NR546 WEEK 5 TEST YOUR
KNOWLEDGE|| 123 QUESTIONS AND
ANSWERS 100% CORRECT
Pharmacologic Treatment of Major Depressive Disorder - ANSWER-Selective serotonin
reuptake inhibitors (SSRIs)
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Norepinephrine and dopamine reuptake inhibitors (NDRIs)
Serotonin antagonists and reuptake inhibitors (SARIs)
Miscellaneous antidepressants
Monoamine oxidase (MAO)-B inhibitors
Adjunct: antipsychotics
Pharmacologic Treatment of Bipolar Disorder - ANSWER-Lithium
Anticonvulsants
Second generation antipsychotics
Mood disorders: role of the psychiatric mental health nurse practitioner (PMHNP) is to: -
ANSWER-determine the malfunctioning brain circuit responsible for the client's
presenting symptoms and select the appropriate medication that targets the associated
neurotransmitter(s)
Mood disorders manifest across a spectrum from: - ANSWER-mania to major
depressive disorder (MDD)
Unipolar depression - ANSWER-major depressive disorder (MDD)
one of the most common mental disorders
-Approximately 7.1% of adults in the U.S. had episode in last year, prevalence highest
(13.1%) among individuals aged 18-25
S/S
-depressed mood
-loss of interest or pleasure in daily activities
-irritability
-withdrawal
-problems with sleep, eating, energy, concentration, or self-worth
-severe depression: may experience thoughts of suicide or psychotic symptoms.
Bipolar disorder (BD) - ANSWER-Chronic condition characterized by extreme
fluctuations in mood, energy, and ability to function
-Moods may be manic, hypomanic, or depressed and may include mixed mood or
psychotic features
,-many have only experienced only one manic episode in their lifetime
-Mood fluctuations may be separated by periods of high stability or may cycle rapidly
-diagnosed when a client has one or more episodes of mania or hypomania with a
history of one or more major depressive episodes
-high risk for suicide
mania - ANSWER-characterized by a persistently elevated, expansive, or irritable
mood. Related symptoms may include inflated self-esteem, increased goal-directed
activity or energy, including grandiosity, decreased need for sleep, excessive
talkativeness, racing thoughts, flight of ideas (FOI), distractibility, psychomotor agitation,
and a propensity to be involved in high-risk activities. Mania leads to significant
functional impairment and may include psychotic features or necessitate hospitalization
Bipolar Type I: - ANSWER-requires at least one episode of mania for at least one week
(or any duration if hospitalization due to symptoms is required)
Bipolar Type II: - ANSWER-diagnosis requires a current or past hypomanic episode and
a current or past major depressive episode. Symptoms last for at least 4 days but fewer
than seven.
-Hypomanic symptoms are not of sufficient duration or severity to cause significant
functional impairment, psychosis, or hospitalization.
-Anger and irritability are common.
-Clients often enjoy the elevation of mood and are reluctant to report these symptoms,
making bipolar more difficult to diagnose if the client presents in the depression phase.
Cyclothymia: - ANSWER-involves the chronic presentation of hypomanic and
depressive symptoms that do not meet the diagnostic criteria for a major depressive or
manic/hypomanic episode.
If bipolar depression is mistaken for MDD: - ANSWER-antidepressant therapy may
precipitate a manic episode or induce rapid-cycling bipolar depression
-may contribute to the increased incidence of death by suicide in children and adults
younger than 25
Antidepressants are used cautiously in clients with bipolar disorder and never as
________________. - ANSWER-monotherapy
-Antidepressants should be combined with a mood stabilizer to prevent the onset of a
hypomanic or manic episode
DA, NE Dysfunction causes what mood related symptoms - ANSWER-Decreased
positive affect:
depressed mood
loss of joy
lack of interest
loss of energy
decreased alertness
, decreased self-confidence
appetite changes
MDD symptoms associated with malfunctioning brain circuit: Prefrontal Cortex (PFC) -
ANSWER-Concentration
Mental fatigue
Mood
MDD symptoms associated with malfunctioning brain circuit: PFC & Amygdala -
ANSWER-Guilt
suicidality
worthlessness
MDD symptoms associated with malfunctioning brain circuit: Striatum - ANSWER-
Physical fatigue
MDD symptoms associated with malfunctioning brain circuit: Nucleus Accumbens -
ANSWER-Pleasure interests
MDD symptoms associated with malfunctioning brain circuit: Hypothalamus - ANSWER-
Sleep
appetite
5HT, NE Dysfunction causes what mood related symptoms - ANSWER-Increased
negative affect:
depressed mood
guilt
fear/anxiety
hostility
irritability
loneliness
appetite changes
neurobiological factors that contribute to mood and mood disorders: Genetics -
ANSWER-MDD and BD are heritable disorders
-genetic factors 31-42% of the disease risk in MDD and 59-85% in BD
-causes of mood disorders complex, likely involve interactions between
genetic/epigenetic, biological, psychological, and social factors including:
• dysfunctions in brain
• imbalance of neurotransmitters
• life events
• abuse or trauma
• substance use or medication
• menstruation
• season changes
KNOWLEDGE|| 123 QUESTIONS AND
ANSWERS 100% CORRECT
Pharmacologic Treatment of Major Depressive Disorder - ANSWER-Selective serotonin
reuptake inhibitors (SSRIs)
Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Norepinephrine and dopamine reuptake inhibitors (NDRIs)
Serotonin antagonists and reuptake inhibitors (SARIs)
Miscellaneous antidepressants
Monoamine oxidase (MAO)-B inhibitors
Adjunct: antipsychotics
Pharmacologic Treatment of Bipolar Disorder - ANSWER-Lithium
Anticonvulsants
Second generation antipsychotics
Mood disorders: role of the psychiatric mental health nurse practitioner (PMHNP) is to: -
ANSWER-determine the malfunctioning brain circuit responsible for the client's
presenting symptoms and select the appropriate medication that targets the associated
neurotransmitter(s)
Mood disorders manifest across a spectrum from: - ANSWER-mania to major
depressive disorder (MDD)
Unipolar depression - ANSWER-major depressive disorder (MDD)
one of the most common mental disorders
-Approximately 7.1% of adults in the U.S. had episode in last year, prevalence highest
(13.1%) among individuals aged 18-25
S/S
-depressed mood
-loss of interest or pleasure in daily activities
-irritability
-withdrawal
-problems with sleep, eating, energy, concentration, or self-worth
-severe depression: may experience thoughts of suicide or psychotic symptoms.
