Exam 1: NURS660/ NURS 660 (Latest 2023/
2024) Psychopharmacology and Advanced
Mental Health Exam| Questions and Verified
Answers| Grade A – Maryville
Q: How does aripiprazole work?
Answer:
1.Partial agonism at dopamine 2 receptors
2.Reduces dopamine output when dopamine is high thus improving positive symp- toms and
mediating antipsychotic actions.
3.Increases dopamine output when dopamine levels are low thus improving cogni- tion, negative,
and mood symptoms
4.Also acts on dopamine 3 receptors
5.Blocks serotonin 2A receptors thus increasing dopamine
Q: How long does it take aripiprazole to work?
Answer:
May begin working in one week. It is best to wait 4-6 weeks to see full efficacy.
Q: How does aripiprazole cause side effects
Answer:
1.Blocking alpha 1 adrenergic receptors causing dizziness, sedation, and hypertension
2.Partial agonist at dopamine 2 receptors in the striatum can cause motor side effects such as
akathisia
3.Partial agonist at dopamine 2 receptor causing nausea, vomiting, and activation side effects
Q: Notable side effects of aripiprazole?
Answer:
1.Dizziness
2.Insomnia
3.Akathisia
4.Activation
5.Nausea and vomiting
6.Orthostatic hypotension
7.Constipation
8.Headache, asthenia (muscle weakness)
9.Theoretical risk of tardive dyskinisia
Q: What are the adverse effects (life threatening) of aripiprazole
Answer:
Impulse con- trol problems
NMS Seizures
Cerebral vascular events
Sedation and vomiting in overdose (not reported fatal)
Q: What is the dosage for aripiprazole?
Answer:
15-30 mg daily for schizophrenia
Q: What is Brexpiprazole (Rexulti)?
Answer:
Atypical antipsychotic
Dopamine partial agonist
Third generation antipsychotic
Q: What is brexpiprazole (Rexulti) prescribed for?
Answer:
Schizophrenia
Treatment resistant depression
Acute mania-(Mixed mania)
Q: How does brexpiprazole (Rexulti) work?
Answer:
1.Partial dopamine 2 receptor ag- onist (reduces dopamine output where dopamine is high, thus
reducing positive symptoms of schizophrenia).
2.Increases dopamine output where dopamine concentrations are low thus decreas- ing cognitive,
negative and mood symptoms by blocking serotonin 2A receptors.
3.Partial agonism of 5HT1A receptor which can help mood anxiety and cognition.
4.Block alpha 1B receptors reducing akathisia
5.Block alpha 2C receptors reducing depression symptoms
Q: How long until brexpiprazole (Rexulti) works?
Answer:
Some effects in 1 week and optimal results in 4-6 weeks. Most schizophrenics will have 1/3
decease in symp- toms. Super responders will have decrease of 50-60%.
Q: How does brexpiprazole (Rexulti) cause side effects?
Answer:
1.By blocking alpha
1 adrenergic receptors the medication can cause sedation, dizziness, and hypoten- sion.
2.Partial agonist actions at the dopamine 2 receptors in the striatum causes akathisia
3.Partial agonist actions at the dopamine 2 receptors and 5HT1A receptors causes nausea and
vomiting
Q: What are the side effects of brexpiprazole (Rexulti)?
Answer:
1.Weight gain
2.Akathisia
3.Sedation
Exam 1: NURS660/ NURS 660 (Latest 2023/
2024) Psychopharmacology and Advanced
Mental Health Exam| Complete guide with
Questions and Verified Answers| 100%
Correct – Maryville
Q: What is Hyperprolactinemia?
Answer:
Higher-than-normal prolactin levels, which may result in spontaneous breastmilk production and
amenorrhea.
Q: Hyperprolactinemia causes
Answer:
-adenoma
-drugs (SSRI, antipsychotics, cocaine)
-hypothyroidism
-mass effect
-trauma
Q: Hyperprolactinemia Tx
Answer:
dopamine agonists (cabergoline, bromocriptine)
Q: D2 receptor benefit
Answer:
Improves positive symptoms
Q: Postural hypotension (orthostatic hypotension)
Answer:
alpha 1 adrenergic side effect
Q: Sedation
Answer:
Histamine H1 side effect
Q: Affective side effects
Answer:
Q: What receptors are involved in weight gain?
