NR 546\ NR546 FINAL EXAM GUIDE 2025 |
ADVANCED PSYCHOPHARMACOLOGY
COMPREHENSIVE QUESTIONS AND
CORRECT ANSWERS
Pharmacologic Treatment of Bipolar Disorder - CORRECT ANSWER
✅✅✅Lithium
Anticonvulsants
Second generation antipsychotics
Unipolar depression - CORRECT ANSWER ✅✅✅major depressive disorder
(MDD)
one of the most common mental disorders
-Approximately 7.1% of adults in the U.S. had episode in last year, prevalence
highest (13.1%) among individuals aged 18-25
S/S
-depressed mood
-loss of interest or pleasure in daily activities
-irritability
-withdrawal
-problems with sleep, eating, energy, concentration, or self-worth
-severe depression: may experience thoughts of suicide or psychotic
symptoms.
Bipolar disorder (BD) - CORRECT ANSWER ✅✅✅Chronic condition
characterized by extreme fluctuations in mood, energy, and ability to function
,-Moods may be manic, hypomanic, or depressed and may include mixed mood
or psychotic features
-many have only experienced only one manic episode in their lifetime
-Mood fluctuations may be separated by periods of high stability or may cycle
rapidly
-diagnosed when a client has one or more episodes of mania or hypomania
with a history of one or more major depressive episodes
-high risk for suicide
mania - CORRECT ANSWER ✅✅✅characterized by a persistently elevated,
expansive, or irritable mood. Related symptoms may include inflated self-
esteem, increased goal-directed activity or energy, including grandiosity,
decreased need for sleep, excessive talkativeness, racing thoughts, flight of
ideas (FOI), distractibility, psychomotor agitation, and a propensity to be
involved in high-risk activities. Mania leads to significant functional impairment
and may include psychotic features or necessitate hospitalization
Bipolar Type I: - CORRECT ANSWER ✅✅✅requires at least one episode of
mania for at least one week (or any duration if hospitalization due to
symptoms is required)
Bipolar Type II: - CORRECT ANSWER ✅✅✅diagnosis requires a current or
past hypomanic episode and a current or past major depressive episode.
Symptoms last for at least 4 days but fewer than seven.
-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: - CORRECT 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: - CORRECT 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 ________________. - CORRECT 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 - CORRECT 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 - CORRECT ANSWER
✅✅✅Increased negative affect:
depressed mood
guilt
, fear/anxiety
hostility
irritability
loneliness
appetite changes
monoamine hypothesis of depression - CORRECT 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: - CORRECT
ANSWER ✅✅✅• Selective Serotonin Reuptake Inhibitors (SSRIs)
• Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
• Norepinephrine Dopamine Reuptake Inhibitors (NDRI)
• Serotonin Antagonist and Reuptake Inhibitors (SARIs)
SSRI's - CORRECT ANSWER ✅✅✅Mechanism of action
• inhibit 5-HT reuptake
Adverse effects
-diarrhea
-headache
-weight gain
-sexual side effects
SNRI's - CORRECT ANSWER ✅✅✅Mechanism of action
ADVANCED PSYCHOPHARMACOLOGY
COMPREHENSIVE QUESTIONS AND
CORRECT ANSWERS
Pharmacologic Treatment of Bipolar Disorder - CORRECT ANSWER
✅✅✅Lithium
Anticonvulsants
Second generation antipsychotics
Unipolar depression - CORRECT ANSWER ✅✅✅major depressive disorder
(MDD)
one of the most common mental disorders
-Approximately 7.1% of adults in the U.S. had episode in last year, prevalence
highest (13.1%) among individuals aged 18-25
S/S
-depressed mood
-loss of interest or pleasure in daily activities
-irritability
-withdrawal
-problems with sleep, eating, energy, concentration, or self-worth
-severe depression: may experience thoughts of suicide or psychotic
symptoms.
Bipolar disorder (BD) - CORRECT ANSWER ✅✅✅Chronic condition
characterized by extreme fluctuations in mood, energy, and ability to function
,-Moods may be manic, hypomanic, or depressed and may include mixed mood
or psychotic features
-many have only experienced only one manic episode in their lifetime
-Mood fluctuations may be separated by periods of high stability or may cycle
rapidly
-diagnosed when a client has one or more episodes of mania or hypomania
with a history of one or more major depressive episodes
-high risk for suicide
mania - CORRECT ANSWER ✅✅✅characterized by a persistently elevated,
expansive, or irritable mood. Related symptoms may include inflated self-
esteem, increased goal-directed activity or energy, including grandiosity,
decreased need for sleep, excessive talkativeness, racing thoughts, flight of
ideas (FOI), distractibility, psychomotor agitation, and a propensity to be
involved in high-risk activities. Mania leads to significant functional impairment
and may include psychotic features or necessitate hospitalization
Bipolar Type I: - CORRECT ANSWER ✅✅✅requires at least one episode of
mania for at least one week (or any duration if hospitalization due to
symptoms is required)
Bipolar Type II: - CORRECT ANSWER ✅✅✅diagnosis requires a current or
past hypomanic episode and a current or past major depressive episode.
Symptoms last for at least 4 days but fewer than seven.
-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: - CORRECT 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: - CORRECT 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 ________________. - CORRECT 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 - CORRECT 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 - CORRECT ANSWER
✅✅✅Increased negative affect:
depressed mood
guilt
, fear/anxiety
hostility
irritability
loneliness
appetite changes
monoamine hypothesis of depression - CORRECT 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: - CORRECT
ANSWER ✅✅✅• Selective Serotonin Reuptake Inhibitors (SSRIs)
• Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
• Norepinephrine Dopamine Reuptake Inhibitors (NDRI)
• Serotonin Antagonist and Reuptake Inhibitors (SARIs)
SSRI's - CORRECT ANSWER ✅✅✅Mechanism of action
• inhibit 5-HT reuptake
Adverse effects
-diarrhea
-headache
-weight gain
-sexual side effects
SNRI's - CORRECT ANSWER ✅✅✅Mechanism of action
