NURS 6501 FINAL EXAM ADVANCED
PATHOPHYSIOLOGY COMPREHENSIVE STUDY
GUIDE 2026 CELLULAR AND SYSTEMIC
DISEASE MECHANISMS
◉ about PHQ2
- what does it screen for, what are the questions, scoring
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
- what its used for, questions, scoring
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?
,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?
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?
- what are the common SSRIs, LEAP of them, and zoloft AE
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
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?
Answer: - Increased serotonergic activity in the CNS
- Can be due to therapeutic med use, inadvertent drug interactions,
or self-OD
PATHOPHYSIOLOGY COMPREHENSIVE STUDY
GUIDE 2026 CELLULAR AND SYSTEMIC
DISEASE MECHANISMS
◉ about PHQ2
- what does it screen for, what are the questions, scoring
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
- what its used for, questions, scoring
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?
,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?
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?
- what are the common SSRIs, LEAP of them, and zoloft AE
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
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?
Answer: - Increased serotonergic activity in the CNS
- Can be due to therapeutic med use, inadvertent drug interactions,
or self-OD
