NR546 EXAM QUESTIONS WITH COMPLETE SOLUTIONS
GUARANTEED PASS BRAND NEW 2025
Prefrontal Cortex Symptoms of MDD - ANSWER>>Concentration
Mental Fatigue
Mood
PFC & Amygdala Symptoms of MDD - ANSWER>>Guilt
Suicidality
Worthlessness
Striatum Symptoms of MDD - ANSWER>>Physical fatigue
Nucleus Accumbens Symptoms of MDD - ANSWER>>Pleasure interests
Hypothalamus Symptoms of MDD - ANSWER>>Sleep
Appetite
Thalamus & Hypothalamus Symptoms of Mania - ANSWER>>Decreased
sleep/arousal
Striatum Symptoms of Mania - ANSWER>>Motor/agitation
Prefrontal cortex (PFC) Symptoms of Mania - ANSWER>>Risk-taking
Talkative/pressured speech
Nucleus Accumbens & PFC Symptoms of Mania - ANSWER>>Racing thoughts,
grandiosity
PFC & Amygdala Symptoms of Mania - ANSWER>>Mood
,Medication Management - ANSWER>>SSRI-Selective Serotonin Reuptake
Inhibitors
*Inhibit 5 HT reuptake
SNRI-Serotonin Norepinephrine Reuptake Inhibitors
*inhibit 5-HT reuptake
*inhibit NE reuptake (increase energy, focus)
*increase DA in prefrontal cortex (increase cognition)
NDRI-Norepinephrine Dopamine Reuptake inhibitors
*inhibit DA reuptake (increase alertness, motivation)
*inhibit NE reuptake (increase energy)
SARI-Serotonin Antagonist Reuptake Inhibitors
Selective Serotonin Reuptake Inhibitors (SSRIs): Most adverse effects will
subside after 4-5 days once the body adjusts to increased serotonin levels. -
ANSWER>>diarrhea headache weight gain sexual side effects
Serotonin Norepinephrine Reuptake Inhibitors (SNRIs): Medications should not
be abruptly stopped to avoid discontinuation symptoms. NE effects of the
medication may increase anxiety in some clients. Report worsening anxiety to
the provider. - ANSWER>>elevated blood pressure anxiety insomnia
constipation
Norepinephrine Dopamine Reuptake Inhibitors (NDRI): Take medication in the
morning. Stop taking medication if seizures occur. Stop taking medication if
anxiety is noted. - ANSWER>>agitation headache dry mouth constipation
weight loss
escitalopram (Lexapro) SSRI - ANSWER>>no known drug interactions best
tolerated SSRI
27-32 hour half-life good for forgetful prone clients least
CYP reactions
Substrate for 3A4
,citalopram (Celexa) SSRI - ANSWER>>mild antihistamine effects; Half-Life: 23-45
hours
Weak Inhibitor of 2D6
fluoxetine (Prozac) SSRI - ANSWER>>longest half-life
Use caution in patients with comorbid anxiety due to risk for activation and panic
attacks
Half-Life: 2-3 days parent, 2 week metabolite
Inhibits 2D6 and 3A4
paroxetine (Paxil) SSRI - ANSWER>>also treats social anxiety and insomnia
associated with weight gain
will experience withdrawal with missed dose or abrupt stop
Half-Life: 24 hours
Inhibits 2D6
fluvoxamine (Luvox) SSRI - ANSWER>>treats anxious depression smokers
require an increased dose Half-Life: 9-28 hours
Inhibits 3A4, 2C9, 1A2
sertraline (Zoloft) SSRI - ANSWER>>also treats social anxiety and
hypersomnolence
Half-Life: 22-36 hour parent; 62-104 hour metabolite
Inhibits 2D6 and 3A4 weakly at low doses
venlafaxine (Effexor) - ANSWER>>treats both depression and anxiety disorders,
ensure trial of higher dose before switching to a different medication Half-life:
Parent drug 3-7 hour; metabolite has 9-13 hour
duloxetine (Cymbalta) SNRI - ANSWER>>effective for atypical pain at higher doses;
appropriate for clients who present with somatic symptoms of depression;
effective for atypical pain, such as fibromyalgia and diabetic neuropathy
, Half-Life: 12 hours
Inhibitor of 2D6
bupropion (Wellbutrin) - ANSWER>>NDRI may improve energy, alertness, and
motivation; not first-line treatment for anxiety; contraindicated in clients with a
history of seizures
Avoid in patients with comorbid anxiety
Half-Life: Parent 10-14 hours; Metabolite 20-27 hours
Inhibits 2D6
Serotonin Antagonist and Reuptake Inhibitors (SARIs) - ANSWER>>SARIs potently
block 5-HT2A and 5HT 2C receptors, which allow more 5-HT to interact at
postsynaptic 5-HT1A sites. Serotonin blockade and reuptake inhibition is present
at higher doses.
Trazodone - ANSWER>>The most common SARI, also blocks histaminergic and α-
adrenergic receptors.
