NR546/ NR 546 Study Guide
Week 1 to Week 4
Advanced Pharṃacology Psychopharṃacology
for the Psychiatric-Ṃental Health Nurse Practitioner
The Ultiṃate Study Guide to Pass Your Exaṃ
Inside, you'll get:
Key areas to focus on in your NR 546 study guide:
Review course:
Review notes:
Practice questions with answers:
Case studies:
key terṃs and definitions:
,1. How does reviewing the genetic makeup of a client help guide the PMHNP in
selecting medication for clients
Answer> -Genetic testing can assist by providing more information on how clients
may respond to certain psychotropic medications
-provides information on how a client may break down and metabolize medications
based on the cytochrome P450 system.
2. Tanr1kulu and Erba_ (2020) investigated identical 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% identical
DNA, why don't both persons develop the exact illnesses? Studies of identical
Danish twins found that if one twin had schizophrenia, the other twin had a
50% lifetime risk of developing schizophrenia (Lemvigh et al., 2020). Why is
there only half the risk
Answer> Both environmental and psychosocial stressors can im- pact mental
health. Although twins may have identical 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.
3. The field of epigenetics is rapidly growing and can help explain how
gene expression is
Answer> influenced by environmental factors and how epigenetics contributes
to the manifestation of mental illness
,4. How does epigenetics impact a person's mental health
Answer> internal or external factors activate portions of the genome that result in
the manifestation of mental health symptoms
-activation is often a result of a stressful event, which, when combined with the
genetic 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."
5. Types of epigenetic changes
Answer> DNA Methylation Histone modification
Non-coding RNA
6. The potential legal and ethical issues impacting mental health
treatment must also be taken into account, including
Answer> -informed consent
-competence to make healthcare decisions
-off-label prescribing
7. What should the PMHNP consider when prescribing chemical restraints
Answer> -
-allergy status
-prior med hx for adverse drug reactions r/t the meds ordered in the chemical
, restraint
-state regulations regarding chemical restrains must be reviewed
8. Are the PMHNP and other staff liable if the client has an allergic reaction or
adverse side effects to the drugs used for chemical restraint
Answer> No.
The client has been court-ordered to take the prescribed medications and the
standing order for chemical restraints is approved. The PMHNP and other staff are
not liable if the patient has an allergic reaction or adverse side effects.
9. Informed consent: Clients have the right to receive enough information to make
decisions about treatment.
-must also be informed about potential risks associated with medications.
-have the right to refuse treatment
-cannot be forcibly medicated in non-emergencies. However, clients can be forcibly
medicated if they are violent toward themselves or others and when less restrictive
methods have failed
10. Compliance: A court order may be issued for a client to receive treatment
against their wishes if they are considered a danger to themselves or others.
-Examples: clients with schizophrenia or sex offenders
-Guardians can provide consent for clients who have limited cognitive capabilities
or are incompetent to make decisions
-PMHNPs are responsible for being knowledgeable about their state laws and
Week 1 to Week 4
Advanced Pharṃacology Psychopharṃacology
for the Psychiatric-Ṃental Health Nurse Practitioner
The Ultiṃate Study Guide to Pass Your Exaṃ
Inside, you'll get:
Key areas to focus on in your NR 546 study guide:
Review course:
Review notes:
Practice questions with answers:
Case studies:
key terṃs and definitions:
,1. How does reviewing the genetic makeup of a client help guide the PMHNP in
selecting medication for clients
Answer> -Genetic testing can assist by providing more information on how clients
may respond to certain psychotropic medications
-provides information on how a client may break down and metabolize medications
based on the cytochrome P450 system.
2. Tanr1kulu and Erba_ (2020) investigated identical 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% identical
DNA, why don't both persons develop the exact illnesses? Studies of identical
Danish twins found that if one twin had schizophrenia, the other twin had a
50% lifetime risk of developing schizophrenia (Lemvigh et al., 2020). Why is
there only half the risk
Answer> Both environmental and psychosocial stressors can im- pact mental
health. Although twins may have identical 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.
3. The field of epigenetics is rapidly growing and can help explain how
gene expression is
Answer> influenced by environmental factors and how epigenetics contributes
to the manifestation of mental illness
,4. How does epigenetics impact a person's mental health
Answer> internal or external factors activate portions of the genome that result in
the manifestation of mental health symptoms
-activation is often a result of a stressful event, which, when combined with the
genetic 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."
5. Types of epigenetic changes
Answer> DNA Methylation Histone modification
Non-coding RNA
6. The potential legal and ethical issues impacting mental health
treatment must also be taken into account, including
Answer> -informed consent
-competence to make healthcare decisions
-off-label prescribing
7. What should the PMHNP consider when prescribing chemical restraints
Answer> -
-allergy status
-prior med hx for adverse drug reactions r/t the meds ordered in the chemical
, restraint
-state regulations regarding chemical restrains must be reviewed
8. Are the PMHNP and other staff liable if the client has an allergic reaction or
adverse side effects to the drugs used for chemical restraint
Answer> No.
The client has been court-ordered to take the prescribed medications and the
standing order for chemical restraints is approved. The PMHNP and other staff are
not liable if the patient has an allergic reaction or adverse side effects.
9. Informed consent: Clients have the right to receive enough information to make
decisions about treatment.
-must also be informed about potential risks associated with medications.
-have the right to refuse treatment
-cannot be forcibly medicated in non-emergencies. However, clients can be forcibly
medicated if they are violent toward themselves or others and when less restrictive
methods have failed
10. Compliance: A court order may be issued for a client to receive treatment
against their wishes if they are considered a danger to themselves or others.
-Examples: clients with schizophrenia or sex offenders
-Guardians can provide consent for clients who have limited cognitive capabilities
or are incompetent to make decisions
-PMHNPs are responsible for being knowledgeable about their state laws and
