NUR 4290 UPDATED 2026 EXAM SCRIPT QUESTIONS AND
ANSWERS RATED A+
✔✔premenstrual dysphoric disorder (PDD) - ✔✔occurs in the last week before the
onset of a woman's period
resolves when she gets her period
mood swings, irritability, depression, anxiety, overwhelm
✔✔SSRIs patient teaching - ✔✔BLACK BOX WARNING
inform provider of increase in energy
no OTC drug should be taken without consulting PCP first
liver, renal, CBC tests
do not take within 14 days of starting an MAOI
do not discontinue medication abruptly (discontinuation syndrome)
✔✔MAOIs patient teaching - ✔✔EAT A LOW TYRAMINE DIET
avoid CAAN
Calcium
Antacids
Acetaminophen
NSAIDs
have a wallet card
go to emergency dept if they have a headache
maintain dietary restrictions for 14 days after stopping the drug
✔✔TCAs patient teaching - ✔✔mood elevation can take 6-8 weeks to occur
postural hypotension (change positions slowly)
✔✔cognitive behavioral therapy - ✔✔can help individuals to identify and change
inaccurate core perceptions of themselves & others
✔✔dialectical behavioral therapy - ✔✔an evidence-based theory developed by Linehan
to treat chronically suicidal individuals with BORDERLINE PERSONALITY DISORDER
focuses on behavioral targets, identify interventions for suicidal behaviors, and
progressing to less destructive behaviors
✔✔what is the major indication for ECT? - ✔✔MAJOR DEPRESSIVE DISORDER
✔✔mania (bipolar I) characteristics - ✔✔PSYCHIATRIC EMERGENCY
initially feel euphoric, energized
do not eat, sleep, are in perpetual motion
feel important & powerful
engage in dangerous activities
utter exhaustion & ultimate collapse into depression
, ✔✔nursing diagnoses for manic patient - ✔✔risk of injury to self & others
altered speech patients
inadequate nutrition: less than body requirements
✔✔hypomania (bipolar II) characteristics - ✔✔increase in functioning
sexual indiscretions
unrestrained buying sprees
foolish business investments
✔✔nursing interventions for mania - ✔✔encourage frequent rest periods
high-calorie foods consumption
completion of ADLs
take patient away from distractions
S/S of lithium toxicity
✔✔lithium drug type - ✔✔mood stabilizer
✔✔lithium patient teachings - ✔✔LEVELS MUST BE MONITORED CLOSELY for
toxicity
CONSUME A CONSISTENT AMOUNT OF SODIUM & FLUIDS
do not take any OTC meds w/out consulting PCP
✔✔S/S of lithium toxicity - ✔✔excessive thirst
tremors
N&V
sweating
diarrhea
GO TO DOCTOR!!
✔✔lithium therapeutic range - ✔✔0.6-1.2 mEq/L
✔✔Lamictal (lamotrigine) drug typ - ✔✔ANTICONVULSANT medication used for bipolar
✔✔Lamictal (lamotrigine) patient teachings - ✔✔report ANY RASH TO DOCTOR
may be Stevens' Johnson's syndrome
✔✔Valproic acid drug class - ✔✔mood stabilizer
✔✔valproic acid patient teachings - ✔✔monitor for S/S of jaundice
BIG RISK FOR BLEEDING (THROMBOCYTOPENIA)
monitor liver labs (ALTs and ASTs)
measure platelets
✔✔Tegretol (carbamazepine) - ✔✔Anticonvulsant used for mood stabilization
ANSWERS RATED A+
✔✔premenstrual dysphoric disorder (PDD) - ✔✔occurs in the last week before the
onset of a woman's period
resolves when she gets her period
mood swings, irritability, depression, anxiety, overwhelm
✔✔SSRIs patient teaching - ✔✔BLACK BOX WARNING
inform provider of increase in energy
no OTC drug should be taken without consulting PCP first
liver, renal, CBC tests
do not take within 14 days of starting an MAOI
do not discontinue medication abruptly (discontinuation syndrome)
✔✔MAOIs patient teaching - ✔✔EAT A LOW TYRAMINE DIET
avoid CAAN
Calcium
Antacids
Acetaminophen
NSAIDs
have a wallet card
go to emergency dept if they have a headache
maintain dietary restrictions for 14 days after stopping the drug
✔✔TCAs patient teaching - ✔✔mood elevation can take 6-8 weeks to occur
postural hypotension (change positions slowly)
✔✔cognitive behavioral therapy - ✔✔can help individuals to identify and change
inaccurate core perceptions of themselves & others
✔✔dialectical behavioral therapy - ✔✔an evidence-based theory developed by Linehan
to treat chronically suicidal individuals with BORDERLINE PERSONALITY DISORDER
focuses on behavioral targets, identify interventions for suicidal behaviors, and
progressing to less destructive behaviors
✔✔what is the major indication for ECT? - ✔✔MAJOR DEPRESSIVE DISORDER
✔✔mania (bipolar I) characteristics - ✔✔PSYCHIATRIC EMERGENCY
initially feel euphoric, energized
do not eat, sleep, are in perpetual motion
feel important & powerful
engage in dangerous activities
utter exhaustion & ultimate collapse into depression
, ✔✔nursing diagnoses for manic patient - ✔✔risk of injury to self & others
altered speech patients
inadequate nutrition: less than body requirements
✔✔hypomania (bipolar II) characteristics - ✔✔increase in functioning
sexual indiscretions
unrestrained buying sprees
foolish business investments
✔✔nursing interventions for mania - ✔✔encourage frequent rest periods
high-calorie foods consumption
completion of ADLs
take patient away from distractions
S/S of lithium toxicity
✔✔lithium drug type - ✔✔mood stabilizer
✔✔lithium patient teachings - ✔✔LEVELS MUST BE MONITORED CLOSELY for
toxicity
CONSUME A CONSISTENT AMOUNT OF SODIUM & FLUIDS
do not take any OTC meds w/out consulting PCP
✔✔S/S of lithium toxicity - ✔✔excessive thirst
tremors
N&V
sweating
diarrhea
GO TO DOCTOR!!
✔✔lithium therapeutic range - ✔✔0.6-1.2 mEq/L
✔✔Lamictal (lamotrigine) drug typ - ✔✔ANTICONVULSANT medication used for bipolar
✔✔Lamictal (lamotrigine) patient teachings - ✔✔report ANY RASH TO DOCTOR
may be Stevens' Johnson's syndrome
✔✔Valproic acid drug class - ✔✔mood stabilizer
✔✔valproic acid patient teachings - ✔✔monitor for S/S of jaundice
BIG RISK FOR BLEEDING (THROMBOCYTOPENIA)
monitor liver labs (ALTs and ASTs)
measure platelets
✔✔Tegretol (carbamazepine) - ✔✔Anticonvulsant used for mood stabilization
