pg. 1
NUR546 MID -TERM EXAM WITH STUDY GUIDE EXAM
LATEST 2025| COMPLETE 300 ACCURATE QUESTIONS AND
CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+
Types of epigenetic changes: - ANSWER - DNA Methylation
Histone modification Non-coding RNA
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
Informed consent - ANSWER - 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
Compliance - ANSWER - 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 1 / 4
pg. 2 -Guardians can provide consent for clients who have limited cognitive capabilities or are incompetent to make decisions -PMHNPs are responsible for being knowledgeable about their state laws and abiding by them.
Off-Label Prescribing - ANSWER - Some clients may benefit from the unapproved use of a drug for symptom management.
-Example: many SSRIs used to tx anxiety and OCD but are not FDA
approved for use in this disorder.-potentially raises ethical and legal concerns -PMHNP must remain up to date with the latest recommendations for off- label prescribing.
Incidence of mental illness-what factors are increasing the incidence - ANSWER - Psychological and sociological factors Lifestyle factors such as a client's smoking status, diet, exercise, history of medication adherence, or history of addiction should be considered when prescribing psychotropic medications
Adherence - ANSWER - Persistence -taking med over intended time period Compliance -taking med as prescribed
left hemisphere - ANSWER - -speech comprehension -word recognition -grammar -sequential processing -recognition of detail 2 / 4
pg. 3 -conscious mental processing
right hemisphere - ANSWER - -prosody of speech -emotional modulation -visual-spatial skills -recognition of facial expression -music -abstract mathematical skills -holistic processing -unconscious mental processing
Pharmacokinetics - ANSWER - the study of what happens to a drug from the time of administration until the parent drug and all metabolites leave the body
CYP450 - ANSWER - CYP450 enzymes in the gut wall or liver convert drug substrate into a biotransformed product in the bloodstream, responsible for degradating of a large # of psychotropic drugs -Not all ind. have same genetic form of CYP450 enzymes, determined with pharmacogenetic testing *Most individuals have "normal" rates of drug metabolism from the major CYP450 enzymes and are said to be "extensive metabolizers", most drug doses are set for these individuals.*genetic variants of these enzymes can make poor metabolizers or ultra rapid metabolizers
Five of the most important:
CYP450 1A2, 2B6, 2D6, 2C9, 2C19, and 3A4. 3 / 4
pg. 4 ultra rapid metabolizers - ANSWER - elevated enzyme activity subtherapeutic drug levels poor efficacy with standard doses
genotyping - ANSWER - the patient for pharmacogenomic use -genes for these CYP450 enzymes can now be readily measured and used to predict which patients might need to have dosage adjustments -measurement of genes for drug metabolism
most common targets of psychotropic drugs - ANSWER - G-protein receptors -Drug actions at these receptors occur in a spectrum, from full agonist actions, to partial agonist actions, to antagonism, and even to inverse agonism.
Pharmacokinetics concepts - ANSWER - absorption distribution metabolism excretion
Flockhart Table - ANSWER - drug interactions that are mediated by cytochrome P450 enzymes comprehensive list of drugs and the interactions related to the cytochrome P450 system
Neurotransmitters - ANSWER - chemicals released by neurons to send communication across synaptic clefts to other neurons -impact human emotion and behavior
- / 4