NURS 6501 ADVANCED PATHOPHYSIOLOGY
FINAL EXAM QUESTIONS AND VERIFIED
ANSWERS EXAM PREP
◉ What is the role of the primary care provider in mental health?
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 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)
FINAL EXAM QUESTIONS AND VERIFIED
ANSWERS EXAM PREP
◉ What is the role of the primary care provider in mental health?
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 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)
