NR546 MIDTERM EXAM
(QUESTIONS AND 100%
CORRECT ANSWERS) LATEST
UPDATE 2024/2025
What should the PMHNP consider when prescribing chemical restraints?
-allergy status
-prior med hx for adverse drug reac?ons r/t the meds ordered in the chemical
restraint
-state regula?ons regarding chemical restrains must be reviewed
Are the PMHNP and other staff liable if the client has an allergic reac?on or
adverse side effects to the drugs used for chemical restraint?
No.
The client has been court-ordered to take the prescribed medica?ons and the
standing order for chemical restraints is approved. The PMHNP and other staff
are not liable if the pa?ent has an allergic reac?on or adverse side effects.
How does reviewing the gene?c makeup of a client help guide the PMHNP in
selec?ng medica?on for clients?
-Gene?c tes?ng can assist by providing more informa?on on how clients may
respond to certain psychotropic medica?ons
-provides informa?on on how a client may break down and metabolize
medica?ons based on the cytochrome P450 system.
Tanrıkulu and Erbaş (2020) inves?gated iden?cal twins to determine the
presence of an inherited link for schizophrenia and why one twin may develop
schizophrenia when the other does not. When two people have 100% iden?cal
DNA, why don't both persons develop the exact illnesses? Studies of iden?cal
,Danish twins found that if one twin had schizophrenia, the other twin had a
50% life?me risk of developing schizophrenia (Lemvigh et al., 2020). Why is
there only half the risk?
Both environmental and psychosocial stressors can impact mental health.
Although twins may have iden?cal genes, their gene expression may be
different.
There may be an environmental exposure that turned a gene "on" that should
have been "off" for one twin to develop schizophrenia and not the other.
Central sulcus
Separates the frontal lobe from the parietal lobe
Frontal lobe
Associated with movement, intelligence, abstract thinking
Broca's area
Speech produc?on
Temporal lobe
Involves object iden?fica?on and auditory signals
Cerebellum
Coordina?on
Wernicke's area
Speech comprehension
Occipital lobe
Primary visual area
Parietal lobe
Keeps us alert to what is going on around us
Sensory cortex
Pain, heat, and other sensa?ons
,Motor cortex
Movement
Hippocampus
Involved in both memory and anxiety
Nucleus accumbens
Involved in the reward process
Thalamus
Involved in sensory organ and motor command processing
Striatum
Involved in complex motor ac?ons, also links cogni?on to motor ac?ons
Limbic system
Includes circuits that are associated with pleasure and reward
Basal ganglia
Group of structures involved in voluntary motor movements
Amygdala
Involved in emo?onal regula?on and percep?on of odors
Corpus callosum
Controls the communica?on between the two brain hemispheres
White maaer
Contains nerve fibers that connect neurons from different regions into
func?onal circuits
Grey maaer
Contains nerve cells and dendrites
Brain ?ssue
Made up of grey maaer and white maaer
Dorsal striatum
, Involved in complex motor ac?ons and linkage of cogni?on to motor ac?ons
-main input area for basal ganglia
*ac?vated when an?cipa?ng or engaging in pleasure
The field of epigene?cs is rapidly growing and can help explain how gene
expression is:
Influenced by environmental factors and how epigene?cs contributes to the
manifesta?on of mental illness
How does epigene?cs impact a person's mental health?
Internal or external factors ac?vate por?ons of the genome that result in the
manifesta?on of mental health symptoms
-ac?va?on is oeen a result of a stressful event, which, when combined with the
gene?c risk, results in the disease
-genes being on or off
-occurrence of symptoms may be the result of inheritance of an abnormal gene
or of normal genes being "on" when they should be "off."
Types of epigene?c changes:
DNA Methyla?on
Histone modifica?on
Non-coding RNA
The poten?al legal and ethical issues impac?ng mental health treatment must
also be taken into account, including:
-informed consent
-competence to make healthcare decisions
-off-label prescribing
Informed consent
Clients have the right to receive enough informa?on to make decisions about
treatment.
