NRNP 6665 Final Exam Test
Comprehensive Questions (Frequently
Tested) with Verified Answers Graded
A+
Question 18:
Christine is a 9-year-old female who presents for care after having been placed in the local
foster care system. She has been in and out of foster care for the last 4 years after her parents
were killed in an automobile accident. Christine has been placed in a variety of homes and
residential care facilities. The PMHNP recognizes that Christine is at high risk for: - Answer: A.
Dissociative disorders
B. Post-traumatic stress disorder
C. Impulse-control disorder
D. Attachment disorder
Question 7:
Caylee is a 5-year-old girl who is referred for evaluation by child protective services. She was
recently removed from her biological family and placed in foster care, as her home environment
was reportedly unsafe due to conditions of extreme neglect. Her foster mother reports that
Caylee is very quiet and withdrawn and always appears sad and disinterested in her
surroundings; however, she becomes very irritable when anything unexpected or unplanned
occurs. The foster mother became very concerned when it appeared that Caylee was
hallucinating. The PMHNP considers that: - Answer: A. Caylee is at high risk for suicide and
precautions should be taken
B. The hallucinations are consistent with brief psychotic disorder or schizophrenia
C. The history and reported symptoms are typical of depressive disorder in young children
,D. This is a common situation when prepubertal children are removed from the biological
parents regardless of how dysfunctional they are
Question 2:
Debi is a 15-year-old girl who is currently being treated for depression. Her parents have been
very proactive and involved in her care, and Debi has achieved remission 2 months after
beginning treatment with a combination of pharmacotherapy and cognitive behavioral therapy.
While counseling Debi's parents about important issues in management, the PMHNP advises
that: - Answer: A. There is a > 50% likelihood that Debi's younger sibling will develop depressive
symptoms
B. The mean length of major depressive episode in adolescents is 4 months
C. 20 to 40% of adolescents who have major depressive disorder will develop bipolar I within 5
years
D. Adolescent-onset depression typically need long-term pharmacologic management to
prevent relapses
Agomelatine - Answer: Brand: Valdoxan
-Melatonin multimodal (Mel-MM)
-Agonist at melatonergic 1 and melatonergic 2 receptors
-Antagonist at 5HT2C receptors
-Not FDA approved: Rx for Depression, Generalized anxiety disorder
-Initial 25 mg/day at bedtime; after 2 weeks can increase to 50 mg/day at bedtime
Amitriptyline (Elavil) - Answer: Tricyclic antidepressant.
Aripiprazole (Abilify) - Answer: Treatment for depression. Atypical antipsychotic. "Dopamine
stabilizer". Dopamine receptor antagonist in high concentration and also stimulates increase of
dopamine in low concentrations. Side effects: insomnia, akathisia.
,Brexpiprazole (Rexulti) - Answer: Treatment for depression. Atypical antipsychotic
Bupropion (Wellbutrin) - Answer: Antidepressant and smoking cessation aid, It can treat
depression and help people quit smoking. It can also prevent depression caused by seasonal
affective disorder (SAD).
Citalopram (Celexa) - Answer: Antidepressant, SSRI: 20-40 mg qd.
Clomipramine (Anafranil) - Answer: -Serotonin reuptake inhibitor (S-RI)
-Tricyclic antidepressant (TCA)
-Parent drug is a potent serotonin reuptake inhibitor
Active metabolite is a potent norepinephrine/noradrenaline reuptake inhibitor
-Increases serotonergic neurotransmission by blocking the serotonin reuptake pump
(transporter), -Desensitization of serotonin receptors, especially serotonin 1A receptors
-Increases noradrenergic neurotransmission by blocking the norepinephrine reuptake pump
(transporter), -Desensitization of beta adrenergic receptors
-Dopamine is inactivated by norepinephrine reuptake in the frontal cortex
-Lacks dopamine transporters
-Increases dopamine neurotransmission in this part of the brain
**FDA Approved for Pediatrics in tx Obsessive-compulsive disorder (OCD) (ages 10 and older)
*Off-Label for Pediatric Use: Depression, Severe and treatment-resistant, depression, Cataplexy
syndrome, Anxiety, Insomnia,
Neuropathic pain/chronic pain
-Full therapeutic benefits may take 2-8 weeks
-Dosing: in Peds/Adolescents/Adults:
100-250mg/day
Cyamemazine (Tercian) - Answer: Treatment for depression.
, -Known as cyamepromazine
-Typical antipsychotic drug of the phenothiazine class.
-Treatment for schizophrenia
and psychosis-associated
anxiety
-Behaves like an atypical
antipsychotic, due to its
potent anxiolytic effects (5-HT2C) and lack of extrapyramidal side effects (5-HT2A).
-Conventional antipsychotic (neuroleptic, phenothiazine, dopamine 2 antagonist, serotonin
dopamine antagonist)
-Commonly Prescribed for (not FDA approved):
-Schizophrenia
-Anxiety associated with psychosis (short-term)
-Anxiety associated with nonpsychotic disorders, including mood disorders and personality
disorders (short-term)
-Severe depression
-Bipolar disorder
-Other psychotic disorders
-Acute agitation/aggression (injection)
-Benzodiazepine withdrawal
Desiprimine (Norpramine) - Answer: Treats depression
Brand: Norpramin
-TCA
-Norepinephrine noradrenaline reuptake inhibitor.
-FDA approved for treating depression.
