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NR 547 FINAL EXAM 2024/2025 COMPLETE QUESTION
AND ANSWER 100% ACCURATE, EXAMS OF NURSING
when should lithium trough levels be drawn - ANSWER-12 hours after the last dose
What other labs should be monitored when on lithium - ANSWER-kid function and thyroid levels
Depakote (Valproic Acid) Level - ANSWER-Therapeutic range
50-125
Toxicity risk
>150
Severe Toxicity >200
Symptoms of Depakote Toxicity - ANSWER-Liver tox
pancreatitis
CNS depression
When should trough levels be drawn for depakote level - ANSWER-before the next dose
what other labs should be monitored when on depakote - ANSWER-liver enzymes
platelets
ammonia level
What are specifiers for MDD - ANSWER-describes its features, severity, and course. can help
guide treatment planning and prognosis
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Severity specifiers for MDD - ANSWER-Indicates how severe the episode is.
Milk
Moderate
Severe
With Psychotic Features
Mild MDD - ANSWER-few symptoms beyond diagnostic criteria, manageable distress
Moderate MDD - ANSWER-More symptoms, significant impairment but manageable
Severe MDD - ANSWER-Many symptoms, major impairment in functioning
MDD with psychotic features - ANSWER-Hallucinations or delusions present
MDD with psychotic features, mood congruent - ANSWER-Delusions/hallucinations consistent
with depressive themes (guilt, worthlessness)
MDD with psychotic features, mood- incongruent - ANSWER-Psychotic features unrelated to
mood (ex paranoia)
MDD Episode features specifiers - ANSWER-Adds details about the characteristics of the
depressive episode
With anxious distress
With mixed features
With melancholic Features
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With atypical features
with psychotic features
with catatonia
with peripartum onset
with seasonal pattern
MDD with anxious distress - ANSWER-feeling tense, restless, difficulty concentrating due to
worry, fear of losing control
**High risk of suicide and treatment resistance
MDD with mixed features - ANSWER-some manic/hypomanic symptoms present, but not
enough for Bipolar Disorder (increased energy, elevated mood, talkativeness)
**May indicate Bipolar Spectrum Disorder
MDD with melancholic features - ANSWER-Severe loss of pleasure (anhedonia)
Lack of mood reactivity
profound despair, guilt
Early morning awakening, significant weight loss, psychmotor agitation/retardation
**More biological in origin, better response to antidepressants or ECT
MDD with atypical features - ANSWER-Mood reactivity (can feel better with positive events)
Increased appetitie or weight gain
Hypersomnia (excessive sleeping)
Heavy limb sensation (leaden paralysis)
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Sensitivity to rejection
**Often seen in Bipolar II Disorder, responds well with MAOIs
MDD mood congruent with psychotic features - ANSWER-delusions/hallucinations related to
depressive themes (guilt, worthlessness)
MDD with Mood incongruent psychotic features - ANSWER-Bizzare or unrelated psychotic
symptoms
MDD with catatonia - ANSWER-mutism
stupor
posturing
rigidity
bizzare movements
**Can occur in severe depression, bipolar disorder, or schizophrenia. Requires urgent treatment
MDD with peripartum onset - ANSWER-Depression during pregnancy or within 4 week
postpartum
**Can include psychotic features, risk of postpartum psychosis
MDD With seasonal Pattern (Seasonal Affective Disorder-SAD) - ANSWER-Depression occurs in
seasonal pattern, typically in fall/winter
**Related too light exposure, responds to light therapy
NR 547 FINAL EXAM 2024/2025 COMPLETE QUESTION
AND ANSWER 100% ACCURATE, EXAMS OF NURSING
when should lithium trough levels be drawn - ANSWER-12 hours after the last dose
What other labs should be monitored when on lithium - ANSWER-kid function and thyroid levels
Depakote (Valproic Acid) Level - ANSWER-Therapeutic range
50-125
Toxicity risk
>150
Severe Toxicity >200
Symptoms of Depakote Toxicity - ANSWER-Liver tox
pancreatitis
CNS depression
When should trough levels be drawn for depakote level - ANSWER-before the next dose
what other labs should be monitored when on depakote - ANSWER-liver enzymes
platelets
ammonia level
What are specifiers for MDD - ANSWER-describes its features, severity, and course. can help
guide treatment planning and prognosis
,2|Page
Severity specifiers for MDD - ANSWER-Indicates how severe the episode is.
Milk
Moderate
Severe
With Psychotic Features
Mild MDD - ANSWER-few symptoms beyond diagnostic criteria, manageable distress
Moderate MDD - ANSWER-More symptoms, significant impairment but manageable
Severe MDD - ANSWER-Many symptoms, major impairment in functioning
MDD with psychotic features - ANSWER-Hallucinations or delusions present
MDD with psychotic features, mood congruent - ANSWER-Delusions/hallucinations consistent
with depressive themes (guilt, worthlessness)
MDD with psychotic features, mood- incongruent - ANSWER-Psychotic features unrelated to
mood (ex paranoia)
MDD Episode features specifiers - ANSWER-Adds details about the characteristics of the
depressive episode
With anxious distress
With mixed features
With melancholic Features
,3|Page
With atypical features
with psychotic features
with catatonia
with peripartum onset
with seasonal pattern
MDD with anxious distress - ANSWER-feeling tense, restless, difficulty concentrating due to
worry, fear of losing control
**High risk of suicide and treatment resistance
MDD with mixed features - ANSWER-some manic/hypomanic symptoms present, but not
enough for Bipolar Disorder (increased energy, elevated mood, talkativeness)
**May indicate Bipolar Spectrum Disorder
MDD with melancholic features - ANSWER-Severe loss of pleasure (anhedonia)
Lack of mood reactivity
profound despair, guilt
Early morning awakening, significant weight loss, psychmotor agitation/retardation
**More biological in origin, better response to antidepressants or ECT
MDD with atypical features - ANSWER-Mood reactivity (can feel better with positive events)
Increased appetitie or weight gain
Hypersomnia (excessive sleeping)
Heavy limb sensation (leaden paralysis)
, 4|Page
Sensitivity to rejection
**Often seen in Bipolar II Disorder, responds well with MAOIs
MDD mood congruent with psychotic features - ANSWER-delusions/hallucinations related to
depressive themes (guilt, worthlessness)
MDD with Mood incongruent psychotic features - ANSWER-Bizzare or unrelated psychotic
symptoms
MDD with catatonia - ANSWER-mutism
stupor
posturing
rigidity
bizzare movements
**Can occur in severe depression, bipolar disorder, or schizophrenia. Requires urgent treatment
MDD with peripartum onset - ANSWER-Depression during pregnancy or within 4 week
postpartum
**Can include psychotic features, risk of postpartum psychosis
MDD With seasonal Pattern (Seasonal Affective Disorder-SAD) - ANSWER-Depression occurs in
seasonal pattern, typically in fall/winter
**Related too light exposure, responds to light therapy
