. Cyclothymia: - Answer-involves the chronic presentation of hypomanic and depressive symptoms that do not meet the diagnostic criteria for a major depressive or manic/hypomanic episode. If bipolar depression is mistaken for MDD: - Answer-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 Antidepressants are used cautiously in clients with bipolar disorder and never as ________________. - Answer-monotherapy -Antidepressants should be combined with a mood stabilizer to prevent the onset of a hypomanic or manic episode DA, NE Dysfunction causes what mood related symptoms - Answer-Decreased positive affect: depressed mood loss of joy lack of interest loss of energy decreased alertness decreased self-confidence appetite changes 5HT, NE Dysfunction causes what mood related symptoms - Answer-Increased negative affect: depressed mood guilt fear/anxiety hostility irritability loneliness appetite changes monoamine hypothesis of depression - Answer--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 Medication Management for Depression, First-Line Treatment: - Answer-• Selective Serotonin Reuptake Inhibitors (SSRIs) • Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) • Norepinephrine Dopamine Reuptake Inhibitors (NDRI) • Serotonin Antagonist and Reuptake Inhibitors (SARIs) SSRI's - Answer-Mechanism of action • inhibit 5-HT reuptake Adverse effects -diarrhea -headache -weight gain -sexual side effects SNRI's - Answer-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 NDRI's - Answer-Mechanism of action • inhibit DA reuptake (increase alertness, motivation) • inhibit NE reuptake (increase energy) Adverse effects -agitation -headache -dry mouth -constipation -weight loss SSRI Prescribing Pearls: med with mild antihistamine effects - Answer-citalopram (Celexa) SSRI Prescribing Pearls: med with no known drug interactions - Answer-escitalopram (Lexapro) SSRI Prescribing Pearls: med with longest half-life - Answer-fluoxetine (Prozac) SSRI Prescribing Pearls: med that also treats social anxiety and insomnia - Answer-paroxetine (Paxil)