NSG 591 - EXAM 2 QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026

NSG 591 - EXAM 2 QUESTIONS ANSWERED CORRECTLY LATEST UPDATE 2026 PTSD first line treatment - Answers SSRI Medication to avoid with PTSD - Answers Benzodiazepines Treatment for social anxiety performance - Answers Propranolol avoidant personality disorder - Answers a personality disorder characterized by inhibition in social situations; feelings of inadequacy; oversensitivity to criticism Persistent Depressive Disorder (Dysthymia) - Answers Low mood that persists for two years or more Cyclothymia criteria - Answers At least 2 years of hypomanic sx and depressive sx *BUT doesn't meet hypomanic or MDD criteria* During 2 yr period: hypomanic and depressive sx present at least half of the time AND pt has not been episode free for more than 2 mo. MDD/manic/hypomanic d/o NEVER MET Treatment for major depressive disorder with insomnia, and or weight loss - Answers Mirtazapine Treatment of major depressive disorder with sexual side effect concern - Answers Bupropion How to treat serotonin syndrome - Answers *Discontinue Immediately! Severe=Artificial Ventilation Common=Histamine 1-Receptor Antagonist & Cyproheptadine how to treat lithium toxicity - Answers Stop medication and check levels Lithium monitoring - Answers TSH, creatinine Major adverse effect of valproate - Answers severe hepatotoxicity Major risk with carbamazepine - Answers Agranulocytosis Major risk with lamotrigine - Answers Steven Johnson syndrome How to treat a patient with acute agitation - Answers IM Haloperidol plus lorazepam How to treat catatonia - Answers Ativan (lorazepam) or ECT When is ECT indicated? - Answers severe depression, mania, catatonia, when patients fail to respond to the meds, need for a rapid, definitive response, and during pregnancy when meds aren't available Post partum depression treatment - Answers SSRI Treatment for postpartum psychosis - Answers Immediate medical attention, hospitalization Antipsychotics Antidepressants Careful monitoring Treatment for seasonal depression - Answers light therapy, antidepressants Treatment for MDD with anxiety - Answers SSRI Treatment for generalized anxiety disorder with insomnia - Answers Antidepressant with trazodone adjunct A patient with panic disorder that has comorbidity of asthma what to avoid - Answers Propranolol Treatment for body dysmorphic disorder - Answers SSRIs and CBT Treatment For hoarding disorder - Answers CBT Treatment for trichotillomania - Answers Behavioral therapy + SSRIs Treatment for excoriation disorder - Answers SSRIs and therapy Treatment for adjustment disorders - Answers psychotherapy first line Definition of "rapid cycling" bipolar disorder - Answers Pts with four or more discrete episodes of a moood disturbance in 1 year. Bipolar disorder with mixed features - Answers Treat with mood stabilizer Bipolar disorder with Mixed features - Answers Full criteria met for one manic or depressive episode + ≥3 sx of other Which antipsychotic to use in a patient with metabolic risk - Answers Olanzapine Which antipsychotic to use if there is EPS risk - Answers Haloperidol Treatment for alcohol withdrawal anxiety - Answers Benzodiazepine Which medication to avoid in an elderly patient with GAD - Answers Avoid benzodiazepines Treatment for a pregnant patient with panic disorder - Answers CBT Which medication to avoid in a pregnant bipolar patient - Answers Valproate Which disorder carries the highest suicide risk - Answers Bipolar disorder Which therapy is gold standard for the treatment of OCD - Answers ERP Major depressive disorder duration - Answers Minimum duration is two weeks Generalized anxiety disorder, duration - Answers Minimum duration is six months Panic disorder duration - Answers 1 month or more PTSD duration requirement - Answers 1 month Acute stress disorder duration - Answers 3 days to 1 month after trauma exposure Adjustment disorder duration - Answers Develops usually within three months of stressor and must resolve within six months of termination of stressor Persistent depression disorder duration - Answers At least two years Cyclothymia duration of symptoms - Answers At least two years Mania duration - Answers at least 1 week Hypomania duration - Answers at least 4 days First line treatment for insomnia - Answers CBT Side effects of SSRIs - Answers Sexual dysfunction (anorgasmia) [30%] anxiety Weight gain Side effect of bupropion - Answers seizures Mirtazapine side effects - Answers sedation, increased appetite, weight gain Trazodone side effects - Answers sedation, priapism Venlafaxine side effects - Answers elevated BP and HR Duloxetine side effects - Answers dizziness, drowsiness, headache, GI upset, anorexia, and hepatotoxicity; Liver caution Risperidone side effects - Answers Increase prolactin levels risk with clozapine - Answers agranulocytosis - CBC must be done regularly Lithium therapeutic range - Answers 0.6-1.2 mEq/L What laboratory monitoring is necessary with valproate - Answers Liver function testing MDD hallmark symptoms - Answers Anhedonia symptoms of major depressive disorder - Answers - Depressed mood most of the day. - Markedly diminished interest or pleasure in activities most of the day. - Significant weight loss or gain when not