NR606 Week 2 Questions With Complete
Solutions
___________ and ___________ have been
demonstrated to have the lowest serum
concentrations among infants exposed to
medication during breastfeeding Correct Answers
Bupropion and Sertraline
__________________ is considered a psychiatric
emergency and requires immediate hospitalization
and treatment Correct Answers Perinatal
psychosis
________, __________, and _____________ have shown
benefits across the spectrum of perinatal mental
health disorders. Correct Answers Yoga
massage
peer support
After a few weeks, Elaine started to feel more tired.
She started to experience episodes of guilt about
being more focused on her projects than her baby.
She began to have difficulty making decisions and
withdrew from her friends and husband. At her 6-
week follow-up with her provider, she explained
that she was feeling a little down and described
her symptoms. The provider administered an EPDS.
Elaine's score was 15. Since Elaine was
breastfeeding, the provider prescribed sertraline.
,Is this t Correct Answers no
Rationale: This is not the correct treatment
decision for this client. Clients with bipolar disorder
may present during the depressive phase of the
illness and may not report any symptoms of
hypomanic or manic episodes. The provider must
obtain a careful history from the client and/or
family members to differentiate between bipolar
disorder and depression. Bipolar disorder should be
ruled out as a cause of depression before
prescribing medication as certain antidepressant
medications can precipitate a manic episode or
induce rapid-cycling bipolar depression, which may
contribute to the increased incidence of death by
suicide in children and adults younger than 25.
Anxiety Correct Answers -Increased brain activity
in the amygdala & prefrontal cortex
-PET scans have also shown reduced serotonin
binding in patients with anxiety
-GAD
• persistent, uncontrollable worrying that causes
emotional distress, symptoms on most days, for a
period of at least 6 months
-Symptoms:
• worrying, restlessness, irritability, muscle
tension, fatigue, sleep disturbances
Anxiety meds Correct Answers -Anxiolytic
,• Buspirone
➣↓ drug interactions
➣↓ adverse effects
-SSRIs/SNRIs
• escilatopram (Lexapro)
• paroxetine (Paxil)
• duloxetine (Cymbalta)
➣highly effective
➣↑ drug interactions
➣risk of hyponatremia
-Benzodiazepines
• alprazolam (Xanax)
• clonazepam (Klonopin)
➣multiple adverse effects
➣risk of misuse
➣fall risk
➣highly effective
➣rapid onset
➣can be used PRN
At Shawnta's next appointment two weeks later,
she endorses increased feelings of sadness and
worry, mostly surrounding the baby. Her repeat
EPDS screening score is 14.
Which of the following management strategies is
the most appropriate next course of action for
Shawnta?
, plan to repeat the screening in two weeks at
Shawnta's next therapy appointment
request that Shawnta schedule an in-person visit
as soon as possible
request a joint therapy session with Shawnta's
partner
discuss antid Correct Answers discuss
antidepressant medications
Rationale: Shawnta's current EPDS score of 14
indicates likely depressive disorder, which requires
the PMHNP to discuss treatment options with her,
which may include antidepressant medications.
Barriers to Maternal Mental Health Care Correct
Answers -inconsistencies in terminology can lead
to mistreatment in maternity care
-classification of maternal mental health disorders
in the (DSM-5-TR)
• depressive disorder specifier "with peripartum
onset" timeframe for using the specifier remains
confined to the first four weeks after birth
Bipolar disorder medications Correct Answers -
Lithium
-lamotrigine (Lamictal)
Solutions
___________ and ___________ have been
demonstrated to have the lowest serum
concentrations among infants exposed to
medication during breastfeeding Correct Answers
Bupropion and Sertraline
__________________ is considered a psychiatric
emergency and requires immediate hospitalization
and treatment Correct Answers Perinatal
psychosis
________, __________, and _____________ have shown
benefits across the spectrum of perinatal mental
health disorders. Correct Answers Yoga
massage
peer support
After a few weeks, Elaine started to feel more tired.
She started to experience episodes of guilt about
being more focused on her projects than her baby.
She began to have difficulty making decisions and
withdrew from her friends and husband. At her 6-
week follow-up with her provider, she explained
that she was feeling a little down and described
her symptoms. The provider administered an EPDS.
Elaine's score was 15. Since Elaine was
breastfeeding, the provider prescribed sertraline.
,Is this t Correct Answers no
Rationale: This is not the correct treatment
decision for this client. Clients with bipolar disorder
may present during the depressive phase of the
illness and may not report any symptoms of
hypomanic or manic episodes. The provider must
obtain a careful history from the client and/or
family members to differentiate between bipolar
disorder and depression. Bipolar disorder should be
ruled out as a cause of depression before
prescribing medication as certain antidepressant
medications can precipitate a manic episode or
induce rapid-cycling bipolar depression, which may
contribute to the increased incidence of death by
suicide in children and adults younger than 25.
Anxiety Correct Answers -Increased brain activity
in the amygdala & prefrontal cortex
-PET scans have also shown reduced serotonin
binding in patients with anxiety
-GAD
• persistent, uncontrollable worrying that causes
emotional distress, symptoms on most days, for a
period of at least 6 months
-Symptoms:
• worrying, restlessness, irritability, muscle
tension, fatigue, sleep disturbances
Anxiety meds Correct Answers -Anxiolytic
,• Buspirone
➣↓ drug interactions
➣↓ adverse effects
-SSRIs/SNRIs
• escilatopram (Lexapro)
• paroxetine (Paxil)
• duloxetine (Cymbalta)
➣highly effective
➣↑ drug interactions
➣risk of hyponatremia
-Benzodiazepines
• alprazolam (Xanax)
• clonazepam (Klonopin)
➣multiple adverse effects
➣risk of misuse
➣fall risk
➣highly effective
➣rapid onset
➣can be used PRN
At Shawnta's next appointment two weeks later,
she endorses increased feelings of sadness and
worry, mostly surrounding the baby. Her repeat
EPDS screening score is 14.
Which of the following management strategies is
the most appropriate next course of action for
Shawnta?
, plan to repeat the screening in two weeks at
Shawnta's next therapy appointment
request that Shawnta schedule an in-person visit
as soon as possible
request a joint therapy session with Shawnta's
partner
discuss antid Correct Answers discuss
antidepressant medications
Rationale: Shawnta's current EPDS score of 14
indicates likely depressive disorder, which requires
the PMHNP to discuss treatment options with her,
which may include antidepressant medications.
Barriers to Maternal Mental Health Care Correct
Answers -inconsistencies in terminology can lead
to mistreatment in maternity care
-classification of maternal mental health disorders
in the (DSM-5-TR)
• depressive disorder specifier "with peripartum
onset" timeframe for using the specifier remains
confined to the first four weeks after birth
Bipolar disorder medications Correct Answers -
Lithium
-lamotrigine (Lamictal)
