NR 546 MIDTERM 2026/2027 EXAM FINAL QUESTIONS
AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
LATEST UPDATE GRADED A+
Prescribing for Peds Considerations -Pediatrics needs smaller dose in most cases because of heightened drug
sensitivity and bodies still developing.
Prescribing for Pregnancy and Breastfeeding -Many psychotropic meds are not safe for pregnancy or breastfeeding.
Must Considerations weight risk/benefits and know which meds are contraindicated.
Prescribing for Elderly Considerations Elderly patients may have impaired pharmacokinetics and could need lower
doses. Always check Beer's Criteria. Watch for polypharmacy and drug
interactions.
Medication Adherence persistence-taking the medication over the period of time intended
compliance-taking the medication as prescribed
factors that influence adherence client factors (eg fear of addiction to med), provider factors (eg not explaining
side effects to pt), structural factors (eg lack of access to medication)
Informed Consent clients must be given enough information to determine if they want to
proceed with treatment, including MOA and risks such as adverse effects
instance where we do not need informed consent if the patient is violent towards themselves or others
Off-Label Prescribing -some patients benefit from the unapproved use of a drug for symptom mgmt
-FDA has not approved the drug for that specific use
-could raise ethical and legal concerns
-NPs need to be up to date with latest recs
frontal lobe functions movement, intelligence, abstract thinking
temporal lobe functions object identification, auditory signals
parietal lobe functions keeps us alert to what's going on around us
occipital lobe functions primary visual area
, dorsal striatum involved in complex motor actions; links cognition to movement
basal ganglia group of structures involved in voluntary
movement, Parkinson's
nucleus accumbens function reward circuit; reinforces addictive behaviors
amygdala function emotional regulation, perception of odors, fight or flight response, releases stress
hormones (HPA axis)
hippocampus functions involved in anxiety and memory-making; impaired in schizo and dementia
limbic system associated with pleasure, reward, and reinforcing behavior; drug abuse
negatively effects the limbic system
Thalamus processes all motor command and sensory information besides olfactory
associated with schizo and PTSD
corpus callosum controls communication between two hemis of brain
cerebellum function coordination
central sulcus separates frontal and parietal lobes
inheriting epigenomes epigenome chemical compounds are not part of the DNA sequence but are
attached to the DNA and can be passed down to offspring in
subsequent
generations
how does gene expression impact mental health Normal and abnormal genes both contribute to disease and drug efficacy.
Epigenetics can contribute to the risk of any disorder or disease. Psychiatric
disorders can also be due to normal genes that are "on" that should be "off."
CYP450 inducers effect on metabolism speed up metabolism, therefore there's less of the drug in the bloodstream, pt
may need a higher dose for efficacy
CYP450 inhibitor effect on metabolism slows down metabolism, therefore more of the drug in the bloodstream, could
cause toxicity, pt may need lower dose of drug
SSRI action and side effects inhibits reuptake of serotonin; can cause nausea, agitation, headache and sexual
dysfunction
SNRI action and side effect inhibits reuptake of serotonin and norepinephrine; can cause nausea, sweating,
insomnia, tremors, sexual dysfunction
tricyclic antidepressants action inhibits reuptake of serotonin and norepinephrine, blocks norepi receptors,
AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED
LATEST UPDATE GRADED A+
Prescribing for Peds Considerations -Pediatrics needs smaller dose in most cases because of heightened drug
sensitivity and bodies still developing.
Prescribing for Pregnancy and Breastfeeding -Many psychotropic meds are not safe for pregnancy or breastfeeding.
Must Considerations weight risk/benefits and know which meds are contraindicated.
Prescribing for Elderly Considerations Elderly patients may have impaired pharmacokinetics and could need lower
doses. Always check Beer's Criteria. Watch for polypharmacy and drug
interactions.
Medication Adherence persistence-taking the medication over the period of time intended
compliance-taking the medication as prescribed
factors that influence adherence client factors (eg fear of addiction to med), provider factors (eg not explaining
side effects to pt), structural factors (eg lack of access to medication)
Informed Consent clients must be given enough information to determine if they want to
proceed with treatment, including MOA and risks such as adverse effects
instance where we do not need informed consent if the patient is violent towards themselves or others
Off-Label Prescribing -some patients benefit from the unapproved use of a drug for symptom mgmt
-FDA has not approved the drug for that specific use
-could raise ethical and legal concerns
-NPs need to be up to date with latest recs
frontal lobe functions movement, intelligence, abstract thinking
temporal lobe functions object identification, auditory signals
parietal lobe functions keeps us alert to what's going on around us
occipital lobe functions primary visual area
, dorsal striatum involved in complex motor actions; links cognition to movement
basal ganglia group of structures involved in voluntary
movement, Parkinson's
nucleus accumbens function reward circuit; reinforces addictive behaviors
amygdala function emotional regulation, perception of odors, fight or flight response, releases stress
hormones (HPA axis)
hippocampus functions involved in anxiety and memory-making; impaired in schizo and dementia
limbic system associated with pleasure, reward, and reinforcing behavior; drug abuse
negatively effects the limbic system
Thalamus processes all motor command and sensory information besides olfactory
associated with schizo and PTSD
corpus callosum controls communication between two hemis of brain
cerebellum function coordination
central sulcus separates frontal and parietal lobes
inheriting epigenomes epigenome chemical compounds are not part of the DNA sequence but are
attached to the DNA and can be passed down to offspring in
subsequent
generations
how does gene expression impact mental health Normal and abnormal genes both contribute to disease and drug efficacy.
Epigenetics can contribute to the risk of any disorder or disease. Psychiatric
disorders can also be due to normal genes that are "on" that should be "off."
CYP450 inducers effect on metabolism speed up metabolism, therefore there's less of the drug in the bloodstream, pt
may need a higher dose for efficacy
CYP450 inhibitor effect on metabolism slows down metabolism, therefore more of the drug in the bloodstream, could
cause toxicity, pt may need lower dose of drug
SSRI action and side effects inhibits reuptake of serotonin; can cause nausea, agitation, headache and sexual
dysfunction
SNRI action and side effect inhibits reuptake of serotonin and norepinephrine; can cause nausea, sweating,
insomnia, tremors, sexual dysfunction
tricyclic antidepressants action inhibits reuptake of serotonin and norepinephrine, blocks norepi receptors,
