Comprehensive NR 547 Final Exam.
Latest Updated Exam Study Guide
2026/2027
What does a score of 0-7 on the Hamilton Depression Rating Scale (HAM-D) indicate? -
ansNormal (no depression)
What does a score of 8-16 on the Hamilton Depression Rating Scale (HAM-D) indicate? -
ansMild depression
What does a score of 17-23 on the Hamilton Depression Rating Scale (HAM-D) indicate? -
ansModerate depression
What does a score of 24 or higher on the Hamilton Depression Rating Scale (HAM-D)
indicate? - ansSevere depression
How are items on the Hamilton Depression Rating Scale (HAM-D) scored? - ansEach item is
scored 0-2 or 0-4, depending on severity.
What type of tool is the Hamilton Depression Rating Scale (HAM-D)? - ansA clinician
administered tool used to assess the severity of depression symptoms.
What aspects of depression does the Hamilton Depression Rating Scale (HAM-D) evaluate? -
ansPsychological and physical aspects of depression.
HAM-D 17 Components - ansMood
Guilt Feelings
SI
Insomnia
Work and Activities
Psychomotor Agitation or retardation
Anxiety (psychological and somatic symptoms)
Somatic symptoms
Hypochondriasis
Loss of weight
Insight
Limitation of HAM-D rating scale - ansMore focused on somatic symptoms which can over
estimate depression in medically ill patients
Alternative to HAM-D Scale - ansMontgomery-Ashberg Depression Rating Scale (MADRS)
which is better for tracking and treatment response
Geriatric Depression Scale (GDS) - ansConsists of yes/no questions that assess emotional,
cognitive, and behavioral symptoms of depresion in older adults. It avoids somatic symptoms
that may overlap with medical conditions
Key Areas assessed in GDS - ansMood and Enjoyment
Energy Levels
Social Withdrawal
Feelings of Hopelessness
Memory Concerns
Anxiety and Worry
Suicidal Thoughts
Scoring GDS - ans1 point of each depressed response
Yes to negative statements and no to positive statements
Scoring Interpretation of GDS-30 - ans0-30
0-9 Normal (no depression)
10-19 Mild Depression
,Comprehensive NR 547 Final Exam.
Latest Updated Exam Study Guide
2026/2027
20-30 Moderate to Severe Depression
Scoring Interpretation GDS-15 - ans0-15
Shorter version
0-4: Normal (No depression)
5-8: Mild Depression
9-11: Moderate Depression
12-15: Severe Depression
Patient Health Questionnaire-9 (PHQ-9) - ansself report tool for screening, diagnosing, and
monitoring depression. Based on the DSM-5 criteria for MDD and evaluates symptom
severity over the past two weeks
Components of the PHQ-9 - ansNine Symptom Domains
1. Anhedonia
2. Depressed Mood
3. Sleep Problems
4. Fatigue
5. Appetite Changes
6. Low Self Worth
7. Concentration Issues
8. Psychomotor Changes
9. Suicidal Thoughts
PHQ-9 Scoring Interpretation - ansEach question is scored:
0=Not at all
1= Several Days
2= More than half the days
3= Nearly Every Day
Total Score: 0-27
PHQ-9 Depression Severity Levels - ans0-4: Minimal or No depression
5-9: Mild Depression
10-14: Moderate Depression
15-19: Moderately Severe Depression
20-27: Severe Depression
Clinica Use of the PHQ-9 - ansScore >= 10: Possible clinical depression, further evaluation
needed
Score >=15: Likely MDD, consider therapy and/or medication
Score >=20: Severe Depression, requires urgent intervention
Mood Disorder Questionnaire - ansscreening tool used for Bipolar Disorder, and helps
differentiate bipolar disorder from unipolar depression and other mood disorders
Consists of three parts, assessing lifetime history of manic or hypomanic symptoms
Part one of MDQ - ansSymptom Checklist
,Comprehensive NR 547 Final Exam.
Latest Updated Exam Study Guide
2026/2027
13 yes/no questions
Increased Energy and Activity
Euphoric or irritable mood
Decreased need for sleep
Unusual talkativeness or pressured speech
Racing Thoughts
Easily Distracted
Increase in goal-directed activities
Involvement in Risky behaviors
Unusual Confidence or grandiosity
More outgoing/social than usual
episodes lasting several days or longer
other people noticing these changes
symptoms occurring together in the same time period
Part 2 MDQ - ansSymptom Clustering
1 yes/no question
"Have several of the above symptoms ever happened during the same period of time?"
Part 3 MDQ - ansFunctional Impairment
1 questions, 3 point scale: No, Minor, or Serious problem
"How much did these problems cause difficulty in work, social, or family life?"
