PRNU 235 COMPREHENSIVE EXAM QUESTIONS WITH
SOLUTIONS 2025 GRADED A+
✔✔persistent depressive disorder (dysthymia) - ✔✔sad or "down in the dumps", no
evidence of psychotic symptoms, essential feature is chronically depressed (irritable for
children) mood for: most of the day, more days than not, for at least 2 years (1 year for
children)
✔✔premenstrual dysphoric disorder - ✔✔depressed mood, anxiety, mood swings,
decreased interest in activities, symptoms begin during week prior to menses and
subside shortly after onset of menstruation
✔✔bipolar I disorder - ✔✔is experiencing, or has experienced, a full syndrome of manic
or mixed symptoms
may also have experienced episodes of depression
characterized by mood swings from profound depression to extreme euphoria (mania),
with intervening periods of normalcy
delusions or hallucinations may or may not be part of the clinical picture
✔✔bipolar II disorder - ✔✔characterized by recurrent bouts of major depression with
episodic occurrence of hypomania
has never met criteria for full manic episode
characterized by mood swings from profound depression to extreme euphoria (mania),
with intervening periods of normalcy
delusions or hallucinations may or may not be part of the clinical picture
✔✔cyclothymic disorder - ✔✔chronic mood disturbance
at least 2-year duration
numerous episodes of hypomania and depressed mood of insufficient severity to meet
the criteria for either bipolar I or bipolar II
never without symptoms for two months
✔✔transient depression - ✔✔symptoms at this level of the continuum not necessarily
dysfunctional
affective: the "blues"
behavioral: some crying
cognitive: some difficulty getting mind off one's disappointment
physiological: feeling tired and listless
✔✔mild depression - ✔✔symptoms of mild depression are identified by clinicians as
those associated with normal grieving
affective: denial of feelings, anger, anxiety, guilt, helplessness, sadness, despondency
behavioral: tearful, regression, etc.
cognitive: preoccupied with loss, etc.
physiological: anorexia, insomnia, etc.
,✔✔moderate depression - ✔✔symptoms associated with dysthymic disorder
affective: feelings of sadness, dejection, helpless, powerless, low self-esteem
behavioral: slowed physical movements, slumped posture, limited verbalization, social
isolation
cognitive: slowed thinking processes, difficulty with concentration & directing attention,
obsessive & repetitive thoughts of pessimism, negativism
physiological: anorexia or overeating, sleep disturbances, headaches, backaches, chest
pain, low energy level, fatigue
✔✔severe depression (MDD) - ✔✔includes symptoms of major depressive disorder and
bipolar depression
affective: feelings of total despair, worthlessness, nothingness, emptiness, flat affect,
appearance devoid of emotional tone
behavioral: psychomotor retardation, curled-up position, absence of communication, no
personal hygiene & grooming, social isolation & no inclination toward interaction with
others
cognitive: prevalent delusional thinking, with delusions of persecution and somatic
delusions; confusion; indecisiveness; suicidal thoughts
physiological: a general slow-down of the entire body with sluggish digestion,
constipation, urinary retention, anorexia, amenorrhea, weight loss or gain, sleep
difficulties
✔✔stage I - hypomania - ✔✔symptoms not sufficiently severe to cause marked
impairment in social or occupational functioning or to require hospitalization
✔✔stage II - acute mania - ✔✔marked impairment in functioning of mood, cognition and
perception, and activity and behavior; usually requires hospitalization
✔✔stage III - delirious mania - ✔✔a grave form of the disorder, characterized by severe
clouding of consciousness and representing an intensification of the symptoms
associated with acute mania
✔✔manic client - ✔✔dramatic, unforgettable experience
rapid pace
provocative, personal comments
keep interactions brief, do not retreat
join mood at times
keep question simple, direct
eventually, help client to address problems rather than other interests
✔✔psychopharmacology for depression - ✔✔SSRIs (ex: Citalopram/Celexa,
Escitalopram/Lexapro, Fluoxetine/Prozac, Fluvoxamine/Luvox, Paroxetine/Paxil,
Sertraline/Zoloft)
, Heterocyclics (ex: Maprotiline/Ludiomil, Mirtazapine/Remeron, Trazodone/Desyrell,
Nefazodone/"Serzone", BUpropion/Zyban/Wellbutrin)
