NRNP 6665 FINAL EXAM TEST
Questions and Answers
1. 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
2. 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withdrawn and always appears sad and disinterested in her surroundings;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
3. 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
4. Agomelatine; Brand
Answer 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
5. Amitriptyline (Elavil)
Answer Tricyclic antidepressant.
6. 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.
7. Brexpiprazole (Rexulti)
Answer Treatment for depression. Atypical antipsychotic
8. 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 attective disorder (SAD).
9. Citalopram (Celexa) Antidepressant, SSRI
Answer 20-40 mg qd.
10. 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), -Desensi-
tization 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)
*Ott-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
11. 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 ettects (5-HT2C) and lack of extrapyramidal side ettects (5-HT2A).
Questions and Answers
1. 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
2. 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
3. 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
4. Agomelatine; Brand
Answer 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
5. Amitriptyline (Elavil)
Answer Tricyclic antidepressant.
6. 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.
7. Brexpiprazole (Rexulti)
Answer Treatment for depression. Atypical antipsychotic
8. 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 attective disorder (SAD).
9. Citalopram (Celexa) Antidepressant, SSRI
Answer 20-40 mg qd.
10. 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), -Desensi-
tization 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)
*Ott-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
11. 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 ettects (5-HT2C) and lack of extrapyramidal side ettects (5-HT2A).
