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6. Nutritional disorders implicated in MDD - ANS ✔Pernicious
anemia and pellagra
ANCC Certification PMHNP Exam
Questions with Correct Verified 7. Psychiatric disorders commonly associated with MDD - ANS
✔Anxiety disorders, eating disorders, Bipolar disorder, substance
Answers Latest Update (2025) abuse/dependence disorders
Guaranteed Pass 8. One should continue use of antidepressants for a minimum of -
ANS ✔8-12 months
1. Name 4 risk factors for MDD - ANS ✔Family history (esp. first
degree relative); prior episode, female gender, postpartum period,
medical comorbidity; single marital status; significant environmental 9. If patient has prior episodes of depression, than consider using
stressors, esp. multiple losses antidepressants - ANS ✔For longer than 8-12 months
2. Four to six weeks: - ANS ✔Length of time for therapeutic effect of 10. Medication and counselling - ANS ✔Research demonstrates
antidepressants that the most effective intervention is a combination of these two
treatment modalities
3. Appearance, speech, affect, mood, thought process, thought
content (including suicidal thoughts/behaviors); cognition, 11. Action primarily to increase serotonin levels in CNS by
orientation, memory, concentration, abstraction, judgment - inhibiting their reuptake: - ANS ✔Selective Serotonin Reuptake
ANS ✔Mental Status Exam Inhibitors (SSRIs)
4. Endocrine Disorders implicated in MDD - ANS 12. Elevate serotonin and norepinephrine levels primarily by
✔Hypothyroidism, DM, hyperaldosteronism, and inhibiting their reuptake - ANS ✔Tricyclic Antidepressants
Cushing's/Addison's Disease (TCAs)
5. Infectious and inflammatory states implicated in MDD - ANS 13. Elevate serotonin and norepinephrine levels primarily by
✔Mono, AIDS, viral and bacterial pneumonia; systemic lupus inhibiting MAO, the enzyme that destroys neurotransmitters -
erythematosus, temporal arteritis, tuberculosis ANS ✔Monoamine Oxidase Inhibitors (MAOIs)
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14. Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) -
ANS ✔Inhibit dual reuptake; action very selective on 22. Two SSRIs have potential for teratogenic effects, name
neurotransmitters; elevate serotonin and norepinephrine levels by
them. - ANS ✔Paxil and Zoloft
inhibiting their reuptake.
23. This SSRI has a black box warning for liver toxicity. - ANS
15. Norepinephrine Dopamine Reuptake Inhibitors (NDRIs) -
✔Luvox
ANS ✔Inhibit dual reuptake; action very selective on
neurotransmitters; elevate dopamine and norepinephrine levels by
inhibiting their reuptake. 24. GI upset, sexual dysfunction, nervousness, headache and
dry mouth are common side effects associated with... - ANS
✔SSRIs
16. Serotonin Agonist and Reuptake Inhibitors (SARIs) - ANS
✔Dual action; agonist of serotonin 5HT-2 receptors; action very
selective on neurotransmitters; elevates serotonin levels by 25. Second line drugs for treatment of MDD: - ANS ✔Tricyclic
inhibiting serotonin reuptake
Antidepressants (TCAs)
17. SSRIs side effects - ANS ✔Most common side effects of this
26. The side effect profile for TCAs - ANS ✔Dirty side-effect
class: gi upset, sexual dysfunction, nervousness, headache and dry
profile
mouth
27. Dirty side effect profile contributes to - ANS ✔Poor patient
18. Name the six SSRIs - ANS ✔Celexa, Lexapro, Prozac, Luvox,
compliance
Paxil (Pexeva), Zoloft.
28. Anticholinergic dirty side effects associated with TCA's: -
19. Which is safer in overdose, Paxil or Nortriptyline? - ANS
ANS ✔Dry mouth, blurred vision, constipation, memory problems.
✔Paxil. SSRIs are safer in overdose than TCAs.
Caused due to muscarinic receptor blockade.
20. SSRI's are also effective for treatment of panic disorder,
29. Antiadrenergic dirty side effects associated with TCAs: -
OCD, bulimia, GAD social phobia and - ANS ✔PTSD and
ANS ✔Orthostatic hypotension (from alpha 1 receptor blockade)
premenstrual dysphoric disorder
21. Which SSRI has long half-life? - ANS ✔Prozac
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