Answer:
5HT2C weight changes + H1 sedation
Q: What are alpha 1 adrenergic receptor side effects?
Answer:
Orthostatic hypotension
Reflex tachycardia
Dizziness
Q: alpha 2 adrenergic receptors side effect
Answer:
-Modulates alpha tone
-Counter regulatory for alpha-1 stimulation
-Inhibits norepinephrine
Risk of drug interactions
Q: muscarinic receptors side effect
Answer:
are normally activated by acetylcholine
ANS response
blurred vision, dry mouth, constipation, urinary retention, tachycardia, memory
Q: D2 antagonism side effects
Answer:
receptors involved in dopamine transmission decrease limbic activity
EPS, TD,
endocrine effects-prolactin secretion, sexual dysfunction increase reward seeking behaviors
Q: 5HT2A receptors benefit
Answer:
Decreased EPS
Q: 5HT2C benefit
Answer:
unknown
Q: Histamine H1
Answer:
Sedation
Q: muscarinic receptor benefit
Answer:
Decrease EPS
Q: alpha 1 adrenergic receptor benefit
Answer:
unknown
Q: alpha 2 adrenergic benefit
Answer:
unknown
Q: What do all antipsychotics have in common?
Answer:
They reduce dopaminergic neurotransmission
Q: What percentage of receptor occupancy is required for effectiveness?
Answer:
–
60-80%
Q: CYP 450 inducers
Answer:
Carbamazepine
Exam 2: NURS660/ NURS 660 (Latest 2023/
2024) Psychopharmacology and Advanced
Mental Health Exam| Complete guide with
Questions and Verified Answers| 100%
Correct – Maryville
Q: MAO-B action
Answer:
Breaks down and deaminates Dopamine in mitochondria
Q: MAO-B drugs
Answer:
Selegiline (Emsam)
Q: Line of treatment for MAOIs
Answer:
Second or third line due to side effects
Q: Receptor associated with suicide
Answer:
5HT-±2
Q: Receptor Sensitivity Hypothesis
Answer:
Supersensitivity and up-regulation of post-synaptic receptors leads to depression
Q: Four major toxic effects of TCAs
Answer:
Anticholinergic
Cardiovascular
Seizures
Death
Q: Main side effects MAOIs
Answer:
Drowsiness/fatigue
Decreased sexual function
Low blood pressure
Weight gain
Q: MDD and brain neruoanatomy -Prefrontal cortex
Answer:
Concentration/inter- est/pleasure
Psychomotor fatigue (mental) Guilt./ suidicality/ worthlessness Mood
Q: MDD and brain neuroanatomy -Striatum
Answer:
psychomotor fatigue (physical)
Q: MDD and brain neroanatomy – nucleus accumbens
Answer:
Pleasure, interest, fa- tigue, energy
Q: MDD and brain neuroanatomy -Amydgala
Answer:
Guilt, suicidality, worthlessness
Q: MDD and brain neuroanatomy -Hypothalamus
Answer:
Sleep, appetite
Q: MDD and brain neuroanatomy -Spinal cord
Answer:
fatigue (physical)
Q: MDD and brain neuroanatomy-cerebellum
Answer:
psychomotor
Q: How do you know which antidepressant to prescribe?
Answer:
By the secondary pharmacological properties
No two have the same
Q: Effective for Sadness, Panic & Compulsions
Answer:
Effective-Escitolpram
For – fluvoxamine, floxetine
Sadness-Sertraline Panic-Paroxetine Conpulsion-Citalopram
Q: Side effects SSRIs -SSSS
Answer:
S-Stomach upset
S-Sexual dysfunction
S-Serotonin syndrome
S-Suicidal thoughts
Q: H1 histamine receptor side effects
Answer:
sedation drowsiness
weight gain
Q: DA reuptake inhibition
Answer:
psychomotor activation psychosis
Q: 5HT2 agonism
Answer:
sexual dysfunction activating side effects
Q: 5HT3 agonism
Answer:
nausea
Exam 2: NURS660/ NURS 660 (Latest 2023/
2024) Psychopharmacology and Advanced
Mental Health Exam| Questions and Verified
Answers| Grade A – Maryville
Q: You are doing patient teaching for Margaret, who has been prescribed amitriptyline (Elavil)
for treatment of depression. Which of the following state- ments suggest that Margaret needs
further instruction?