SNRIs (ex: Venlafaxine/Effexor, Duloxetine/Cymbalta)
Tricyclic Antidepressants (ex: Amitriptyline/Elavil, Clomipramine/Anafranil,
Desipramine/Norpramine, Doxepin/Sinequan, Imipramine/Tofrani, Nortiptyline/Aventyl,
Trimipramine/Surmontil)
MAOIs (ex: Isocarboxazid/Marplan, Phenelzine/Nardil, Tranycypromine/Parnate,
Selegiline transdermal system/Emsam)
✔✔transcranial magnetic stimulation - ✔✔the introduction of short pulses of magnetic
energy to stimulate nerve cells in the brain
used to treat depression
✔✔light therapy - ✔✔used to treat seasonal affective disorder
also used as adjunct therapy in chronic major depressive disorder or dysthymia with
seasonal exacerbations
✔✔electroconvulsive therapy (ECT) - ✔✔induction of grand mal seizure
often used after trial of medication failed
indications: severe depression, acutely suicidal, experiencing psychotic symptoms,
neurovegetative changes, acute mania
✔✔action of antidepressants - ✔✔increase concentration of norepinephrine and
serotonin in the body, either by blocking their reuptake by the neurons (tricyclics,
tetracyclics, selective serotonin inhibitors [SSRIs]) or by inhibiting the release of
monoamine oxidase (MAOIs)
✔✔side effects of antidepressants - ✔✔dry mouth, sedation, nausea, discontinuation
syndrome (include flu-like symptoms, insomnia, nausea, imbalance, sensory
disturbances, and hyperarousal. These symptoms usually are mild, last one to two
weeks, and are rapidly extinguished with reinstitution of antidepressant medication)
mostly occur with tricyclics: blurred vision, constipation, urinary retention, orthostatic
hypotension, reduction of seizure threshold, tachycardia, arrhythmias, photosensitivity,
weight gain
mostly occur with SSRIs: insomnia, agitation, headache, weight loss, sexual
dysfunction, serotonin syndrome (a group of symptoms that may occur following use of
certain serotonergic medications or drugs. The degree of symptoms can range from
mild to severe. Symptoms include high body temperature, agitation, increased reflexes,
tremor, sweating, dilated pupils, and diarrhea)
mostly occur with MAOIs: hypertensive crisis, site reactions (Selegiline transdermal
system)
miscellaneous side effects: priapism (with trazadone) and hepatic failure (with
Nefazodone)
✔✔serotonin syndrome - ✔✔more likely to be reported in patients taking two or more
serotonin antagonists
SOLUTIONS 2025 GRADED A+
✔✔persistent depressive disorder (dysthymia) - ✔✔sad or "down in the dumps", no
evidence of psychotic symptoms, essential feature is chronically depressed (irritable for
children) mood for: most of the day, more days than not, for at least 2 years (1 year for
children)
✔✔premenstrual dysphoric disorder - ✔✔depressed mood, anxiety, mood swings,
decreased interest in activities, symptoms begin during week prior to menses and
subside shortly after onset of menstruation
✔✔bipolar I disorder - ✔✔is experiencing, or has experienced, a full syndrome of manic
or mixed symptoms
may also have experienced episodes of depression
characterized by mood swings from profound depression to extreme euphoria (mania),
with intervening periods of normalcy
delusions or hallucinations may or may not be part of the clinical picture
✔✔bipolar II disorder - ✔✔characterized by recurrent bouts of major depression with
episodic occurrence of hypomania
has never met criteria for full manic episode
characterized by mood swings from profound depression to extreme euphoria (mania),
with intervening periods of normalcy
delusions or hallucinations may or may not be part of the clinical picture
✔✔cyclothymic disorder - ✔✔chronic mood disturbance
at least 2-year duration
numerous episodes of hypomania and depressed mood of insufficient severity to meet
the criteria for either bipolar I or bipolar II
never without symptoms for two months
✔✔transient depression - ✔✔symptoms at this level of the continuum not necessarily
dysfunctional
affective: the "blues"
behavioral: some crying
cognitive: some difficulty getting mind off one's disappointment
physiological: feeling tired and listless
✔✔mild depression - ✔✔symptoms of mild depression are identified by clinicians as
those associated with normal grieving
affective: denial of feelings, anger, anxiety, guilt, helplessness, sadness, despondency
behavioral: tearful, regression, etc.
cognitive: preoccupied with loss, etc.
physiological: anorexia, insomnia, etc.
