NRNP 6665 Final Exam Test Questions
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: - correct
answer 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reports that Caylee is very quiet and withdrawn and always appears sad and disinterested in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: - correct answer 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: - correct answer 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
,NRNP 6665 Final Exam Test Questions
D. Adolescent-onset depression typically need long-term pharmacologic management to
prevent relapses
Agomelatine - correct answer 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) - correct answer Tricyclic antidepressant.
Aripiprazole (Abilify) - correct answer 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) - correct answer Treatment for depression. Atypical antipsychotic
Bupropion (Wellbutrin) - correct answer 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) - correct answer Antidepressant, SSRI: 20-40 mg qd.
Clomipramine (Anafranil) - correct answer -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)
,NRNP 6665 Final Exam Test Questions
*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) - correct answer 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) - correct answer Treats depression
, NRNP 6665 Final Exam Test Questions
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).
-May have immediate effects in treating insomnia or anxiety.
-If it is not working within 6-8 weeks for depression, it may require a dosage increase or it may
not work at all
-100-200 mg/day (for depression)
50-150 mg/day (for chronic pain).
Desvenlafaxine (Pristiq) - correct answer Dual serotonin and norepinephrine reuptake inhibitor-
often classified as an antidepressant.
-FDA approved to tx MDD.
-Off-label: Vasomotor sx's, fibromyalgia, GAD, Social Anx d/o, panic d/o, PTSD, PMDD
-Dopamine is inactivated by norepinephrine reuptake in frontal cortex (which lack dopamine
transporters) med can increase dopamine neurotransmission in this part of the brain
-
Risperidone (Risperdal) - correct answer Atypical Antipsychotic (most "typical" of atypicals)
Side effects: EPS (dose-dependent), TD, significant increases in PRL (check PRL levels)
--> most dopaminergic of Atypicals
IM formulation is available
Amphetamines - correct answer drugs that stimulate neural activity, causing speeded-up body
functions and associated energy and mood changes
Dextroamphetamine - correct answer CNS stimulant
*Mech*: Inc catecholamines at the synaptic cleft, especially NE and dopamine.
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: - correct
answer 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: - correct answer 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: - correct answer 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
,NRNP 6665 Final Exam Test Questions
D. Adolescent-onset depression typically need long-term pharmacologic management to
prevent relapses
Agomelatine - correct answer 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) - correct answer Tricyclic antidepressant.
Aripiprazole (Abilify) - correct answer 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) - correct answer Treatment for depression. Atypical antipsychotic
Bupropion (Wellbutrin) - correct answer 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) - correct answer Antidepressant, SSRI: 20-40 mg qd.
Clomipramine (Anafranil) - correct answer -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)
,NRNP 6665 Final Exam Test Questions
*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) - correct answer 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) - correct answer Treats depression
, NRNP 6665 Final Exam Test Questions
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).
-May have immediate effects in treating insomnia or anxiety.
-If it is not working within 6-8 weeks for depression, it may require a dosage increase or it may
not work at all
-100-200 mg/day (for depression)
50-150 mg/day (for chronic pain).
Desvenlafaxine (Pristiq) - correct answer Dual serotonin and norepinephrine reuptake inhibitor-
often classified as an antidepressant.
-FDA approved to tx MDD.
-Off-label: Vasomotor sx's, fibromyalgia, GAD, Social Anx d/o, panic d/o, PTSD, PMDD
-Dopamine is inactivated by norepinephrine reuptake in frontal cortex (which lack dopamine
transporters) med can increase dopamine neurotransmission in this part of the brain
-
Risperidone (Risperdal) - correct answer Atypical Antipsychotic (most "typical" of atypicals)
Side effects: EPS (dose-dependent), TD, significant increases in PRL (check PRL levels)
--> most dopaminergic of Atypicals
IM formulation is available
Amphetamines - correct answer drugs that stimulate neural activity, causing speeded-up body
functions and associated energy and mood changes
Dextroamphetamine - correct answer CNS stimulant
*Mech*: Inc catecholamines at the synaptic cleft, especially NE and dopamine.
