NR546 Final Exam Comprehensive Review | Questions
and Answers complete solutions | 2026-2027 Updates
| 100% correct | Chamberlain
Pharmacologic Treatment of Bipolar Disorder - ANSWER- Lithium
Anticonvulsants
Second generation antipsychotics
Unipolar depression - ANSWER- major depressive disorder (MDD)
one of the most common mental disorders
-Approximately 7.1% of adults in the U.S. had episode in last year, prevalence highest (13.1%)
among individuals aged 18-25
S/S
-depressed mood
-loss of interest or pleasure in daily activities
-irritability
-withdrawal
-problems with sleep, eating, energy, concentration, or self-worth
-severe depression: may experience thoughts of suicide or psychotic symptoms.
Bipolar disorder (BD) - ANSWER- Chronic condition characterized by extreme fluctuations in
mood, energy, and ability to function
-Moods may be manic, hypomanic, or depressed and may include mixed mood or psychotic
features
-many have only experienced only one manic episode in their lifetime
-Mood fluctuations may be separated by periods of high stability or may cycle rapidly
,-diagnosed when a client has one or more episodes of mania or hypomania with a history of
one or more major depressive episodes
-high risk for suicide
mania - ANSWER- characterized by a persistently elevated, expansive, or irritable mood.
Related symptoms may include inflated self-esteem, increased goal-directed activity or energy,
including grandiosity, decreased need for sleep, excessive talkativeness, racing thoughts, flight
of ideas (FOI), distractibility, psychomotor agitation, and a propensity to be involved in high-risk
activities. Mania leads to significant functional impairment and may include psychotic features
or necessitate hospitalization
Bipolar Type I: - ANSWER- requires at least one episode of mania for at least one week (or
any duration if hospitalization due to symptoms is required)
Bipolar Type II: - ANSWER- diagnosis requires a current or past hypomanic episode and a
current or past major depressive episode. Symptoms last for at least 4 days but fewer than
seven.
-Hypomanic symptoms are not of sufficient duration or severity to cause significant functional
impairment, psychosis, or hospitalization.
-Anger and irritability are common.
-Clients often enjoy the elevation of mood and are reluctant to report these symptoms, making
bipolar more difficult to diagnose if the client presents in the depression phase.
Cyclothymia: - ANSWER- involves the chronic presentation of hypomanic and depressive
symptoms that do not meet the diagnostic criteria for a major depressive or manic/hypomanic
episode.
If bipolar depression is mistaken for MDD: - ANSWER- antidepressant therapy may
precipitate a manic episode or induce rapid-cycling bipolar depression
-may contribute to the increased incidence of death by suicide in children and adults younger
than 25
Antidepressants are used cautiously in clients with bipolar disorder and never as
________________. - ANSWER- monotherapy
-Antidepressants should be combined with a mood stabilizer to prevent the onset of a
hypomanic or manic episode
,DA, NE Dysfunction causes what mood related symptoms - ANSWER- Decreased positive
affect:
depressed mood
loss of joy
lack of interest
loss of energy
decreased alertness
decreased self-confidence
appetite changes
5HT, NE Dysfunction causes what mood related symptoms - ANSWER- Increased negative
affect:
depressed mood
guilt
fear/anxiety
hostility
irritability
loneliness
appetite changes
monoamine hypothesis of depression - ANSWER- -depression occurs as a result of a
deficiency of one or all three monoamine transmitters
• serotonin, norepinephrine, and dopamine
-while mania may result from an excess
Medication Management for Depression, First-Line Treatment: - ANSWER- • Selective
Serotonin Reuptake Inhibitors (SSRIs)
• Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
• Norepinephrine Dopamine Reuptake Inhibitors (NDRI)
• Serotonin Antagonist and Reuptake Inhibitors (SARIs)
, SSRI's - ANSWER- Mechanism of action
• inhibit 5-HT reuptake
Adverse effects
-diarrhea
-headache
-weight gain
-sexual side effects
SNRI's - ANSWER- Mechanism of action
• inhibit 5-HT reuptake
• inhibit NE reuptake (increase energy, focus)
• increase DA in prefrontal cortex (increase cognition)
Adverse effects
-elevated blood pressure
-anxiety
-insomnia
-constipation
NDRI's - ANSWER- Mechanism of action
• inhibit DA reuptake (increase alertness, motivation)
• inhibit NE reuptake (increase energy)
Adverse effects
-agitation
-headache
-dry mouth
-constipation
-weight loss
SSRI Prescribing Pearls: med with mild antihistamine effects - ANSWER- citalopram (Celexa)
and Answers complete solutions | 2026-2027 Updates
| 100% correct | Chamberlain
Pharmacologic Treatment of Bipolar Disorder - ANSWER- Lithium
Anticonvulsants
Second generation antipsychotics
Unipolar depression - ANSWER- major depressive disorder (MDD)
one of the most common mental disorders
-Approximately 7.1% of adults in the U.S. had episode in last year, prevalence highest (13.1%)
among individuals aged 18-25
S/S
-depressed mood
-loss of interest or pleasure in daily activities
-irritability
-withdrawal
-problems with sleep, eating, energy, concentration, or self-worth
-severe depression: may experience thoughts of suicide or psychotic symptoms.
