Final Exam: NR547/ NR 547 (Latest 2023/ 2024) Differential Diagnosis in Psychiatric-Mental Health Across the Lifespan Practicum Exam Review| Weeks 5-8 Covered| Complete Guide with Questions and Verified Answers- Chamberlain

Final Exam: NR547/ NR 547 (Latest 2023/ 2024) Differential Diagnosis in Psychiatric-Mental Health Across the Lifespan Practicum Exam Review| Weeks 5-8 Covered| Complete Guide with Questions and Verified Answers- Chamberlain

Final Exam: NR547/ NR 547 (Latest 2023/ 2024) Differential
Diagnosis in Psychiatric-Mental Health Across the Lifespan
Practicum Exam Review| Weeks 5-8 Covered| Complete
Guide with Questions and Verified Answers- Chamberlain
Q: Suicide in the U.S.
Answer:
-Approximately 2/3 of clients with depression contemplate suicide

• 10-15% die by suicide
  -Suicide is the second leading cause of death between the ages of 10-24 years
  -Almost 2 million adolescents attempt suicide each year
  -One in four older adults suicide attempts are fatal
  -One in 200 adolescent suicide attempts are fatal
  -Conversations about suicidal ideation are critical
• Screening tools such as the National Institutes of Health (NIH) Ask Suicide-Screening
  Questions (ASQ) are helpful resources to support these conversations.
  Q: Risk factors for suicide:
  Answer:
  -family history of suicide
  -history of depression
  -drug and alcohol use
  -history of school difficulties
  -high achiever
  -anxiety
  -having been bullied
  -access to lethal means
  -exposure to others with previous thoughts or actions of suicide
  -incarceration
  -traumatic life events or relationship issues
  -identifying as LGBTQ+
  -Native American descent
  Q: Depression Lifespan Considerations: Older Adults

Answer:
second leading cause of disability after cardiovascular disease
-impacts around 7% of the geriatric population
-often underreport symptoms of depression
-not a normal part of the aging process
-Risk factors:

• Chronic illness
• Disability/ loss of mobility
• Change in living situation
• Role transitions
• Loss of independence
• Bereavement
• Economic hardships
  Q: Depression Lifespan Considerations: Older Adults, pertinent information for an interview
  Answer:
  -socialization, including recent changes or loss
  -ability to complete activities of daily living (ADLs)
  -typical physical activity
  -appetite changes
  -weight loss or gain
  -psychotic symptoms
  -suicidal thoughts or ideations
  Q: Bipolar Lifespan considerations: older adults
  Answer:
  Approximately 10% of bipolar cases are diagnosed after the age of 50
  -mania is more likely to be expressed as agitation or irritability rather than euphoria
  -more likely to experience mixed episodes
  -Late-onset bipolar disorder may be difficult to distinguish from dementia
  Q: Geriatric Depression Scale (GDS)

Answer:
self-reporting tool that may be used to diagnose and treat depression
0-4: No depression
No treatment indicated
5-8: Mild depression
Pharmacologic or psychotherapeutic treatment may be indicated
Base treatment on duration of symptoms and functional impairment
9-11: Moderate depression
Pharmacologic, psychotherapeutic, or combination treatment indicated
12-15: Severe depression
Pharmacologic, psychotherapeutic, or combination treatment indicated
Q: It is important to evaluate ___ when depression is suspected
Answer:
cognitive function
-Older clients may have associated memory loss, slowed processing, or impaired executive
functioning

• Depression is an independent risk factor for dementia
• A Mini-Cog or other cognitive screening tool can provide a baseline assessment for clients
  Q: In clients who have dementia, self-reporting scales, such as the GDS, may be inappropriate.
  The ______________________ may be used as an alternative
  Answer:
  Cornell Rating Scale for Depression in Dementia
  Q: goal of treatment for older adults experiencing depression
  Answer:
  achieve symptom remission

-Options

• pharmacotherapy
• psychotherapy
• psychosocial interventions
  Q: Depression tx for older adult: Pharmacologic
  Answer:
  SSRIs & SNRIs
  -Escitalopram, citalopram, and sertraline have fewer drug-drug interactions than other
  medications and are appropriate choices for initial therapy in older adults taking multiple
  medications
  Q: Depression tx for older adult: Nonpharmacologic
  Answer:
  Engagement
  Social support
  Exercise
  Relaxation
  Q: DIGFAST
  Answer:
  mnemonic that may be helpful to assess for bipolar disorder in the clinical setting:
  Distractibility
  Impulsivity
  Grandiosity
  Flight of ideas
  Activity level
  Sleep
  Talkativeness
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