Bipolar disorder (BD) - ANSWER-Chronic condition characterized by extreme
fluctuations in mood, energy, and ability to function
-Moods may be manic, hypomanic, or depressed and may include mixed mood or
psychotic features
,-many have only experienced only one manic episode in their lifetime
-Mood fluctuations may be separated by periods of high stability or may cycle rapidly
-diagnosed when a client has one or more episodes of mania or hypomania with a
history of one or more major depressive episodes
-high risk for suicide
mania - ANSWER-characterized by a persistently elevated, expansive, or irritable
mood. Related symptoms may include inflated self-esteem, increased goal-directed
activity or energy, including grandiosity, decreased need for sleep, excessive
talkativeness, racing thoughts, flight of ideas (FOI), distractibility, psychomotor agitation,
and a propensity to be involved in high-risk activities. Mania leads to significant
functional impairment and may include psychotic features or necessitate hospitalization
Bipolar Type I: - ANSWER-requires at least one episode of mania for at least one week
(or any duration if hospitalization due to symptoms is required)
Bipolar Type II: - ANSWER-diagnosis requires a current or past hypomanic episode and
a current or past major depressive episode. Symptoms last for at least 4 days but fewer
than seven.
-Hypomanic symptoms are not of sufficient duration or severity to cause significant
functional impairment, psychosis, or hospitalization.
-Anger and irritability are common.
-Clients often enjoy the elevation of mood and are reluctant to report these symptoms,
making bipolar more difficult to diagnose if the client presents in the depression phase.
Cyclothymia: - ANSWER-involves the chronic presentation of hypomanic and
depressive symptoms that do not meet the diagnostic criteria for a major depressive or
manic/hypomanic episode.
If bipolar depression is mistaken for MDD: - ANSWER-antidepressant therapy may
precipitate a manic episode or induce rapid-cycling bipolar depression
-may contribute to the increased incidence of death by suicide in children and adults
younger than 25
Antidepressants are used cautiously in clients with bipolar disorder and never as
________________. - ANSWER-monotherapy
-Antidepressants should be combined with a mood stabilizer to prevent the onset of a
hypomanic or manic episode
DA, NE Dysfunction causes what mood related symptoms - ANSWER-Decreased
positive affect:
depressed mood
loss of joy
lack of interest
loss of energy
decreased alertness
, decreased self-confidence
appetite changes
MDD symptoms associated with malfunctioning brain circuit: Prefrontal Cortex (PFC) -
ANSWER-Concentration
Mental fatigue
Mood
MDD symptoms associated with malfunctioning brain circuit: PFC & Amygdala -
ANSWER-Guilt
suicidality
worthlessness
MDD symptoms associated with malfunctioning brain circuit: Striatum - ANSWER-
Physical fatigue
MDD symptoms associated with malfunctioning brain circuit: Nucleus Accumbens -
ANSWER-Pleasure interests
MDD symptoms associated with malfunctioning brain circuit: Hypothalamus - ANSWER-
Sleep
appetite
5HT, NE Dysfunction causes what mood related symptoms - ANSWER-Increased
negative affect:
depressed mood
guilt
fear/anxiety
hostility
irritability
loneliness
appetite changes
neurobiological factors that contribute to mood and mood disorders: Genetics -
ANSWER-MDD and BD are heritable disorders
-genetic factors 31-42% of the disease risk in MDD and 59-85% in BD
-causes of mood disorders complex, likely involve interactions between
genetic/epigenetic, biological, psychological, and social factors including:
• dysfunctions in brain
• imbalance of neurotransmitters
• life events
• abuse or trauma
• substance use or medication
• menstruation
• season changes
