Midterm Exams: NR 546/ NR546 (New 2025/
2026 Updates BUNDLED TOGETHER PACKAGE
WITH SOLUTIONS) Psychopharmacology |
Questions & Answers| Grade A| 100% Correct
(Verified Solutions)- Chamberlain
What should the PMHNP consider when prescribing chemical restraints? -
ANSWERS-allergy status
-prior med hx for adverse drug reactions r/t the meds ordered in the chemical
restraint
-state regulations regarding chemical restrains must be reviewed
ntal health? - ANSWERSinternal or external factors activate portions of the genome
that result in the manifestation of mental health symptoms
-activation is often a result of a stressful event, which, when combined with the
genetic risk, results in the disease
-genes being on or off
-occurrence of symptoms may be the result of inheritance of an abnormal gene or of
normal genes being "on" when they should be "off."
Types of epigenetic changes: - ANSWERSDNA Methylation
Histone modification
Non-coding RNA
The potential legal and ethical issues impacting mental health treatment must also
be taken into account, including: - ANSWERS-informed consent
-competence to make healthcare decisions
-off-label prescribing
Informed consent - ANSWERSClients have the right to receive enough information
to make decisions about treatment.
-must also be informed about potential risks associated with medications.
-have the right to refuse treatment
-cannot be forcibly medicated in non-emergencies. However, clients can be forcibly
medicated if they are violent toward themselves or others and when less restrictive
methods have failed
Compliance - ANSWERSA court order may be issued for a client to receive
treatment against their wishes if they are considered a danger to themselves or
others.
-Examples: clients with schizophrenia or sex offenders
-Guardians can provide consent for clients who have limited cognitive capabilities or
are incompetent to make decisions
,-PMHNPs are responsible for being knowledgeable about their state laws and
abiding by them.
Off-Label Prescribing - ANSWERSSome clients may benefit from the unapproved
use of a drug for symptom management.
-Example: many SSRIs used to tx anxiety and OCD but are not FDA approved for
use in this disorder.
-potentially raises ethical and legal concerns
-PMHNP must remain up to date with the latest recommendations for off-label
prescribing.
Incidence of mental illness-what factors are increasing the incidence -
ANSWERSPsychological and sociological factors
Are the PMHNP and other staff liable if the client has an allergic reaction or adverse
side effects to the drugs used for chemical restraint? - ANSWERSNo.
The client has been court-ordered to take the prescribed medications and the
standing order for chemical restraints is approved. The PMHNP and other staff are
not liable if the patient has an allergic reaction or adverse side effects.
How does reviewing the genetic makeup of a client help guide the PMHNP in
selecting medication for clients? - ANSWERS-Genetic testing can assist by providing
more information on how clients may respond to certain psychotropic medications
-provides information on how a client may break down and metabolize medications
based on the cytochrome P450 system.
Tanrıkulu and Erbaş (2020) investigated identical twins to determine the presence of
an inherited link for schizophrenia and why one twin may develop schizophrenia
when the other does not. When two people have 100% identical DNA, why don't both
persons develop the exact illnesses? Studies of identical Danish twins found that if
one twin had schizophrenia, the other twin had a 50% lifetime risk of developing
schizophrenia (Lemvigh et al., 2020). Why is there only half the risk? -
ANSWERSBoth environmental and psychosocial stressors can impact mental
health. Although twins may have identical genes, their gene expression may be
different.
There may be an environmental exposure that turned a gene "on" that should have
been "off" for one twin to develop schizophrenia and not the other.
