Which of the following medications are FDA approved for Major Depressive Disorder?
Which of the following medications are FDA approved for Major Depressive Disorder? SELECT ALL THAT APPLY.
Paxil (Paroxetine)
Celexa (Citalpram)
Lexapro (Escitalopram)
Prozac (fluoxetine)
Luvox (Fluvoxamine)
Question 2The PMHNP has determined that Prozac (Fluoxetine) is not effective for the patient. The patient must be educated about how to stop this medication. Which of the following statements is correct?
Because Prozac (Fluoxetine) has very low percentage of protein binding you may stop the medication immediately
Because Prozac is not inhibitor, it must be tapered slowly over several weeks
Due the short half life of the medication you take half the doss for one week, then one half of the dose for a second week
Due to the long half life of Prozac (Fluoxetine), you may stop the medication without taper
Question 3An inducing agent of the CYP450 system can increase the rate of another medication’s metabolism, resulting in decreased plasma level of that medication. True or False?
True
False
Question 4Which of the following Selective Serotonin Reuptake Inhibitor (SSRI) would be the best choice for treating someone with Major Depressive Disorder with Psychotic Features?
Prozac (fluoxetine)
Lexapro ( Escitalopram)
Celexa (Citalopram)
Zoloft ( Sertraline)
Question 5The PMHNP has decided to start the patient on a Selective Serotonin Re-uptake Inhibitor. Which of the following should be included in patient education? SELECT ALL THAT APPLY
There is a Black Box Warning for increased suicidal thoughts in children, adolescents, and young adults.
If you experience side effects, they may go away in 2-4 weeks
Side effects may include diaphoresis, sexual dysfunction, and sedation
If you experience any side effect stop the medication immediately
Therapeutic effect may take at least 4-8 weeks
Question 6The PMHNP is assessing the patient who is being treated for Major Depressive Disorder. The patient is noted to be exhibiting the following symptoms:
-Tachycardia
-Fever of 101 degrees
-Diarrhea
-Diaphoresis, color is pink
Increased muscle tone
-Muscle spams/jerking
-Hyperreflexia
The PMHNP is concerned the client may be suffering from___________
Serotonin Syndrome
Hypertensive Crisis
A drug interaction due to the CYP450 System
Discontinuation Syndrome
Question 7Which class of medications are considered first line treatment for first episode of Major Depressive Disorder?
Monoamine oxidase inhibitors (MAOIs)
Norepinephrine-Dopamine Reuptake Inhibitors (NDRI)
Tricyclic antidepressants (TCA)
Selective Serotonin Reuptake Inhibitors (SSRI)
Question 8Which of the following test would the PMHNP consider ordering for a patient who is on Celexa?
EKG
Lab Values for therapeutic level
Lipid panel
MRI
Question 9The PMHNP is assessing a patient who has been tapering off Paxil. The patient is noted to be exhibiting the following symptoms:
Dizziness
Vertigo
Paresthesia
“Electric Shock”
Fever, Sweating
Nausea
Vomiting
Muscle pain
Fatigue
Tremor
Headache
The PMHNP is concerned the client may be suffering from___________
A drug interaction due to the CYP450 System
Discontinuation Syndrome
Serotonin syndrome
Hypertensive Crisis
Question 10Which of the following receptors is associated with Anxiety?
DA reuptake blockade
NE reuptake blockade
5HT2 Blockade
5HT1A Blockade
Question 11The PMHNP is seeing a 48 year old Female with Major Depressive Disorder. During the initial evaluation it is identified that the patient has is being treated for hypertension. Which of the following medications would the PMHNP want to avoid?
Prozac (fluoxetine)
Effexor ( Venlafaxine)
Zoloft (Sertraline)
Lexapro (Escitalopram)
Question 12The only class of antidepressants that have a black box warning for suicidal thoughts for children, adolescents, and young adults is Selective Serotonin Re-uptake Inhibitors. True or False
True
False
Question 13The PMHNP is care for a patient with Major Depressive Disorder, Alcohol Use Disorder, and Cirrhosis of the Liver. The PMHNP should avoid which of the following Serotonin and Norepinephrine Reuptake Inhibitors (SNRI).
Cymbalta (Duloxetine)
Pristiq (Desvenlafaxine)
Savella (Milnacipran)
Fetzima (Levomilnacipran)
Question 14Which of the following conditions are contraindicated when prescribing Wellbutrin (Bupropion)? SELECT ALL THAT APPLY.
Bulimia
Hypertension
Anorexia nervosa
Concurrent Use of Cocaine
History of Seizures
Question 15The Tricyclic antidepressants are known to cause multiple side effects including anticholinergic side effects. These include dry mouth, constipation, blurred vision, urinary hesitancy, esophageal reflux
This is due to the ________ of the ___________ receptor.
Blockade of the M1 Ach ( Muscarinic Acetylcholine Receptors)
Agonism of the 5HT1A (Sub type of the Serotonin Receptor
Agonism of the M1 Ach ( Muscarinic Acetylcholine Receptors)
Blockade of the 5HT1A (Sub type of the Serotonin Receptor)
Question 16 A prescriber should avoid prescribing Tricylclic Antidepressants (TCA) in patients who are suicidal.
True
False
Question 17The PMHNP has decided to change the patient’s MAOI medication to a SSRI. Which of the following must be done to ensure a safe transition? SELECT ALL THAT APPLY
Monitor for signs of Serotonin Syndrome
Allow for an appropriate wash out period
Start the SSRI the day after stopping the MAO
Weekly lab work
Question 18The PMHNP is assessing the patient, who is taking Phenelzine for Major Depressive Disorder. The patient reports the following symptoms:
headache
Neck stiffness, soreness
Nausea, vomiting
Sweating
Fever, with cold, clammy skin
Photophobia
Racing Heart
The PMHNP is concerned that the patient may be experiencing a ________________.
Discontinuation Syndrome
A drug interaction due to the CYP450 System
Hypertensive Crisis
Serotonin syndrome
Question 19The PMHNP is doing education with a patient who is taking a Monoamine oxidase inhibitors (MAOIs). Education should include which of the following. SELECT ALL THAT APPLY
Report a headache or neck stiffness immediately
Lab work must be drawn weekly for one month
Consult your provider befor taking over the counter sleep aids or cold medication
Avoid aged or smoked meats and cheeses
Avoid Beer
Question 20Dietary and drug restrictions must be maintained for 2 weeks after stopping Monoamine oxidase inhibitors (MAOIs). True or False
True
False
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