Bipolar disorder (BD) - ANSWER- Chronic condition characterized by extreme fluctuations in
mood, energy, and ability to function
-Moods may be manic, hypomanic, or depressed and may include mixed mood or psychotic
features
-many have only experienced only one manic episode in their lifetime
-Mood fluctuations may be separated by periods of high stability or may cycle rapidly
,-diagnosed when a client has one or more episodes of mania or hypomania with a history of
one or more major depressive episodes
-high risk for suicide
mania - ANSWER- characterized by a persistently elevated, expansive, or irritable mood.
Related symptoms may include inflated self-esteem, increased goal-directed activity or energy,
including grandiosity, decreased need for sleep, excessive talkativeness, racing thoughts, flight
of ideas (FOI), distractibility, psychomotor agitation, and a propensity to be involved in high-risk
activities. Mania leads to significant functional impairment and may include psychotic features
or necessitate hospitalization
Bipolar Type I: - ANSWER- requires at least one episode of mania for at least one week (or
any duration if hospitalization due to symptoms is required)
Bipolar Type II: - ANSWER- diagnosis requires a current or past hypomanic episode and a
current or past major depressive episode. Symptoms last for at least 4 days but fewer than
seven.
-Hypomanic symptoms are not of sufficient duration or severity to cause significant functional
impairment, psychosis, or hospitalization.
-Anger and irritability are common.
-Clients often enjoy the elevation of mood and are reluctant to report these symptoms, making
bipolar more difficult to diagnose if the client presents in the depression phase.
Cyclothymia: - ANSWER- involves the chronic presentation of hypomanic and depressive
symptoms that do not meet the diagnostic criteria for a major depressive or manic/hypomanic
episode.
If bipolar depression is mistaken for MDD: - ANSWER- antidepressant therapy may
precipitate a manic episode or induce rapid-cycling bipolar depression
-may contribute to the increased incidence of death by suicide in children and adults younger
than 25
Antidepressants are used cautiously in clients with bipolar disorder and never as
________________. - ANSWER- monotherapy
-Antidepressants should be combined with a mood stabilizer to prevent the onset of a
hypomanic or manic episode
,DA, NE Dysfunction causes what mood related symptoms - ANSWER- Decreased positive
affect:
depressed mood
loss of joy
lack of interest
loss of energy
decreased alertness
decreased self-confidence
appetite changes
5HT, NE Dysfunction causes what mood related symptoms - ANSWER- Increased negative
affect:
depressed mood
guilt
fear/anxiety
hostility
irritability
loneliness
appetite changes
monoamine hypothesis of depression - ANSWER- -depression occurs as a result of a
deficiency of one or all three monoamine transmitters
• serotonin, norepinephrine, and dopamine
-while mania may result from an excess
Medication Management for Depression, First-Line Treatment: - ANSWER- • Selective
Serotonin Reuptake Inhibitors (SSRIs)
• Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)
• Norepinephrine Dopamine Reuptake Inhibitors (NDRI)
• Serotonin Antagonist and Reuptake Inhibitors (SARIs)
, SSRI's - ANSWER- Mechanism of action
• inhibit 5-HT reuptake
Adverse effects
-diarrhea
-headache
-weight gain
-sexual side effects
SNRI's - ANSWER- Mechanism of action
• inhibit 5-HT reuptake
• inhibit NE reuptake (increase energy, focus)
• increase DA in prefrontal cortex (increase cognition)
Adverse effects
-elevated blood pressure
-anxiety
-insomnia
-constipation
NDRI's - ANSWER- Mechanism of action
• inhibit DA reuptake (increase alertness, motivation)
• inhibit NE reuptake (increase energy)
Adverse effects
-agitation
-headache
-dry mouth
-constipation
-weight loss
SSRI Prescribing Pearls: med with mild antihistamine effects - ANSWER- citalopram (Celexa)