a. I know I might not start feeling better for a few weeks, but I’ll keep taking my medication just
as the doctor prescribed
b. I’ll keep some hard candies in my purse in case my mouth gets dry from the medicine
c. Once I start feeling better, I am looking forward to cutting down on this medication
d. I’m worried I may gain some weight, but that is the small price to pay to feeling better
Answer:
c
Q: What is the main difference between depression and dysthymic depres- sion?
a. Dysthymia is a short-term depression and major depression lasts for years
b. Dysthymia is a chronic, low-level depression that lasts for years, while major depression is
more severe
c. Dysthymia is more likely to be caused by psychological factors and major depression is caused
by neurological dysfunction
d. Dysthymia is normally treated with psychotherapy only, while major depres- sion is treated
with antidepressants and psychotherapy
Answer:
b
Q: Your depressed patient is starting a new medication called phenelzine
(Nardil). Which teaching would be most important to emphasize?
a. Educate the patient to take this medication ongoing, even as symptoms improve
b. Instruct the patient and family about the many food-drug interactions
c. Instruct the patient about interventions to relieve dry mouth
d. Inform the patient that this medication takes 4 to 6 weeks to take full effect
Answer:
b
Q: Which of the following antidepressants is a tricyclic?
a. Bupropion (Wellbutrin)
b. Sertraline (Zoloft)
c. Nortriptyline (Pamelor)
d. Venlafaxine (Effexor)
Answer:
c
Q: Which statement is most true about depression?
a. It is more common in women than men
b. It is rare to have more than one episode of major depression in one’s lifetime
c. Young children do not suffer from depression
d. As one ages, there is reduced risk of depression
Answer:
a
Q: A newly admitted client has been diagnosed with major depressive disorder. Which nursing
diagnosis takes priority?
a. Impaired social interaction
b. Self-esteem deficit
c. Hopelessness
d. Self-care deficit
Answer:
c
Q: The nurse knows that the two factors that often differentiate major depression from
dysthymia depression are
a. Amounts of mania and sadness
b. Presence or absence of anger and guilt
c. Severity and duration of symptoms
d. Patient’s gender and age
Answer:
c
Q: You are caring for an older adult who is recently widowed. She says “No one cares if I die.
Everyone I ever loved is dead.” What is the best response?
a. I am sure that you still have people who care about you
b. You sound like you are feeling alone
c. Boy, that is depressing
d. I don’t believe that
Answer:
b
Q: Your patient with major depression tells you he suffers from urinary retention. Which
medication would most likely to cause this?
a. Amitriptyline
b. Duloxetine
c. Carbamazepine
d. Ritalin
Answer:
a
Q: Which activity would be best for a depressed patient?
a. A puzzle
b. Drawing
c. Crossword puzzles
d. Television
Answer:
b
Q: Which of the following meal choices indicates the patient understands the diet restrictions
when taking an MAOI?
a. Pepperoni pizza and beer
b. Roast chicken, baked potato, and beer
c. Fried fish, rice, and cola
d. Pickled herring, eggs, and coffee
Answer:
c
Q: Your patient with major depression sits in her room for hours staring out the window. Which
of the following would be the most appropriate interven- tion?
a. Sit with the patient and gently offer your availability to help
b. Keep encouraging the patient to go to exercise class
c. Offer the class once and then let the patient decide
d. Sit with the patient and ask her to list reasons for her depression
Answer:
a
Q: Which of the following drugs is a tricyclic antidepressant?
a. Bupropion (Wellbutrin)
b. Amitriptyline (Elavil)
c. Fluoxetine (Prozac)
d. Citalopram (Celexa)
Answer:
b
Q: Some medications such as tricyclics cause blurred vision. What is the cause of this effect?