Half-Life: 3-6 hours
Serotonin Antagonist and Reuptake Inhibitors (SARIs) - ANSWER>>Common
Adverse Effects
· sedation
· drowsiness
· blurred vision
· constipation
· dry mouth
Serious Adverse Effect priapism
Serotonin norepinephrine receptor agonist, alpha2 receptor agonist -
ANSWER>>Mirtazapine
Serotonin multimodal (SMM)/serotonin partial agonist reuptake inhibitor
(SPARI) - ANSWER>>Vilazodone (Viibryd)
GUARANTEED PASS BRAND NEW 2025
Prefrontal Cortex Symptoms of MDD - ANSWER>>Concentration
Mental Fatigue
Mood
PFC & Amygdala Symptoms of MDD - ANSWER>>Guilt
Suicidality
Worthlessness
Striatum Symptoms of MDD - ANSWER>>Physical fatigue
Nucleus Accumbens Symptoms of MDD - ANSWER>>Pleasure interests
Hypothalamus Symptoms of MDD - ANSWER>>Sleep
Appetite
Thalamus & Hypothalamus Symptoms of Mania - ANSWER>>Decreased
sleep/arousal
Striatum Symptoms of Mania - ANSWER>>Motor/agitation
Prefrontal cortex (PFC) Symptoms of Mania - ANSWER>>Risk-taking
Talkative/pressured speech
Nucleus Accumbens & PFC Symptoms of Mania - ANSWER>>Racing thoughts,
grandiosity
PFC & Amygdala Symptoms of Mania - ANSWER>>Mood
,Medication Management - ANSWER>>SSRI-Selective Serotonin Reuptake
Inhibitors
*Inhibit 5 HT reuptake
SNRI-Serotonin Norepinephrine Reuptake Inhibitors
*inhibit 5-HT reuptake
*inhibit NE reuptake (increase energy, focus)
*increase DA in prefrontal cortex (increase cognition)
NDRI-Norepinephrine Dopamine Reuptake inhibitors
*inhibit DA reuptake (increase alertness, motivation)
*inhibit NE reuptake (increase energy)
SARI-Serotonin Antagonist Reuptake Inhibitors
Selective Serotonin Reuptake Inhibitors (SSRIs): Most adverse effects will
subside after 4-5 days once the body adjusts to increased serotonin levels. -
ANSWER>>diarrhea headache weight gain sexual side effects
Serotonin Norepinephrine Reuptake Inhibitors (SNRIs): Medications should not
be abruptly stopped to avoid discontinuation symptoms. NE effects of the
medication may increase anxiety in some clients. Report worsening anxiety to
the provider. - ANSWER>>elevated blood pressure anxiety insomnia
constipation
Norepinephrine Dopamine Reuptake Inhibitors (NDRI): Take medication in the
morning. Stop taking medication if seizures occur. Stop taking medication if
anxiety is noted. - ANSWER>>agitation headache dry mouth constipation
weight loss
escitalopram (Lexapro) SSRI - ANSWER>>no known drug interactions best
tolerated SSRI
27-32 hour half-life good for forgetful prone clients least
CYP reactions
Substrate for 3A4
,citalopram (Celexa) SSRI - ANSWER>>mild antihistamine effects; Half-Life: 23-45
hours
Weak Inhibitor of 2D6
fluoxetine (Prozac) SSRI - ANSWER>>longest half-life
Use caution in patients with comorbid anxiety due to risk for activation and panic
attacks
Half-Life: 2-3 days parent, 2 week metabolite
Inhibits 2D6 and 3A4
paroxetine (Paxil) SSRI - ANSWER>>also treats social anxiety and insomnia
associated with weight gain
will experience withdrawal with missed dose or abrupt stop
Half-Life: 24 hours
Inhibits 2D6
fluvoxamine (Luvox) SSRI - ANSWER>>treats anxious depression smokers
require an increased dose Half-Life: 9-28 hours
Inhibits 3A4, 2C9, 1A2
sertraline (Zoloft) SSRI - ANSWER>>also treats social anxiety and
hypersomnolence
Half-Life: 22-36 hour parent; 62-104 hour metabolite
Inhibits 2D6 and 3A4 weakly at low doses
venlafaxine (Effexor) - ANSWER>>treats both depression and anxiety disorders,
ensure trial of higher dose before switching to a different medication Half-life:
Parent drug 3-7 hour; metabolite has 9-13 hour
duloxetine (Cymbalta) SNRI - ANSWER>>effective for atypical pain at higher doses;
appropriate for clients who present with somatic symptoms of depression;
effective for atypical pain, such as fibromyalgia and diabetic neuropathy
, Half-Life: 12 hours
Inhibitor of 2D6
bupropion (Wellbutrin) - ANSWER>>NDRI may improve energy, alertness, and
motivation; not first-line treatment for anxiety; contraindicated in clients with a
history of seizures
Avoid in patients with comorbid anxiety
Half-Life: Parent 10-14 hours; Metabolite 20-27 hours
Inhibits 2D6
Serotonin Antagonist and Reuptake Inhibitors (SARIs) - ANSWER>>SARIs potently
block 5-HT2A and 5HT 2C receptors, which allow more 5-HT to interact at
postsynaptic 5-HT1A sites. Serotonin blockade and reuptake inhibition is present
at higher doses.
Trazodone - ANSWER>>The most common SARI, also blocks histaminergic and α-
adrenergic receptors.
Half-Life: 3-6 hours
Serotonin Antagonist and Reuptake Inhibitors (SARIs) - ANSWER>>Common
Adverse Effects
· sedation
· drowsiness
· blurred vision
· constipation
· dry mouth
Serious Adverse Effect priapism
Serotonin norepinephrine receptor agonist, alpha2 receptor agonist -
ANSWER>>Mirtazapine
Serotonin multimodal (SMM)/serotonin partial agonist reuptake inhibitor
(SPARI) - ANSWER>>Vilazodone (Viibryd)