central sulcus - ANSWERSseparates the frontal lobe from the parietal lobe
frontal lobe - ANSWERSassociated with movement, intelligence, abstract thinking
broca's area - ANSWERSspeech production
temporal lobe - ANSWERSinvolves object identification and auditory signals
cerebellum - ANSWERScoordination
wernicke's area - ANSWERSspeech comprehension
,occipital lobe - ANSWERSprimary visual area
parietal lobe - ANSWERSkeeps us alert to what is going on around us
sensory cortex - ANSWERSpain, heat, and other sensations
motor cortex - ANSWERSmovement
hippocampus - ANSWERSinvolved in both memory and anxiety
nucleus accumbens - ANSWERSinvolved in the reward process
thalamus - ANSWERSinvolved in sensory organ and motor command processing
striatum - ANSWERSinvolved in complex motor actions, also links cognition to motor
actions
limbic system - ANSWERSincludes circuits that are associated with pleasure and
reward
basal ganglia - ANSWERSgroup of structures involved in voluntary motor
movements
amygdala - ANSWERSinvolved in emotional regulation and perception of odors
corpus callosum - ANSWERScontrols the communication between the two brain
hemispheres
white matter - ANSWERScontains nerve fibers that connect neurons from different
regions into functional circuits
grey matter - ANSWERScontains nerve cells and dendrites
brain tissue - ANSWERSmade up of grey matter and white matter
dorsal striatum - ANSWERSinvolved in complex motor actions and linkage of
cognition to motor actions
-main input area for basal ganglia
*activated when anticipating or engaging in pleasure
The field of epigenetics is rapidly growing and can help explain how gene expression
is: - ANSWERSinfluenced by environmental factors and how epigenetics contributes
to the manifestation of mental illness
How does epigenetics impact a person's me
Lifestyle factors such as a client's smoking status, diet, exercise, history of
medication adherence, or history of addiction should be considered when prescribing
psychotropic medications
Adherence - ANSWERSPersistence
, -taking med over intended time period
Compliance
-taking med as prescribed
left hemisphere - ANSWERS-speech comprehension
-word recognition
-grammar
-sequential processing
-recognition of detail
-conscious mental processing
right hemisphere - ANSWERS-prosody of speech
-emotional modulation
-visual-spatial skills
-recognition of facial expression
-music
-abstract mathematical skills
-holistic processing
-unconscious mental processing
-example: dopamine action in the prefrontal cortex, at the sites of autoreceptors on
monoamine neurons
Excitatory neurotransmitters: - ANSWERSincrease the likelihood that the neuron will
fire an action potential
inhibitory neurotransmitters: - ANSWERSdecrease the likelihood that a neuron will
fire an action
neurotransmitters that most impact mental health can be classified into four major
categories: - ANSWERScholinergics
-acetylcholine
monoamines
-norepinephrine, dopamine, serotonin, histamine
amino acids
-gamma- amino-butyric acid and glutamate
neuropeptides
Inhibitors: VISA CKGQ - ANSWERSValproate
Isoniazid
Sulfonamides
Amiodarone
Chloramphenicol
Ketoconazole
Grapefruit Juice
Quinidine
-decrease medication metabolism
2026 Updates BUNDLED TOGETHER PACKAGE
WITH SOLUTIONS) Psychopharmacology |
Questions & Answers| Grade A| 100% Correct
(Verified Solutions)- Chamberlain
What should the PMHNP consider when prescribing chemical restraints? -
ANSWERS-allergy status
-prior med hx for adverse drug reactions r/t the meds ordered in the chemical
restraint
-state regulations regarding chemical restrains must be reviewed
ntal health? - ANSWERSinternal or external factors activate portions of the genome
that result in the manifestation of mental health symptoms
-activation is often a result of a stressful event, which, when combined with the
genetic risk, results in the disease
-genes being on or off
-occurrence of symptoms may be the result of inheritance of an abnormal gene or of
normal genes being "on" when they should be "off."
Types of epigenetic changes: - ANSWERSDNA Methylation
Histone modification
Non-coding RNA
The potential legal and ethical issues impacting mental health treatment must also
be taken into account, including: - ANSWERS-informed consent
-competence to make healthcare decisions
-off-label prescribing
Informed consent - ANSWERSClients have the right to receive enough information
to make decisions about treatment.
-must also be informed about potential risks associated with medications.
-have the right to refuse treatment
-cannot be forcibly medicated in non-emergencies. However, clients can be forcibly
medicated if they are violent toward themselves or others and when less restrictive
methods have failed
Compliance - ANSWERSA court order may be issued for a client to receive
treatment against their wishes if they are considered a danger to themselves or
others.
-Examples: clients with schizophrenia or sex offenders
-Guardians can provide consent for clients who have limited cognitive capabilities or
are incompetent to make decisions
,-PMHNPs are responsible for being knowledgeable about their state laws and
abiding by them.
Off-Label Prescribing - ANSWERSSome clients may benefit from the unapproved
use of a drug for symptom management.
-Example: many SSRIs used to tx anxiety and OCD but are not FDA approved for
use in this disorder.
-potentially raises ethical and legal concerns
-PMHNP must remain up to date with the latest recommendations for off-label
prescribing.
Incidence of mental illness-what factors are increasing the incidence -
ANSWERSPsychological and sociological factors
Are the PMHNP and other staff liable if the client has an allergic reaction or adverse
side effects to the drugs used for chemical restraint? - ANSWERSNo.