MDQ Scoring Interpretation - ans7 or more "yes" responses in Part 1
"Yes" in Part 2
Moderate or serious impairment in part 3 is a positive screen. This is possible bipolar
disorder, needs a clinical assessment
Negative Screen:
Fewer than 7 "yes" responses in Part 1 OR "No" in part 2 OR "No/Minor problems" in Part
3= unlikely bipolar disorder
Limitations to MDQ - ansMore sensitive to Bipolar I Disorder than Bipolar II or Cyclothymia
May produce false positives in BPD
Anhedonia - ansa diminished ability to experience pleasure
TSH - ans0.4-4
For patients on thyroid medications 0.5 -3 is often targeted
Elevated TSH - ansHypothyroidism
Low TSH - anshyperthyroidism
hemoglobin - ansMen
13.8-17.2
Women
12.1-15.1
Pregnant women
11-14
, Comprehensive NR 547 Final Exam.
Latest Updated Exam Study Guide
2026/2027
Children
11-16
Lithium Level - ansTherapeutic range
0.6-1.2
Toxicity Risk
>1.5
Severe toxicity
>2
lithium toxicity symptoms - ansconfusion
seizures
tremors
coma
when should lithium trough levels be drawn - ans12 hours after the last dose
What other labs should be monitored when on lithium - anskid function and thyroid levels
Depakote (Valproic Acid) Level - ansTherapeutic range
50-125
Toxicity risk
>150
Severe Toxicity >200
Symptoms of Depakote Toxicity - ansLiver tox
pancreatitis
CNS depression
When should trough levels be drawn for depakote level - ansbefore the next dose
what other labs should be monitored when on depakote - ansliver enzymes
platelets
ammonia level
What are specifiers for MDD - ansdescribes its features, severity, and course. can help guide
treatment planning and prognosis
Severity specifiers for MDD - ansIndicates how severe the episode is.
Milk
Moderate
Severe
With Psychotic Features
Mild MDD - ansfew symptoms beyond diagnostic criteria, manageable distress
Moderate MDD - ansMore symptoms, significant impairment but manageable
Severe MDD - ansMany symptoms, major impairment in functioning
MDD with psychotic features - ansHallucinations or delusions present
MDD with psychotic features, mood congruent - ansDelusions/hallucinations consistent with
depressive themes (guilt, worthlessness)
MDD with psychotic features, mood- incongruent - ansPsychotic features unrelated to mood
(ex paranoia)
MDD Episode features specifiers - ansAdds details about the characteristics of the depressive
episode
Latest Updated Exam Study Guide
2026/2027
What does a score of 0-7 on the Hamilton Depression Rating Scale (HAM-D) indicate? -
ansNormal (no depression)
What does a score of 8-16 on the Hamilton Depression Rating Scale (HAM-D) indicate? -
ansMild depression
What does a score of 17-23 on the Hamilton Depression Rating Scale (HAM-D) indicate? -
ansModerate depression
What does a score of 24 or higher on the Hamilton Depression Rating Scale (HAM-D)
indicate? - ansSevere depression
How are items on the Hamilton Depression Rating Scale (HAM-D) scored? - ansEach item is
scored 0-2 or 0-4, depending on severity.
What type of tool is the Hamilton Depression Rating Scale (HAM-D)? - ansA clinician
administered tool used to assess the severity of depression symptoms.
What aspects of depression does the Hamilton Depression Rating Scale (HAM-D) evaluate? -
ansPsychological and physical aspects of depression.
HAM-D 17 Components - ansMood
Guilt Feelings
SI
Insomnia
Work and Activities
Psychomotor Agitation or retardation
Anxiety (psychological and somatic symptoms)
Somatic symptoms
Hypochondriasis
Loss of weight
Insight
Limitation of HAM-D rating scale - ansMore focused on somatic symptoms which can over
estimate depression in medically ill patients
Alternative to HAM-D Scale - ansMontgomery-Ashberg Depression Rating Scale (MADRS)
which is better for tracking and treatment response
Geriatric Depression Scale (GDS) - ansConsists of yes/no questions that assess emotional,
cognitive, and behavioral symptoms of depresion in older adults. It avoids somatic symptoms
that may overlap with medical conditions
Key Areas assessed in GDS - ansMood and Enjoyment
Energy Levels
Social Withdrawal
Feelings of Hopelessness
Memory Concerns
Anxiety and Worry
Suicidal Thoughts
Scoring GDS - ans1 point of each depressed response
Yes to negative statements and no to positive statements
Scoring Interpretation of GDS-30 - ans0-30
0-9 Normal (no depression)
10-19 Mild Depression
,Comprehensive NR 547 Final Exam.