,✔✔moderate depression - ✔✔symptoms associated with dysthymic disorder
affective: feelings of sadness, dejection, helpless, powerless, low self-esteem
behavioral: slowed physical movements, slumped posture, limited verbalization, social
isolation
cognitive: slowed thinking processes, difficulty with concentration & directing attention,
obsessive & repetitive thoughts of pessimism, negativism
physiological: anorexia or overeating, sleep disturbances, headaches, backaches, chest
pain, low energy level, fatigue
✔✔severe depression (MDD) - ✔✔includes symptoms of major depressive disorder and
bipolar depression
affective: feelings of total despair, worthlessness, nothingness, emptiness, flat affect,
appearance devoid of emotional tone
behavioral: psychomotor retardation, curled-up position, absence of communication, no
personal hygiene & grooming, social isolation & no inclination toward interaction with
others
cognitive: prevalent delusional thinking, with delusions of persecution and somatic
delusions; confusion; indecisiveness; suicidal thoughts
physiological: a general slow-down of the entire body with sluggish digestion,
constipation, urinary retention, anorexia, amenorrhea, weight loss or gain, sleep
difficulties
✔✔stage I - hypomania - ✔✔symptoms not sufficiently severe to cause marked
impairment in social or occupational functioning or to require hospitalization
✔✔stage II - acute mania - ✔✔marked impairment in functioning of mood, cognition and
perception, and activity and behavior; usually requires hospitalization
✔✔stage III - delirious mania - ✔✔a grave form of the disorder, characterized by severe
clouding of consciousness and representing an intensification of the symptoms
associated with acute mania
✔✔manic client - ✔✔dramatic, unforgettable experience
rapid pace
provocative, personal comments
keep interactions brief, do not retreat
join mood at times
keep question simple, direct
eventually, help client to address problems rather than other interests
✔✔psychopharmacology for depression - ✔✔SSRIs (ex: Citalopram/Celexa,
Escitalopram/Lexapro, Fluoxetine/Prozac, Fluvoxamine/Luvox, Paroxetine/Paxil,
Sertraline/Zoloft)
, Heterocyclics (ex: Maprotiline/Ludiomil, Mirtazapine/Remeron, Trazodone/Desyrell,
Nefazodone/"Serzone", BUpropion/Zyban/Wellbutrin)
SNRIs (ex: Venlafaxine/Effexor, Duloxetine/Cymbalta)
Tricyclic Antidepressants (ex: Amitriptyline/Elavil, Clomipramine/Anafranil,
Desipramine/Norpramine, Doxepin/Sinequan, Imipramine/Tofrani, Nortiptyline/Aventyl,
Trimipramine/Surmontil)
MAOIs (ex: Isocarboxazid/Marplan, Phenelzine/Nardil, Tranycypromine/Parnate,
Selegiline transdermal system/Emsam)
✔✔transcranial magnetic stimulation - ✔✔the introduction of short pulses of magnetic
energy to stimulate nerve cells in the brain
used to treat depression
✔✔light therapy - ✔✔used to treat seasonal affective disorder
also used as adjunct therapy in chronic major depressive disorder or dysthymia with
seasonal exacerbations
✔✔electroconvulsive therapy (ECT) - ✔✔induction of grand mal seizure
often used after trial of medication failed
indications: severe depression, acutely suicidal, experiencing psychotic symptoms,
neurovegetative changes, acute mania
✔✔action of antidepressants - ✔✔increase concentration of norepinephrine and
serotonin in the body, either by blocking their reuptake by the neurons (tricyclics,
tetracyclics, selective serotonin inhibitors [SSRIs]) or by inhibiting the release of
monoamine oxidase (MAOIs)
✔✔side effects of antidepressants - ✔✔dry mouth, sedation, nausea, discontinuation
syndrome (include flu-like symptoms, insomnia, nausea, imbalance, sensory
disturbances, and hyperarousal. These symptoms usually are mild, last one to two
weeks, and are rapidly extinguished with reinstitution of antidepressant medication)
mostly occur with tricyclics: blurred vision, constipation, urinary retention, orthostatic
hypotension, reduction of seizure threshold, tachycardia, arrhythmias, photosensitivity,
weight gain
mostly occur with SSRIs: insomnia, agitation, headache, weight loss, sexual
dysfunction, serotonin syndrome (a group of symptoms that may occur following use of
certain serotonergic medications or drugs. The degree of symptoms can range from
mild to severe. Symptoms include high body temperature, agitation, increased reflexes,
tremor, sweating, dilated pupils, and diarrhea)
mostly occur with MAOIs: hypertensive crisis, site reactions (Selegiline transdermal
system)
miscellaneous side effects: priapism (with trazadone) and hepatic failure (with
Nefazodone)
✔✔serotonin syndrome - ✔✔more likely to be reported in patients taking two or more
serotonin antagonists