dieting, or significant decrease or increase in appetite. - Insomnia or sleeping too much. -Physical agitation or lethargy. - Fatigue or loss of energy. - Feeling worthless, or excessive or inappropriate guilt. - Problems in thinking, concentrating or making decisions. - Recurrent thoughts of death and suicide . How old is major depressive disorder differ from normal sadness - Answers In the duration, severity, and impact or daily life Suicide risk associated with major depressive disorder - Answers Suicidal Ideation and up to 2/3 and 10 to 15% die by suicide if untreated Major depressive disorder, diagnostic criteria - Answers Five (or more) of the following symptoms that have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest or pleasure: 1.Depressed mood most of the day, nearly every day, as indicated by either subjective report or observation by others 2.Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day 3.Significant weight loss when not dieting or gaining weight, or decreased appetite nearly every day 4.Insomnia or hypersomnia nearly every day 5.Psychomotor agitation or retardation nearly every day 6.Fatigue or loss of energy nearly every day 7.Feelings of worthlessness or excessive or inappropriate guilt 8.Diminished ability to think or concentrate, or indecisiveness, nearly every day 9.Recurrent thoughts of death, recurrent suicide ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide Rating scales for depression - Answers Hamilton, depression rating scale, Montgomery-asberg Depression, rating scale, Beck Depression Inventory, Zung Self rating, depression scale MDD Episode Duration - Answers If untreated 6 to 13 months, if treated three months Treatment phases for MDD - Answers Acute phase week 8 to 12; continuation phase 6 to 9 months; maintenance phase 1 to 3 years Pharmacologic treatment for MDD - Answers SSRIs first line (Prozac, Zoloft, Lexapro). Alternative-SNRI, bupropion, mirtazapine. Augmentation with lithium, atypical antipsychotic. Novel therapies with ketamine, esketamine, Brexanolone Psychotherapy treatment for MDD - Answers CBT, IPT, behavioral activation, family therapy Neuro transmitters associated with MDD - Answers Serotonin, norepinephrine, dopamine Dosing for Sertraline (Zoloft) - Answers Start a 25 mg once a day for one week, then increase to 50 mg once a day Side effects to monitor when using SSRIs - Answers G.I., side effects, sleep changes, suicidal ideation When treating MDD, which medication's can be used to augment the SSRI - Answers Wellbutrin, Abilify, aripiprazole, or lithium What should you always rule out before starting an antidepressant to treat major depressive disorder? - Answers Always rule out bipolar disorder How to treat a patient with depression and fibromyalgia - Answers Cymbalta Best treatment for a patient with depression and ADHD - Answers Wellbutrin Why are SSRIs used commonly as a first line therapy for mood disorders - Answers They are first-line therapy due to the efficacy, tolerability, and overall safety What conditions are SSRIs used to treat? - Answers Depression, body, dysmorphic disorder, bulimia, anorexia, binge eating disorder, panic disorder, GAD, OCD, PTSD, premenstrual, dysphoric disorder, social, anxiety disorder, somatoform disorder How do you SSRIs work? - Answers They decrease action of presynaptic, serotonin, reuptake pumps, and increase length of time serotonin exist in the synapse SSRI absorption and metabolism - Answers SSRIs are absorbed in the G.I. tract, food does not affect absorption, peak levels within 1 to 8 hours, binds to proteins and spreads throughout body, enters the brain due to lipophilicity. Metabolized and eliminated through the liver, half-life equals one day or 20 to 30 hours. SSRIs inhibit hepatic cytochrome P450 drug metabolism. Interactions with fluoxetine and paroxetine - Answers Do not use with tamoxifen Do not take SSRI with the following medication's - Answers MAOI's, TCAs, sumatriptan (imitrex), linezolid (zyvox), St. John warts, amphetamines, and NSAIDs (increase risk of G.I. bleeding) First sign of serotonin syndrome - Answers High fever Increase risk of serotonin syndrome With MAOI and SSRI - Answers Always allow 14 days to elapsed between stopping the MAOI and starting the SSRI Common side effects of SSRIs - Answers Sexual dysfunction, weight gain, nausea, insomnia or somnolence, Agitation, Indigestion, diarrhea/constipation, dizziness, blurred vision, dry mouth, sweating, headache, erectile dysfunction SSRI safe with pregnancy - Answers Fluoxetine is safe; paroxetine is not safe Prozac dosing - Answers 20 mg ; increase 10-20 mg every 1-2 weeks; range 20 mg - 80 mg Prozac advantages and disadvantages - Answers Advantage: long, half life, good for poor compliance; low risk withdrawal syndrome. Disadvantage: slower onset, higher risk interaction due to P450 inhibition, more likely to cause insomnia/agitation than other SSRIs. Lexapro dosing - Answers 10 mg then increase to 20mg after one week; range 10 - 20 mg Advantages and disadvantages of Lexapro - Answers Advantage: two times more potent than Celexa; low risk drug interactions. Disadvantages: limited range for dose escalation. Zoloft dosing - Answers Start 50 mg; increase by 50mg after 1-2 weeks range 25-200mg (max = 200 mg)