NR 6665 2025-2026 FINAL EXAM
TEST QUESTIONS AND CORRECT
VERIFIED ANSWERS GRADED A+
Question 18:
Christine is a 9-year-old female who presents for care after
having been placed in the local foster care system. She has
been in and out of foster care for the last 4 years after her
parents were killed in an automobile accident. Christine has
been placed in a variety of homes and residential care
facilities. The PMHNP recognizes that Christine is at high risk
for:
A. Dissociative disorders
B. Post-traumatic stress disorder
C. Impulse-control disorder
D. Attachment disorder
Question 7:
Caylee is a 5-year-old girl who is referred for evaluation by
child protective services. She was recently removed from her
biological family and placed in foster care, as her home
environment was reportedly unsafe due to conditions of
extreme neglect. Her foster mother reports that Caylee is
very quiet and withdrawn and always appears sad and
disinterested in her surroundings; however, she becomes
very irritable when anything unexpected or unplanned
occurs. The foster mother became very concerned when it
appeared that Caylee was hallucinating. The PMHNP
considers that:
A. Caylee is at high risk for suicide and precautions should be
taken
,B. The hallucinations are consistent with brief psychotic disorder
or schizophrenia
C. The history and reported symptoms are typical of depressive
disorder in young children
D. This is a common situation when prepubertal children are
removed from the biological parents regardless of how
dysfunctional they are
Question 2:
Debi is a 15-year-old girl who is currently being treated for
depression. Her parents have been very proactive and
involved in her care, and Debi has achieved remission 2
months after beginning treatment with a combination of
pharmacotherapy and cognitive behavioral therapy. While
counseling Debi's parents about important issues in
management, the PMHNP advises that:
A. There is a > 50% likelihood that Debi's younger sibling will
develop depressive symptoms
B. The mean length of major depressive episode in adolescents is
4 months
C. 20 to 40% of adolescents who have major depressive disorder
will develop bipolar I within 5 years
D. Adolescent-onset depression typically need long-term
pharmacologic management to prevent relapses
Agomelatine
Brand: Valdoxan
-Melatonin multimodal (Mel-MM)
-Agonist at melatonergic 1 and melatonergic 2 receptors
-Antagonist at 5HT2C receptors
-Not FDA approved: Rx for Depression, Generalized anxiety
disorder
-Initial 25 mg/day at bedtime; after 2 weeks can increase to 50
mg/day at bedtime
Amitriptyline (Elavil)
Tricyclic antidepressant.
Aripiprazole (Abilify)
,Treatment for depression. Atypical antipsychotic. "Dopamine
stabilizer". Dopamine receptor antagonist in high concentration
and also stimulates increase of dopamine in low concentrations.
Side effects: insomnia, akathisia.
Brexpiprazole (Rexulti)
Treatment for depression. Atypical antipsychotic
Bupropion (Wellbutrin)
Antidepressant and smoking cessation aid, It can treat depression
and help people quit smoking. It can also prevent depression
caused by seasonal affective disorder (SAD).
Citalopram (Celexa)
Antidepressant, SSRI: 20-40 mg qd.
Clomipramine (Anafranil)
-Serotonin reuptake inhibitor (S-RI)
-Tricyclic antidepressant (TCA)
-Parent drug is a potent serotonin reuptake inhibitor
Active metabolite is a potent norepinephrine/noradrenaline
reuptake inhibitor
-Increases serotonergic neurotransmission by blocking the
serotonin reuptake pump (transporter), -Desensitization of
serotonin receptors, especially serotonin 1A receptors
-Increases noradrenergic neurotransmission by blocking the
norepinephrine reuptake pump (transporter), -Desensitization of
beta adrenergic receptors
-Dopamine is inactivated by norepinephrine reuptake in the frontal
cortex
-Lacks dopamine transporters
-Increases dopamine neurotransmission in this part of the brain
**FDA Approved for Pediatrics in tx Obsessive-compulsive
disorder (OCD) (ages 10 and older)
*Off-Label for Pediatric Use: Depression, Severe and treatment-
resistant, depression, Cataplexy syndrome, Anxiety, Insomnia,
Neuropathic pain/chronic pain
-Full therapeutic benefits may take 2-8 weeks
, -Dosing: in Peds/Adolescents/Adults:
100-250mg/day
Cyamemazine (Tercian)
Treatment for depression.
-Known as cyamepromazine
-Typical antipsychotic drug of the phenothiazine class.
-Treatment for schizophrenia
and psychosis-associated
anxiety
-Behaves like an atypical
antipsychotic, due to its
potent anxiolytic effects (5-HT2C) and lack of extrapyramidal side
effects (5-HT2A).
-Conventional antipsychotic (neuroleptic, phenothiazine,
dopamine 2 antagonist, serotonin dopamine antagonist)
-Commonly Prescribed for (not FDA approved):
-Schizophrenia
-Anxiety associated with psychosis (short-term)
-Anxiety associated with nonpsychotic disorders, including mood
disorders and personality disorders (short-term)
-Severe depression
-Bipolar disorder
-Other psychotic disorders
-Acute agitation/aggression (injection)
-Benzodiazepine withdrawal
Desiprimine (Norpramine)
Treats depression
Brand: Norpramin
-TCA
-Norepinephrine noradrenaline reuptake inhibitor.
-FDA approved for treating depression.
-Off-label: Anxiety, Insomnia,
Neuropathic pain/chronic pain, Treatment-resistant depression.
-More potent inhibitor of norepinephrine reuptake pump than
serotonin reuptake pump (serotonin transporter).
