NFDN UNIT 6 EXAM QUESTIONS AND
ANSWERS
Discontinuation of medication use in DD -Answer- -based on frequency and severity of
past episodes
-based on persistence of dysthymic symptoms after recovery
-Many patients continue taking meds lifelong
Antidepressant drug Categories -Answer- Cyclic (include tricyclics [TCA's])
Selective Serotonin Reuptake Inhibitors (SSRI's) which currently include Lexapro,
Prozac, Zoloft, Luvox, Paxil, and Celexa
Monoamine Oxidase Inhibitors (MAOIs) which include Nardil and Parnate
Atypical antidepressants include Desyrel, Wellbutrin, Effexor and Remeron
This type of antidepressant is reserved for patients whose depression fails to respond to
other antidepressents -Answer- MAOIs
Serotonin Syndrome -Answer- -potentially life-threatening drug reaction; occur following
therapeutic drug use
-excess serotonergic activity at CNS and peripheral serotonin receptors
-excess serotonin activity produces cognitive, autonomic, and somatic effects
-Symptom onset rapid, occurring in minutes
-increased heart rate, shivering, sweating, dilated pupils, myoclonus (intermittent tremor
or twitching), over-responsive reflexes
-hyperactive bowel sounds, high blood pressure and hyperthermia, hypervigilance and
agitation
-Severe symptoms include severe increases in heart rate and blood pressure that may
lead to shock
Most common side effect with TCAs and MAOIs are -Answer- antihistaminic side effects
(sedation and weigh gain)
anticholinergic side effects (potentiating CNS drugs, blurred vision, dry mouth,
constipation, urinary retention, sinus tachycardia, decreased memory)
TCA's should not be prescribed for at risk of suicide patients why -Answer- Lethal dose
of TCAs are only three to five times the therapeutic dose; more than 1 gram is often
toxic and fatal
Most common side effect of MAOIs are -Answer- headache, drowsiness, dry mouth,
constipation, blurred vision, and orthostatic hypotension
, Second generation Antidepressants: SSRIs and Atypical antidepresseants -Answer-
serotonin syndrome caused by serotonin build up when more than one drug acting on
serotonergic system
Herbal substance _________ causing hypertension if taken in combination with agents
containing monoamines -Answer- st. Johns Wart
Other therapies for depression disorder -Answer- Electroconvulsive Therapy - reserved
for those who don't benefit from other tx; contraindicated for pt's with high ICP
Light Therapy - treatment of SAD seasonal affect disorder
Psychological Domain Assessment for Depressive disorder -Answer- mini mental
mood and affect
thought content
suicidal behavior
cognition and memory (decreased)
Establishing nurse-patient relationship requires ______, empathic approach. Too much
enthusiasm can _________ __________ -Answer- quiet; block communication
Psychological Tx for Depressive disorder -Answer- Therapeutic Relationship
Cognitive Therapy (reduce depressive symptoms)
Behavior Therapy
Interpersonal Therapy
Family/Marital Therapy
Group Therapy
Social Domain and depressive disorder -Answer- -looks at family history
-interventions: Milieu Therapy (form of psychotherapy involves use of therapeutic
communities) helps social skills
-safety maintenance
Eval and Tx Outcomes for depressive disorder -Answer- -major goal is to help pt be
independent as possible to achieve stability; remission and recovery from depression
-documenting pt symptoms & functioning
Bipolar Disorders -Answer- distinguished from depressive disorder by occurrence of
manic or hypomanic episodes in addition to depressive episodes
DSM-IV divides bipolar disorders into -Answer- Bipolar 1 and Bipolar 2
Bipolar 1 -Answer- characterized by one or more manic episodes generally with a major
depressive occurrence
Bipolar 2 -Answer- periods of major depression accompanied by at least one incidence
of hypomania
ANSWERS
Discontinuation of medication use in DD -Answer- -based on frequency and severity of
past episodes
-based on persistence of dysthymic symptoms after recovery
-Many patients continue taking meds lifelong
Antidepressant drug Categories -Answer- Cyclic (include tricyclics [TCA's])
Selective Serotonin Reuptake Inhibitors (SSRI's) which currently include Lexapro,
Prozac, Zoloft, Luvox, Paxil, and Celexa
Monoamine Oxidase Inhibitors (MAOIs) which include Nardil and Parnate
Atypical antidepressants include Desyrel, Wellbutrin, Effexor and Remeron
This type of antidepressant is reserved for patients whose depression fails to respond to
other antidepressents -Answer- MAOIs
Serotonin Syndrome -Answer- -potentially life-threatening drug reaction; occur following
therapeutic drug use
-excess serotonergic activity at CNS and peripheral serotonin receptors
-excess serotonin activity produces cognitive, autonomic, and somatic effects
-Symptom onset rapid, occurring in minutes
-increased heart rate, shivering, sweating, dilated pupils, myoclonus (intermittent tremor
or twitching), over-responsive reflexes
-hyperactive bowel sounds, high blood pressure and hyperthermia, hypervigilance and
agitation
-Severe symptoms include severe increases in heart rate and blood pressure that may
lead to shock
Most common side effect with TCAs and MAOIs are -Answer- antihistaminic side effects
(sedation and weigh gain)
anticholinergic side effects (potentiating CNS drugs, blurred vision, dry mouth,
constipation, urinary retention, sinus tachycardia, decreased memory)
TCA's should not be prescribed for at risk of suicide patients why -Answer- Lethal dose
of TCAs are only three to five times the therapeutic dose; more than 1 gram is often
toxic and fatal
Most common side effect of MAOIs are -Answer- headache, drowsiness, dry mouth,
constipation, blurred vision, and orthostatic hypotension
, Second generation Antidepressants: SSRIs and Atypical antidepresseants -Answer-
serotonin syndrome caused by serotonin build up when more than one drug acting on
serotonergic system
Herbal substance _________ causing hypertension if taken in combination with agents
containing monoamines -Answer- st. Johns Wart
Other therapies for depression disorder -Answer- Electroconvulsive Therapy - reserved
for those who don't benefit from other tx; contraindicated for pt's with high ICP
Light Therapy - treatment of SAD seasonal affect disorder
Psychological Domain Assessment for Depressive disorder -Answer- mini mental
mood and affect
thought content
suicidal behavior
cognition and memory (decreased)
Establishing nurse-patient relationship requires ______, empathic approach. Too much
enthusiasm can _________ __________ -Answer- quiet; block communication
Psychological Tx for Depressive disorder -Answer- Therapeutic Relationship
Cognitive Therapy (reduce depressive symptoms)
Behavior Therapy
Interpersonal Therapy
Family/Marital Therapy
Group Therapy
Social Domain and depressive disorder -Answer- -looks at family history
-interventions: Milieu Therapy (form of psychotherapy involves use of therapeutic
communities) helps social skills
-safety maintenance
Eval and Tx Outcomes for depressive disorder -Answer- -major goal is to help pt be
independent as possible to achieve stability; remission and recovery from depression
-documenting pt symptoms & functioning
Bipolar Disorders -Answer- distinguished from depressive disorder by occurrence of
manic or hypomanic episodes in addition to depressive episodes
DSM-IV divides bipolar disorders into -Answer- Bipolar 1 and Bipolar 2
Bipolar 1 -Answer- characterized by one or more manic episodes generally with a major
depressive occurrence
Bipolar 2 -Answer- periods of major depression accompanied by at least one incidence
of hypomania
