NURS 546 EXAM 2 FINAL PAPER 2026
COMPLETE QUESTIONS WITH SOLUTIONS
GRADED A+
⩥ PFC & Amygdala Symptoms of MDD. Answer: Guilt
Suicidality
Worthlessness
⩥ Striatum Symptoms of MDD. Answer: Physical fatigue
⩥ Nucleus Accumbens Symptoms of MDD. Answer: Pleasure interests
⩥ Hypothalamus Symptoms of MDD. Answer: Sleep
Appetite
⩥ Thalamus & Hypothalamus Symptoms of Mania. Answer: Decreased
sleep/arousal
⩥ Striatum Symptoms of Mania. Answer: Motor/agitation
⩥ Prefrontal cortex (PFC) Symptoms of Mania. Answer: Risk-taking
Talkative/pressured speech
,⩥ Nucleus Accumbens & PFC Symptoms of Mania. Answer: Racing
thoughts, grandiosity
⩥ PFC & Amygdala Symptoms of Mania. Answer: Mood
⩥ Medication Management. Answer: SSRI-Selective Serotonin
Reuptake Inhibitors
*Inhibit 5 HT reuptake
SNRI-Serotonin Norepinephrine Reuptake Inhibitors
*inhibit 5-HT reuptake
*inhibit NE reuptake (increase energy, focus)
*increase DA in prefrontal cortex (increase cognition)
NDRI-Norepinephrine Dopamine Reuptake inhibitors
*inhibit DA reuptake (increase alertness, motivation)
*inhibit NE reuptake (increase energy)
SARI-Serotonin Antagonist Reuptake Inhibitors
⩥ Selective Serotonin Reuptake Inhibitors (SSRIs): Most adverse effects
will subside after 4-5 days once the body adjusts to increased serotonin
levels.. Answer: diarrhea
headache
weight gain
,sexual side effects
⩥ Serotonin Norepinephrine Reuptake Inhibitors (SNRIs): Medications
should not be abruptly stopped to avoid discontinuation symptoms. NE
effects of the medication may increase anxiety in some clients. Report
worsening anxiety to the provider.. Answer: elevated blood pressure
anxiety
insomnia
constipation
⩥ Norepinephrine Dopamine Reuptake Inhibitors (NDRI): Take
medication in the morning. Stop taking medication if seizures occur.
Stop taking medication if anxiety is noted.. Answer: agitation
headache
dry mouth
constipation
weight loss
⩥ escitalopram (Lexapro) SSRI. Answer: no known drug interactions
best tolerated SSRI
27-32 hour half-life good for forgetful prone clients
least CYP reactions
Substrate for 3A4
, ⩥ citalopram (Celexa) SSRI. Answer: mild antihistamine effects; Half-
Life: 23-45 hours
Weak Inhibitor of 2D6
⩥ fluoxetine (Prozac) SSRI. Answer: longest half-life
Use caution in patients with comorbid anxiety due to risk for activation
and panic attacks
Half-Life: 2-3 days parent, 2 week metabolite
Inhibits 2D6 and 3A4
⩥ paroxetine (Paxil) SSRI. Answer: also treats social anxiety and
insomnia
associated with weight gain
will experience withdrawal with missed dose or abrupt stop
Half-Life: 24 hours
Inhibits 2D6
⩥ fluvoxamine (Luvox) SSRI. Answer: treats anxious depression
smokers require an increased dose
Half-Life: 9-28 hours
Inhibits 3A4, 2C9, 1A2
COMPLETE QUESTIONS WITH SOLUTIONS
GRADED A+
⩥ PFC & Amygdala Symptoms of MDD. Answer: Guilt
Suicidality
Worthlessness
⩥ Striatum Symptoms of MDD. Answer: Physical fatigue
⩥ Nucleus Accumbens Symptoms of MDD. Answer: Pleasure interests
⩥ Hypothalamus Symptoms of MDD. Answer: Sleep
Appetite
⩥ Thalamus & Hypothalamus Symptoms of Mania. Answer: Decreased
sleep/arousal
⩥ Striatum Symptoms of Mania. Answer: Motor/agitation
⩥ Prefrontal cortex (PFC) Symptoms of Mania. Answer: Risk-taking
Talkative/pressured speech
,⩥ Nucleus Accumbens & PFC Symptoms of Mania. Answer: Racing
thoughts, grandiosity
⩥ PFC & Amygdala Symptoms of Mania. Answer: Mood
⩥ Medication Management. Answer: SSRI-Selective Serotonin
Reuptake Inhibitors
*Inhibit 5 HT reuptake
SNRI-Serotonin Norepinephrine Reuptake Inhibitors
*inhibit 5-HT reuptake
*inhibit NE reuptake (increase energy, focus)
*increase DA in prefrontal cortex (increase cognition)
NDRI-Norepinephrine Dopamine Reuptake inhibitors
*inhibit DA reuptake (increase alertness, motivation)
*inhibit NE reuptake (increase energy)
SARI-Serotonin Antagonist Reuptake Inhibitors
⩥ Selective Serotonin Reuptake Inhibitors (SSRIs): Most adverse effects
will subside after 4-5 days once the body adjusts to increased serotonin
levels.. Answer: diarrhea
headache
weight gain
,sexual side effects
⩥ Serotonin Norepinephrine Reuptake Inhibitors (SNRIs): Medications
should not be abruptly stopped to avoid discontinuation symptoms. NE
effects of the medication may increase anxiety in some clients. Report
worsening anxiety to the provider.. Answer: elevated blood pressure
anxiety
insomnia
constipation
⩥ Norepinephrine Dopamine Reuptake Inhibitors (NDRI): Take
medication in the morning. Stop taking medication if seizures occur.
Stop taking medication if anxiety is noted.. Answer: agitation
headache
dry mouth
constipation
weight loss
⩥ escitalopram (Lexapro) SSRI. Answer: no known drug interactions
best tolerated SSRI
27-32 hour half-life good for forgetful prone clients
least CYP reactions
Substrate for 3A4
, ⩥ citalopram (Celexa) SSRI. Answer: mild antihistamine effects; Half-
Life: 23-45 hours
Weak Inhibitor of 2D6
⩥ fluoxetine (Prozac) SSRI. Answer: longest half-life
Use caution in patients with comorbid anxiety due to risk for activation
and panic attacks
Half-Life: 2-3 days parent, 2 week metabolite
Inhibits 2D6 and 3A4
⩥ paroxetine (Paxil) SSRI. Answer: also treats social anxiety and
insomnia
associated with weight gain
will experience withdrawal with missed dose or abrupt stop
Half-Life: 24 hours
Inhibits 2D6
⩥ fluvoxamine (Luvox) SSRI. Answer: treats anxious depression
smokers require an increased dose
Half-Life: 9-28 hours
Inhibits 3A4, 2C9, 1A2