TEST QUESTIONS AND CORRECT
VERIFIED ANSWERS GRADED A+
Question 18:
Christine is a 9-year-old female who presents for care after
having been placed in the local foster care system. She has
been in and out of foster care for the last 4 years after her
parents were killed in an automobile accident. Christine has
been placed in a variety of homes and residential care
facilities. The PMHNP recognizes that Christine is at high risk
for:
A. Dissociative disorders
B. Post-traumatic stress disorder
C. Impulse-control disorder
D. Attachment disorder
Question 7:
Caylee is a 5-year-old girl who is referred for evaluation by
child protective services. She was recently removed from her
biological family and placed in foster care, as her home
environment was reportedly unsafe due to conditions of
extreme neglect. Her foster mother reports that Caylee is
very quiet and withdrawn and always appears sad and
disinterested in her surroundings; however, she becomes
very irritable when anything unexpected or unplanned
occurs. The foster mother became very concerned when it
appeared that Caylee was hallucinating. The PMHNP
considers that:
A. Caylee is at high risk for suicide and precautions should be
taken
,B. The hallucinations are consistent with brief psychotic disorder
or schizophrenia
C. The history and reported symptoms are typical of depressive
disorder in young children
D. This is a common situation when prepubertal children are
removed from the biological parents regardless of how
dysfunctional they are
Question 2:
Debi is a 15-year-old girl who is currently being treated for
depression. Her parents have been very proactive and
involved in her care, and Debi has achieved remission 2
months after beginning treatment with a combination of
pharmacotherapy and cognitive behavioral therapy. While
counseling Debi's parents about important issues in
management, the PMHNP advises that:
A. There is a > 50% likelihood that Debi's younger sibling will
develop depressive symptoms
B. The mean length of major depressive episode in adolescents is
4 months
C. 20 to 40% of adolescents who have major depressive disorder
will develop bipolar I within 5 years
D. Adolescent-onset depression typically need long-term
pharmacologic management to prevent relapses
Agomelatine
Brand: Valdoxan
-Melatonin multimodal (Mel-MM)
-Agonist at melatonergic 1 and melatonergic 2 receptors
-Antagonist at 5HT2C receptors
-Not FDA approved: Rx for Depression, Generalized anxiety
disorder
-Initial 25 mg/day at bedtime; after 2 weeks can increase to 50
mg/day at bedtime
Amitriptyline (Elavil)
Tricyclic antidepressant.
Aripiprazole (Abilify)
,Treatment for depression. Atypical antipsychotic. "Dopamine
stabilizer". Dopamine receptor antagonist in high concentration
and also stimulates increase of dopamine in low concentrations.
Side effects: insomnia, akathisia.
Brexpiprazole (Rexulti)
Treatment for depression. Atypical antipsychotic
Bupropion (Wellbutrin)
Antidepressant and smoking cessation aid, It can treat depression
and help people quit smoking. It can also prevent depression
caused by seasonal affective disorder (SAD).
Citalopram (Celexa)
Antidepressant, SSRI: 20-40 mg qd.
Clomipramine (Anafranil)
-Serotonin reuptake inhibitor (S-RI)
-Tricyclic antidepressant (TCA)
-Parent drug is a potent serotonin reuptake inhibitor
Active metabolite is a potent norepinephrine/noradrenaline
reuptake inhibitor
-Increases serotonergic neurotransmission by blocking the
serotonin reuptake pump (transporter), -Desensitization of
serotonin receptors, especially serotonin 1A receptors
-Increases noradrenergic neurotransmission by blocking the
norepinephrine reuptake pump (transporter), -Desensitization of
beta adrenergic receptors
-Dopamine is inactivated by norepinephrine reuptake in the frontal
cortex
-Lacks dopamine transporters
-Increases dopamine neurotransmission in this part of the brain
**FDA Approved for Pediatrics in tx Obsessive-compulsive
disorder (OCD) (ages 10 and older)
*Off-Label for Pediatric Use: Depression, Severe and treatment-
resistant, depression, Cataplexy syndrome, Anxiety, Insomnia,
Neuropathic pain/chronic pain
-Full therapeutic benefits may take 2-8 weeks
, -Dosing: in Peds/Adolescents/Adults:
100-250mg/day
Cyamemazine (Tercian)
Treatment for depression.
-Known as cyamepromazine
-Typical antipsychotic drug of the phenothiazine class.
-Treatment for schizophrenia
and psychosis-associated
anxiety
-Behaves like an atypical
antipsychotic, due to its
potent anxiolytic effects (5-HT2C) and lack of extrapyramidal side
effects (5-HT2A).
-Conventional antipsychotic (neuroleptic, phenothiazine,
dopamine 2 antagonist, serotonin dopamine antagonist)
-Commonly Prescribed for (not FDA approved):
-Schizophrenia
-Anxiety associated with psychosis (short-term)
-Anxiety associated with nonpsychotic disorders, including mood
disorders and personality disorders (short-term)
-Severe depression
-Bipolar disorder
-Other psychotic disorders
-Acute agitation/aggression (injection)
-Benzodiazepine withdrawal
Desiprimine (Norpramine)
Treats depression
Brand: Norpramin
-TCA
-Norepinephrine noradrenaline reuptake inhibitor.
-FDA approved for treating depression.
-Off-label: Anxiety, Insomnia,
Neuropathic pain/chronic pain, Treatment-resistant depression.
-More potent inhibitor of norepinephrine reuptake pump than
serotonin reuptake pump (serotonin transporter).