The client has been court-ordered to take the prescribed medications and the
standing order for chemical restraints is approved. The PMHNP and other staff are
not liable if the patient has an allergic reaction or adverse side effects.
How does reviewing the genetic makeup of a client help guide the PMHNP in
selecting medication for clients? - ANSWERS-Genetic testing can assist by providing
more information on how clients may respond to certain psychotropic medications
-provides information on how a client may break down and metabolize medications
based on the cytochrome P450 system.
Tanrıkulu and Erbaş (2020) investigated identical twins to determine the presence of
an inherited link for schizophrenia and why one twin may develop schizophrenia
when the other does not. When two people have 100% identical DNA, why don't both
persons develop the exact illnesses? Studies of identical Danish twins found that if
one twin had schizophrenia, the other twin had a 50% lifetime risk of developing
schizophrenia (Lemvigh et al., 2020). Why is there only half the risk? -
ANSWERSBoth environmental and psychosocial stressors can impact mental
health. Although twins may have identical genes, their gene expression may be
different.
There may be an environmental exposure that turned a gene "on" that should have
been "off" for one twin to develop schizophrenia and not the other.
central sulcus - ANSWERSseparates the frontal lobe from the parietal lobe
frontal lobe - ANSWERSassociated with movement, intelligence, abstract thinking
broca's area - ANSWERSspeech production
temporal lobe - ANSWERSinvolves object identification and auditory signals
cerebellum - ANSWERScoordination
wernicke's area - ANSWERSspeech comprehension
,occipital lobe - ANSWERSprimary visual area
parietal lobe - ANSWERSkeeps us alert to what is going on around us
sensory cortex - ANSWERSpain, heat, and other sensations
motor cortex - ANSWERSmovement
hippocampus - ANSWERSinvolved in both memory and anxiety
nucleus accumbens - ANSWERSinvolved in the reward process
thalamus - ANSWERSinvolved in sensory organ and motor command processing
striatum - ANSWERSinvolved in complex motor actions, also links cognition to motor
actions
limbic system - ANSWERSincludes circuits that are associated with pleasure and
reward
basal ganglia - ANSWERSgroup of structures involved in voluntary motor
movements
amygdala - ANSWERSinvolved in emotional regulation and perception of odors
corpus callosum - ANSWERScontrols the communication between the two brain
hemispheres
white matter - ANSWERScontains nerve fibers that connect neurons from different
regions into functional circuits
grey matter - ANSWERScontains nerve cells and dendrites
brain tissue - ANSWERSmade up of grey matter and white matter
dorsal striatum - ANSWERSinvolved in complex motor actions and linkage of
cognition to motor actions
-main input area for basal ganglia
*activated when anticipating or engaging in pleasure
The field of epigenetics is rapidly growing and can help explain how gene expression
is: - ANSWERSinfluenced by environmental factors and how epigenetics contributes
to the manifestation of mental illness
How does epigenetics impact a person's me
Lifestyle factors such as a client's smoking status, diet, exercise, history of
medication adherence, or history of addiction should be considered when prescribing
psychotropic medications
Adherence - ANSWERSPersistence
, -taking med over intended time period
Compliance
-taking med as prescribed
left hemisphere - ANSWERS-speech comprehension
-word recognition
-grammar
-sequential processing
-recognition of detail
-conscious mental processing
right hemisphere - ANSWERS-prosody of speech
-emotional modulation
-visual-spatial skills
-recognition of facial expression
-music
-abstract mathematical skills
-holistic processing
-unconscious mental processing
-example: dopamine action in the prefrontal cortex, at the sites of autoreceptors on
monoamine neurons
Excitatory neurotransmitters: - ANSWERSincrease the likelihood that the neuron will
fire an action potential
inhibitory neurotransmitters: - ANSWERSdecrease the likelihood that a neuron will
fire an action
neurotransmitters that most impact mental health can be classified into four major
categories: - ANSWERScholinergics
-acetylcholine
monoamines
-norepinephrine, dopamine, serotonin, histamine
amino acids
-gamma- amino-butyric acid and glutamate
neuropeptides
Inhibitors: VISA CKGQ - ANSWERSValproate
Isoniazid
Sulfonamides
Amiodarone
Chloramphenicol
Ketoconazole
Grapefruit Juice
Quinidine
-decrease medication metabolism
