NURS 6501 FINAL EXAM PRACTICE

NURS 6501 FINAL EXAM PRACTICE

QUESTIONS (ACTUAL EXAM

QUESTIONS) WITH DETAILED

CORRECT ANSWER S

What is the role of the primary care provider in mental health?Correct Answer - Screen for mental health issues

• Improve outcomes and reduce health care costs
• Assess and give care to mild-moderate disorders or patients

with stable severe mental disorders

• From strong links with mental health specialty care for complex

cases

Sharing patient info (ex: meds used)

about PHQ2

• what does it screen for, what are the questions, scoring Correct

Answer - Screens for MDD

• It is the first two questions of the PHQ9

• In the last two week, have you been feeling these (not at all,

several days, more than half the day, nearly everyday):

• Little interest or pleasure in doing things?
• Feeling down, depressed, or hopeless?

Scoring:

A single yes or score >3 (out of 0-6) = possible clinical depression ⇒ due the PHQ9

If the pt screens (+) ⇒ continue to eval with the PHQ9

about PHQ9 1 / 3

• what its used for, questions, scoring Correct Answer Used for

screening, diagnosing, and treating

• It asks about functioning impairments which is needed for the

DSM-based diagnosis Includes asking about suicide or hurting self

Scoring:

0-27 available

0-4: Minimal/none

Monitor; may not require treatment

5-9: Mild

Use clinical judgment; follow-up in one month

10-14: Moderate

Use clinical judgment; may need meds if functionally impaired

15-19: Moderately Severe

Warrants active treatment with psychotherapy, meds, or combo

20-27: Severe

Warrants active treatment with psychotherapy, meds, or combo

What is the appropriate initiation dose for fluoxetine for adults and geriatric adults? Correct Answer 20mg PO once daily in the AM

• May ↑ daily dose after several weeks if inadequate response
• Full therapeutic effect may be delayed 4 weeks or longer

- Max dose: 80mg/day

What labs would be appropriate to draw if you initiate fluoxetine in a geriatric patient? Correct Answer Sodium levels

• Baseline screening & after 3-4 weeks in high-risk patients (>

65yrs, previous hx of antidepressant-induced hyponatremia, low body weight, concomitant use of thiazides or other hyponatremia- inducing agents)

• monitor regularly in the elderly

What are potential side effects of SSRI medications? 2 / 3

• what are the common SSRIs, LEAP of them, and zoloft AE

Correct Answer Common SSRIs:

Lexapro, celexa, paxil, zoloft, prozac

L = decreased libido and sleep E = Neutral effect on energy A = neural effect on addiction P = celexa may stop working after awhile (increase or switch)

Zoloft AE:

Insomnia, somnolence, fatigue, abnormal ejaculation, suicidal thoughts

What are characteristics of major depressive disorder or MDD? 9

Correct Answer Diagnostics need 5 or more of the following:

• SS occur more days than not in a 2 week period
• SS cause significant impairment in any realm of functioning
• Depressed mood
• Loss of interest
• Significant unintended ▲ in weight or appetite
• Significant ▲ sleep
• ▲ psychomotor activity (restlessness)
• Fatigue, loss of energy
• Worthlessness, guilt

What is serotonin syndrome? Correct Answer - Increased serotonergic activity in the CNS

• Can be due to therapeutic med use, inadvertent drug

interactions, or self-OD

Serotonin in the Body:

CNS: Modulates attention, behavior, and thermoregulation

PNS: Regulates GI motility, vasoconstriction, uterine contraction,

and bronchoconstriction, promotes PLT aggregation

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