NURS 6501 Advanced Pathophysiology
Final Exam Questions and Answers
1. What is the role of the primary care provider in mental health?: -
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)
2. about PHQ2
- what does it screen for, what are the questions, scoring: - 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 Òd u e the PHQ9
,If the pt screens (+) Òcontinue to eval with the PHQ9
3. about PHQ9
- what its used for, questions, scoring: 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
4. What is the appropriate initiation dose for fluoxetine for adults
and geriatric adults?: 20mg PO once daily in the AM
-May ‘daily dose after several weeks if inadequate response
, -Full therapeutic ettect may be delayed 4 weeks or longer
-Max dose: 80mg/day
5. What labs would be appropriate to draw if you initiate
fluoxetine in a geri-atric patient?: Sodium levels
-Baseline screening & after 3-4 weeks in high-risk patients (> 65yrs, previous hx of antidepressant-
induced hypona-tremia, low body weight, concomitant use of thiazides or other hyponatremia-
inducing agents)
-monitor regularly in the elderly
6. What are potential side effects of SSRI medications?
- what are the common SSRIs, LEAP of them, and zoloft AE:
Common SSRIs: Lexapro, celexa, paxil, zoloft, prozac
L = decreased libido and
sleep E = Neutral ettect on
energy
A = neural ettect on addiction
P = celexa may stop working after awhile (increase or switch)
Zoloft AE:
Insomnia, somnolence, fatigue, abnormal ejaculation, suicidal thoughts
7. What are characteristics of major depressive disorder or MDD? 9:
Final Exam Questions and Answers
1. What is the role of the primary care provider in mental health?: -
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)
2. about PHQ2
- what does it screen for, what are the questions, scoring: - 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 Òd u e the PHQ9
,If the pt screens (+) Òcontinue to eval with the PHQ9
3. about PHQ9
- what its used for, questions, scoring: 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
4. What is the appropriate initiation dose for fluoxetine for adults
and geriatric adults?: 20mg PO once daily in the AM
-May ‘daily dose after several weeks if inadequate response
, -Full therapeutic ettect may be delayed 4 weeks or longer
-Max dose: 80mg/day
5. What labs would be appropriate to draw if you initiate
fluoxetine in a geri-atric patient?: Sodium levels
-Baseline screening & after 3-4 weeks in high-risk patients (> 65yrs, previous hx of antidepressant-
induced hypona-tremia, low body weight, concomitant use of thiazides or other hyponatremia-
inducing agents)
-monitor regularly in the elderly
6. What are potential side effects of SSRI medications?
- what are the common SSRIs, LEAP of them, and zoloft AE:
Common SSRIs: Lexapro, celexa, paxil, zoloft, prozac
L = decreased libido and
sleep E = Neutral ettect on
energy
A = neural ettect on addiction
P = celexa may stop working after awhile (increase or switch)
Zoloft AE:
Insomnia, somnolence, fatigue, abnormal ejaculation, suicidal thoughts
7. What are characteristics of major depressive disorder or MDD? 9:
