NR546 WEEK 5 KNOWLEDGE TEST. // EXAM STUDY GUIDE WITH VERIFIED ANSWERS. // 2024/2025 UPDATE. // NEW EXAM!!! NEW EXAM!!!

NR546 WEEK 5 KNOWLEDGE TEST. // EXAM STUDY GUIDE WITH VERIFIED ANSWERS. // 2024/2025 UPDATE. // NEW EXAM!!! NEW EXAM!!! Cyclothymia: - Ans-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: - Ans-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 ________________. - Ans-monotherapy -Antidepressants should be combined with a mood stabilizer to prevent the onset of a hypomanic or manic episode Prescribing Principles: initial selection of medication for a client with bipolar disorder - Ans-Assess -client safety -comorbidities -treatment adherence Initiate/optimize therapy -choose monotherapy or combination -optimize dose -check for adherence Add-on or switch therapy -use an alternative first-line agent or add on an additional first--line agent -if first-line agents are not effective, may switch to second-line agents factors for nonadherence - Ans-Medication factors -adverse effects -low treatment doses Manifestation of BD -mixed episodes -rapid cycling -hallucinations -BD I Comorbidities -substance use -obsessive-compulsive disorder Demographics -male -younger -lower education level -single Other -poor insight -negative attitude -low self-esteem Lurasidone (Latuda) should be taken with: - Ans-food, at least 350 calories, for maximum absorption Lithium carbonate (Lithobid) starting dose is reduced by at least 50% in clients with ______________ - Ans-renal impairment Lithium levels can be increased by ___________and_____________ and decreased by ___________ and __________. - Ans-NSAIDs, ACE inhibitors, caffeine, mania lab tests required for: Lithium - Ans-serum lithium level renal function thyroid function Rationale: Lithium has a narrow therapeutic index and should be monitored carefully. Serum levels should be evaluated 5 days after any dosage change and regularly at 6-month intervals. Lithium can cause renal and thyroid toxicity. Renal and thyroid function should be evaluated every 6 months. lab tests required for: Valproic acid (Depakote) - Ans-serum valproate level liver function CBC DA, NE Dysfunction causes what mood related symptoms - Ans-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 - Ans-Increased negative affect: depressed mood guilt fear/anxiety hostility irritability loneliness appetite changes neurobiological factors that contribute to mood and mood disorders: Genetics - Ans-MDD and BD are heritable disorders -genetic factors 31-42% of the disease risk in MDD and 59-85% in BD -causes of mood disorders complex, likely involve interactions between genetic/epigenetic, biological, psychological, and social factors including: • dysfunctions in brain • imbalance of neurotransmitters • life events • abuse or trauma • substance use or medication • menstruation • season changes neurobiological factors that contribute to mood and mood disorders: Neuroanatomy - Ans-Inefficient information processing by one or more brain circuits may result in mood disorder symptoms. -Recent research has tied depression to decreased activity of the prefrontal cortex. The prefrontal cortex controls attention, memory, mood, and personality. neurobiological factors that contribute to mood and mood disorders: Neural Networks - Ans-The classic monoamine hypothesis of depression posits that 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 -this hypothesis has limitations, Emphasis is now shifted from the monoamines to their receptors and other downstream events such as the regulation of gene expression, growth factors, environmental factors, and epigenetic changes