NRNP6665 WEEK ELEVEN FINAL 2026
COMPLETE STUDY GUIDE
◉ 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mother reports that Caylee is very quiet and withdrawn and always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:
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: 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
D. Adolescent-onset depression typically need long-term
pharmacologic management to prevent relapses
◉ 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
◉ Amitriptyline (Elavil) Answer: Tricyclic antidepressant.
,◉ 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.
◉ Brexpiprazole (Rexulti) Answer: Treatment for depression.
Atypical antipsychotic
◉ 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).
◉ Citalopram (Celexa) Answer: Antidepressant, SSRI: 20-40 mg qd.
◉ Clomipramine (Anafranil) 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)
*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) 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
COMPLETE STUDY GUIDE
◉ 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:
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: 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
D. Adolescent-onset depression typically need long-term
pharmacologic management to prevent relapses
◉ 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
◉ Amitriptyline (Elavil) Answer: Tricyclic antidepressant.
,◉ 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.
◉ Brexpiprazole (Rexulti) Answer: Treatment for depression.
Atypical antipsychotic
◉ 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).
◉ Citalopram (Celexa) Answer: Antidepressant, SSRI: 20-40 mg qd.
◉ Clomipramine (Anafranil) 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)
*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) 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