-Off-label: Anxiety, Insomnia,
Comprehensive Questions (Frequently
Tested) with Verified Answers Graded
A+
Question 18:
Christine is a 9-year-old female who presents for care after having been placed in the local
foster care system. She has been in and out of foster care for the last 4 years after her parents
were killed in an automobile accident. Christine has been placed in a variety of homes and
residential care facilities. The PMHNP recognizes that Christine is at high risk for: - Answer: A.
Dissociative disorders
B. Post-traumatic stress disorder
C. Impulse-control disorder
D. Attachment disorder
Question 7:
Caylee is a 5-year-old girl who is referred for evaluation by child protective services. She was
recently removed from her biological family and placed in foster care, as her home environment
was reportedly unsafe due to conditions of extreme neglect. Her foster mother reports that
Caylee is very quiet and withdrawn and always appears sad and disinterested in her
surroundings; however, she becomes very irritable when anything unexpected or unplanned
occurs. The foster mother became very concerned when it appeared that Caylee was
hallucinating. The PMHNP considers that: - Answer: A. Caylee is at high risk for suicide and
precautions should be taken
B. The hallucinations are consistent with brief psychotic disorder or schizophrenia
C. The history and reported symptoms are typical of depressive disorder in young children
,D. This is a common situation when prepubertal children are removed from the biological
parents regardless of how dysfunctional they are
Question 2:
Debi is a 15-year-old girl who is currently being treated for depression. Her parents have been
very proactive and involved in her care, and Debi has achieved remission 2 months after
beginning treatment with a combination of pharmacotherapy and cognitive behavioral therapy.
While counseling Debi's parents about important issues in management, the PMHNP advises
that: - Answer: A. There is a > 50% likelihood that Debi's younger sibling will develop depressive
symptoms
B. The mean length of major depressive episode in adolescents is 4 months
C. 20 to 40% of adolescents who have major depressive disorder will develop bipolar I within 5
years
D. Adolescent-onset depression typically need long-term pharmacologic management to
prevent relapses
Agomelatine - Answer: Brand: Valdoxan
-Melatonin multimodal (Mel-MM)
-Agonist at melatonergic 1 and melatonergic 2 receptors
-Antagonist at 5HT2C receptors
-Not FDA approved: Rx for Depression, Generalized anxiety disorder
-Initial 25 mg/day at bedtime; after 2 weeks can increase to 50 mg/day at bedtime
Amitriptyline (Elavil) - Answer: Tricyclic antidepressant.
Aripiprazole (Abilify) - Answer: Treatment for depression. Atypical antipsychotic. "Dopamine
stabilizer". Dopamine receptor antagonist in high concentration and also stimulates increase of
dopamine in low concentrations. Side effects: insomnia, akathisia.
,Brexpiprazole (Rexulti) - Answer: Treatment for depression. Atypical antipsychotic
Bupropion (Wellbutrin) - Answer: Antidepressant and smoking cessation aid, It can treat
depression and help people quit smoking. It can also prevent depression caused by seasonal
affective disorder (SAD).
Citalopram (Celexa) - Answer: Antidepressant, SSRI: 20-40 mg qd.
Clomipramine (Anafranil) - Answer: -Serotonin reuptake inhibitor (S-RI)
-Tricyclic antidepressant (TCA)
-Parent drug is a potent serotonin reuptake inhibitor
Active metabolite is a potent norepinephrine/noradrenaline reuptake inhibitor
-Increases serotonergic neurotransmission by blocking the serotonin reuptake pump
(transporter), -Desensitization of serotonin receptors, especially serotonin 1A receptors
-Increases noradrenergic neurotransmission by blocking the norepinephrine reuptake pump
(transporter), -Desensitization of beta adrenergic receptors
-Dopamine is inactivated by norepinephrine reuptake in the frontal cortex
-Lacks dopamine transporters
-Increases dopamine neurotransmission in this part of the brain
**FDA Approved for Pediatrics in tx Obsessive-compulsive disorder (OCD) (ages 10 and older)
*Off-Label for Pediatric Use: Depression, Severe and treatment-resistant, depression, Cataplexy
syndrome, Anxiety, Insomnia,
Neuropathic pain/chronic pain
-Full therapeutic benefits may take 2-8 weeks
-Dosing: in Peds/Adolescents/Adults:
100-250mg/day
Cyamemazine (Tercian) - Answer: Treatment for depression.
, -Known as cyamepromazine
-Typical antipsychotic drug of the phenothiazine class.
-Treatment for schizophrenia
and psychosis-associated
anxiety
-Behaves like an atypical
antipsychotic, due to its
potent anxiolytic effects (5-HT2C) and lack of extrapyramidal side effects (5-HT2A).
-Conventional antipsychotic (neuroleptic, phenothiazine, dopamine 2 antagonist, serotonin
dopamine antagonist)
-Commonly Prescribed for (not FDA approved):
-Schizophrenia
-Anxiety associated with psychosis (short-term)
-Anxiety associated with nonpsychotic disorders, including mood disorders and personality
disorders (short-term)
-Severe depression
-Bipolar disorder
-Other psychotic disorders
-Acute agitation/aggression (injection)
-Benzodiazepine withdrawal
Desiprimine (Norpramine) - Answer: Treats depression
Brand: Norpramin
-TCA
-Norepinephrine noradrenaline reuptake inhibitor.
-FDA approved for treating depression.
-Off-label: Anxiety, Insomnia,
