NR546/ NR 546 Study Guide
Week 1 to Week 4
Advanced Pharṃacology Psychopharṃacology
for the Psychiatric-Ṃental Health Nurse Practitioner
The Ultiṃate Study Guide to Pass Your Exaṃ
Inside, you'll get:
➢ Key areas to focus on in your NR 546 study guide:
➢ Review course:
➢ Review notes:
➢Practice questions with answers:
➢Case studies:
, ➢key terṃs and definitions:
1. How does reviewing the genetic makeup of a client help guide the PMHNP in selecting
medication for clients
Answer> -Genetic testing can assist by providing more information on how clients may
respond to certain psychotropic medications
-provides information on how a client may break down and metabolize medications
based on the cytochrome P450 system.
2. Tanr1kulu and Erba_ (2020) investigated identical twins to determine the presence of
an inherited link for schizophrenia and why one twin may develop schizophrenia when
the other does not. When two people have 100% identical DNA, why don't both persons
develop the exact illnesses? Studies of identical Danish twins found that if one twin had
schizophrenia, the other twin had a 50% lifetime risk of developing schizophrenia
(Lemvigh et al., 2020). Why is there only half the risk
Answer> Both environmental and psychosocial stressors can im- pact mental health.
Although twins may have identical genes, their gene expression may be different.
There may be an environmental exposure that turned a gene "on" that should have been
"off" for one twin to develop schizophrenia and not the other.
3. The field of epigenetics is rapidly growing and can help explain how gene
expression is
,Answer> influenced by environmental factors and how epigenetics contributes to the
manifestation of mental illness
4. How does epigenetics impact a person's mental health
Answer> internal or external factors activate portions of the genome that result in the
manifestation of mental health symptoms
-activation is often a result of a stressful event, which, when combined with the genetic
risk, results in the disease
-genes being on or off
-occurrence of symptoms may be the result of inheritance of an abnormal gene or of
normal genes being "on" when they should be "off."
5. Types of epigenetic changes
Answer> DNA Methylation Histone modification
Non-coding RNA
6. The potential legal and ethical issues impacting mental health treatment must
also be taken into account, including
Answer> -informed consent
-competence to make healthcare decisions
-off-label prescribing
7. What should the PMHNP consider when prescribing chemical restraints
, Answer> -
-allergy status
-prior med hx for adverse drug reactions r/t the meds ordered in the chemical restraint
-state regulations regarding chemical restrains must be reviewed
8. Are the PMHNP and other staff liable if the client has an allergic reaction or adverse
side effects to the drugs used for chemical restraint
Answer> No.
The client has been court-ordered to take the prescribed medications and the standing
order for chemical restraints is approved. The PMHNP and other staff are not liable if the
patient has an allergic reaction or adverse side effects.
9. Informed consent: Clients have the right to receive enough information to make
decisions about treatment.
-must also be informed about potential risks associated with medications.
-have the right to refuse treatment
-cannot be forcibly medicated in non-emergencies. However, clients can be forcibly
medicated if they are violent toward themselves or others and when less restrictive
methods have failed
10. Compliance: A court order may be issued for a client to receive treatment
against their wishes if they are considered a danger to themselves or others.
-Examples: clients with schizophrenia or sex offenders
Week 1 to Week 4
Advanced Pharṃacology Psychopharṃacology
for the Psychiatric-Ṃental Health Nurse Practitioner
The Ultiṃate Study Guide to Pass Your Exaṃ
Inside, you'll get:
➢ Key areas to focus on in your NR 546 study guide:
➢ Review course:
➢ Review notes:
➢Practice questions with answers:
➢Case studies:
, ➢key terṃs and definitions:
1. How does reviewing the genetic makeup of a client help guide the PMHNP in selecting
medication for clients
Answer> -Genetic testing can assist by providing more information on how clients may
respond to certain psychotropic medications
-provides information on how a client may break down and metabolize medications
based on the cytochrome P450 system.
2. Tanr1kulu and Erba_ (2020) investigated identical twins to determine the presence of
an inherited link for schizophrenia and why one twin may develop schizophrenia when
the other does not. When two people have 100% identical DNA, why don't both persons
develop the exact illnesses? Studies of identical Danish twins found that if one twin had
schizophrenia, the other twin had a 50% lifetime risk of developing schizophrenia
(Lemvigh et al., 2020). Why is there only half the risk
Answer> Both environmental and psychosocial stressors can im- pact mental health.
Although twins may have identical genes, their gene expression may be different.
There may be an environmental exposure that turned a gene "on" that should have been
"off" for one twin to develop schizophrenia and not the other.
3. The field of epigenetics is rapidly growing and can help explain how gene
expression is
,Answer> influenced by environmental factors and how epigenetics contributes to the
manifestation of mental illness
4. How does epigenetics impact a person's mental health
Answer> internal or external factors activate portions of the genome that result in the
manifestation of mental health symptoms
-activation is often a result of a stressful event, which, when combined with the genetic
risk, results in the disease
-genes being on or off
-occurrence of symptoms may be the result of inheritance of an abnormal gene or of
normal genes being "on" when they should be "off."
5. Types of epigenetic changes
Answer> DNA Methylation Histone modification
Non-coding RNA
6. The potential legal and ethical issues impacting mental health treatment must
also be taken into account, including
Answer> -informed consent
-competence to make healthcare decisions
-off-label prescribing
7. What should the PMHNP consider when prescribing chemical restraints
, Answer> -
-allergy status
-prior med hx for adverse drug reactions r/t the meds ordered in the chemical restraint
-state regulations regarding chemical restrains must be reviewed
8. Are the PMHNP and other staff liable if the client has an allergic reaction or adverse
side effects to the drugs used for chemical restraint
Answer> No.
The client has been court-ordered to take the prescribed medications and the standing
order for chemical restraints is approved. The PMHNP and other staff are not liable if the
patient has an allergic reaction or adverse side effects.
9. Informed consent: Clients have the right to receive enough information to make
decisions about treatment.
-must also be informed about potential risks associated with medications.
-have the right to refuse treatment
-cannot be forcibly medicated in non-emergencies. However, clients can be forcibly
medicated if they are violent toward themselves or others and when less restrictive
methods have failed
10. Compliance: A court order may be issued for a client to receive treatment
against their wishes if they are considered a danger to themselves or others.
-Examples: clients with schizophrenia or sex offenders
