Final Exam Test Questions Key

Final Exam Test Questions /Key Questions with 100% Correct Answers.

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: -

Answer:

• Dissociative disorders
• Post-traumatic stress disorder
• Impulse-control disorder
• Attachment disorder

Qs: 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 Her foster mother reports that Caylee is very quiet and withdrawn and always appears sad and disinterested in her surroundings; however, she becomes very irritable when anything unexpected or unplanned occurs.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: -

Answer:

• Caylee is at high risk for suicide and precautions should be taken
• The hallucinations are consistent with brief psychotic disorder or

schizophrenia

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• The history and reported symptoms are typical of depressive disorder in

young children

• This is a common situation when prepubertal children are removed from

the biological parents regardless of how dysfunctional they are Qs: 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: -

Answer:

• There is a > 50% likelihood that Debi's younger sibling will develop

depressive symptoms

• The mean length of major depressive episode in adolescents is 4 months
• 20 to 40% of adolescents who have major depressive disorder will develop

bipolar I within 5 years

• Adolescent-onset depression typically need long-term pharmacologic

management to prevent relapses

Qs: Agomelatine -

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

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Qs: Amitriptyline (Elavil) -

Answer:

Tricyclic antidepressant.

Qs: Aripiprazole (Abilify) -

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.

Qs: Brexpiprazole (Rexulti) -

Answer:

Treatment for depression. Atypical antipsychotic

Qs: Bupropion (Wellbutrin) -

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).

Qs: Citalopram (Celexa) -

Answer:

Antidepressant, SSRI: 20-40 mg qd.

Qs: Clomipramine (Anafranil) -

Answer:

-Serotonin reuptake inhibitor (S-RI)

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-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

Qs: Cyamemazine (Tercian) -

Answer:

Treatment for depression.-Known as cyamepromazine -Typical antipsychotic drug of the phenothiazine class.-Treatment for schizophrenia and psychosis-associated anxiety

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