NR 606 Clinical Reasoning Exam Prep – Practice-Based Questions and answers correct, accurate 2025.2026.pdf

NR 606 Clinical Reasoning Exam Prep – Practice-Based
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1. Common maternal mental health disorders: depression, anxiety, OCD, PTSD, v v v v v v v v




bipolar disorder, and substance use disorder
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2. Prescribing considerations in maternal mental health: -you must consider the v v v v v v v v v




risks vs benefits for both mother and baby
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-work with the client 6-12 months prior to a planned pregnancy
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-most medications are tolerated, but in cases where the -medications are contraindi-
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cated with pregnancy, discuss birth control and a contingency plan should the client
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become pregnant
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-taper drugs when possible
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-physiological changes during pregnancy impact pharmacokinetics so monitor drug v v v v v v v v




levels and symptoms so dosages may be adjusted as necessary
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3. Switching medications during pregnancy: -if the client is stable on their current v v v v v v v v v v v




medication regimen, it is usually better to continue with the same regimen
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-switching exposes the fetus to more substances and meds are tapered up and down
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during the switch
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4. Whattodowhenamentalhealthclientinformsyouofpregnancy:-schedule and
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appointment to discuss a treatment plan as soon as possible (the companion may be
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included)
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-have the client to continue to current medication regiment for now
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-education her to track symptoms (mood, sleet, etc) v v v v v v v




5. Informed consent for maternal mental health: -initiate a discussion regarding v v v v v v v v v




informed consent, including risks vs benefits of medications during pregnancy and
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breastfeeding
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-clients who must stay on high-risk medications may benefit from a referral to
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a perinatal psychiatrist who specialized in psychiatric medication administration during
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pregnancy (valproic acid)
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-documentation of informed consent is required and should contain a description of the v v v v v v v v v v v v




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, conversation with the client including a discussion of all potential serious complications
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associatedwithtreatment.(considerthis...youdonotwantapatientto sayyouknowingly
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gavethemmedicationthatcausedcongenitaldefectswithoutthe client'sconsent.You
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havetomaketherisk andbenefitsclearand let them choose.)
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-discuss all common and serious adverse effects, regardless of incidence
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-documenttheinformedconsentwitheachpregnancy,nomatteriftheclient isnew or
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established.
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6. Medications for depression and anxiety during pregnancy:-SSRIs are v v v v v v v v




first-line Tx for depression and anxiety during pregnancy.
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-SNRIs,TCAs, and bupropion are considered safeTx options
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-SSRIsandSNRIscommonlycausesneonatalwithdrawalsyndromewithinthefirst 2-4
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days ofthe neonate's life(30% of the time;S/Sxincludetremors, high-pitch cry,
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