Latest Updated Exam Study Guide
2026/2027
20-30 Moderate to Severe Depression
Scoring Interpretation GDS-15 - ans0-15
Shorter version
0-4: Normal (No depression)
5-8: Mild Depression
9-11: Moderate Depression
12-15: Severe Depression
Patient Health Questionnaire-9 (PHQ-9) - ansself report tool for screening, diagnosing, and
monitoring depression. Based on the DSM-5 criteria for MDD and evaluates symptom
severity over the past two weeks
Components of the PHQ-9 - ansNine Symptom Domains
1. Anhedonia
2. Depressed Mood
3. Sleep Problems
4. Fatigue
5. Appetite Changes
6. Low Self Worth
7. Concentration Issues
8. Psychomotor Changes
9. Suicidal Thoughts
PHQ-9 Scoring Interpretation - ansEach question is scored:
0=Not at all
1= Several Days
2= More than half the days
3= Nearly Every Day
Total Score: 0-27
PHQ-9 Depression Severity Levels - ans0-4: Minimal or No depression
5-9: Mild Depression
10-14: Moderate Depression
15-19: Moderately Severe Depression
20-27: Severe Depression
Clinica Use of the PHQ-9 - ansScore >= 10: Possible clinical depression, further evaluation
needed
Score >=15: Likely MDD, consider therapy and/or medication
Score >=20: Severe Depression, requires urgent intervention
Mood Disorder Questionnaire - ansscreening tool used for Bipolar Disorder, and helps
differentiate bipolar disorder from unipolar depression and other mood disorders
Consists of three parts, assessing lifetime history of manic or hypomanic symptoms
Part one of MDQ - ansSymptom Checklist
,Comprehensive NR 547 Final Exam.
Latest Updated Exam Study Guide
2026/2027
13 yes/no questions
Increased Energy and Activity
Euphoric or irritable mood
Decreased need for sleep
Unusual talkativeness or pressured speech
Racing Thoughts
Easily Distracted
Increase in goal-directed activities
Involvement in Risky behaviors
Unusual Confidence or grandiosity
More outgoing/social than usual
episodes lasting several days or longer
other people noticing these changes
symptoms occurring together in the same time period
Part 2 MDQ - ansSymptom Clustering
1 yes/no question
"Have several of the above symptoms ever happened during the same period of time?"
Part 3 MDQ - ansFunctional Impairment
1 questions, 3 point scale: No, Minor, or Serious problem
"How much did these problems cause difficulty in work, social, or family life?"
MDQ Scoring Interpretation - ans7 or more "yes" responses in Part 1
"Yes" in Part 2
Moderate or serious impairment in part 3 is a positive screen. This is possible bipolar
disorder, needs a clinical assessment
Negative Screen:
Fewer than 7 "yes" responses in Part 1 OR "No" in part 2 OR "No/Minor problems" in Part
3= unlikely bipolar disorder
Limitations to MDQ - ansMore sensitive to Bipolar I Disorder than Bipolar II or Cyclothymia
May produce false positives in BPD
Anhedonia - ansa diminished ability to experience pleasure
TSH - ans0.4-4
For patients on thyroid medications 0.5 -3 is often targeted
Elevated TSH - ansHypothyroidism
Low TSH - anshyperthyroidism
hemoglobin - ansMen
13.8-17.2
Women
12.1-15.1
Pregnant women
11-14
, Comprehensive NR 547 Final Exam.
Latest Updated Exam Study Guide
2026/2027
Children
11-16
Lithium Level - ansTherapeutic range
0.6-1.2
Toxicity Risk
>1.5
Severe toxicity
>2
lithium toxicity symptoms - ansconfusion
seizures
tremors
coma
when should lithium trough levels be drawn - ans12 hours after the last dose
What other labs should be monitored when on lithium - anskid function and thyroid levels
Depakote (Valproic Acid) Level - ansTherapeutic range
50-125
Toxicity risk
>150
Severe Toxicity >200
Symptoms of Depakote Toxicity - ansLiver tox
pancreatitis
CNS depression
When should trough levels be drawn for depakote level - ansbefore the next dose
what other labs should be monitored when on depakote - ansliver enzymes
platelets
ammonia level
What are specifiers for MDD - ansdescribes its features, severity, and course. can help guide
treatment planning and prognosis
Severity specifiers for MDD - ansIndicates how severe the episode is.
Milk
Moderate
Severe
With Psychotic Features
Mild MDD - ansfew symptoms beyond diagnostic criteria, manageable distress
Moderate MDD - ansMore symptoms, significant impairment but manageable
Severe MDD - ansMany symptoms, major impairment in functioning
MDD with psychotic features - ansHallucinations or delusions present
MDD with psychotic features, mood congruent - ansDelusions/hallucinations consistent with
depressive themes (guilt, worthlessness)
MDD with psychotic features, mood- incongruent - ansPsychotic features unrelated to mood
(ex paranoia)
MDD Episode features specifiers - ansAdds details about the characteristics of the depressive
episode