(QUESTIONS AND 100%
CORRECT ANSWERS) LATEST
UPDATE 2024/2025
What should the PMHNP consider when prescribing chemical restraints?
-allergy status
-prior med hx for adverse drug reac?ons r/t the meds ordered in the chemical
restraint
-state regula?ons regarding chemical restrains must be reviewed
Are the PMHNP and other staff liable if the client has an allergic reac?on or
adverse side effects to the drugs used for chemical restraint?
No.
The client has been court-ordered to take the prescribed medica?ons and the
standing order for chemical restraints is approved. The PMHNP and other staff
are not liable if the pa?ent has an allergic reac?on or adverse side effects.
How does reviewing the gene?c makeup of a client help guide the PMHNP in
selec?ng medica?on for clients?
-Gene?c tes?ng can assist by providing more informa?on on how clients may
respond to certain psychotropic medica?ons
-provides informa?on on how a client may break down and metabolize
medica?ons based on the cytochrome P450 system.
Tanrıkulu and Erbaş (2020) inves?gated iden?cal twins to determine the
presence of an inherited link for schizophrenia and why one twin may develop
schizophrenia when the other does not. When two people have 100% iden?cal
DNA, why don't both persons develop the exact illnesses? Studies of iden?cal
,Danish twins found that if one twin had schizophrenia, the other twin had a
50% life?me risk of developing schizophrenia (Lemvigh et al., 2020). Why is
there only half the risk?
Both environmental and psychosocial stressors can impact mental health.
Although twins may have iden?cal genes, their gene expression may be
different.
There may be an environmental exposure that turned a gene "on" that should
have been "off" for one twin to develop schizophrenia and not the other.
Central sulcus
Separates the frontal lobe from the parietal lobe
Frontal lobe
Associated with movement, intelligence, abstract thinking
Broca's area
Speech produc?on
Temporal lobe
Involves object iden?fica?on and auditory signals
Cerebellum
Coordina?on
Wernicke's area
Speech comprehension
Occipital lobe
Primary visual area
Parietal lobe
Keeps us alert to what is going on around us
Sensory cortex
Pain, heat, and other sensa?ons
,Motor cortex
Movement
Hippocampus
Involved in both memory and anxiety
Nucleus accumbens
Involved in the reward process
Thalamus
Involved in sensory organ and motor command processing
Striatum
Involved in complex motor ac?ons, also links cogni?on to motor ac?ons
Limbic system
Includes circuits that are associated with pleasure and reward
Basal ganglia
Group of structures involved in voluntary motor movements
Amygdala
Involved in emo?onal regula?on and percep?on of odors
Corpus callosum
Controls the communica?on between the two brain hemispheres
White maaer
Contains nerve fibers that connect neurons from different regions into
func?onal circuits
Grey maaer
Contains nerve cells and dendrites
Brain ?ssue
Made up of grey maaer and white maaer
Dorsal striatum
, Involved in complex motor ac?ons and linkage of cogni?on to motor ac?ons
-main input area for basal ganglia
*ac?vated when an?cipa?ng or engaging in pleasure
The field of epigene?cs is rapidly growing and can help explain how gene
expression is:
Influenced by environmental factors and how epigene?cs contributes to the
manifesta?on of mental illness
How does epigene?cs impact a person's mental health?
Internal or external factors ac?vate por?ons of the genome that result in the
manifesta?on of mental health symptoms
-ac?va?on is oeen a result of a stressful event, which, when combined with the
gene?c risk, results in the disease
-genes being on or off
-occurrence of symptoms may be the result of inheritance of an abnormal gene
or of normal genes being "on" when they should be "off."
Types of epigene?c changes:
DNA Methyla?on
Histone modifica?on
Non-coding RNA
The poten?al legal and ethical issues impac?ng mental health treatment must
also be taken into account, including:
-informed consent
-competence to make healthcare decisions
-off-label prescribing
Informed consent
Clients have the right to receive enough informa?on to make decisions about
treatment.
