NURS 6501 FINAL EXAM WITH 72
QUESTIONS AND CORRECT ANSWERS
RATED A+
- 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 ⇒ due the
PHQ9
If the pt screens (+) ⇒ continue to eval with the PHQ9
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
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)
About PHQ2
What is discontinuation syndrome (from ssris)?
"FINISH"
2-3 days after stopping ssris abruptly
F: flu-like SS
I: insomnia
N: nausea
I: imbalance
S: sensory disturbances
H: hyperarousal
Bupropion
- MOA
- BENFITS
AE
CONTRA
, MOA
- act to inhibit reuptake of NE, dopamine, and serotonin
BENFIT
- Depression
- Smoking cessation
- Seasonal affective disorder
- Treat sexual dysfunction relative to SSRI therapy
AE
- weight loss
- increases libido ⇒ combine with SSRI
- can cause seizures by lowering the seizure threshold
CONTRA
- History of seizures
- Do not prescribe to pts with psych disorders ⇒ ↑ risk for delusions or
hallucinations
RF for ETOH abuse 4
Younger adults (18-29 yrs)
Men > women
Native americans
Genetics (low response to ETOH), environment (peer influences), specific
personality traits (impulsivity, extroversion), cognitive fxn
What are predisposing factors impacting the likelihood of someone developing a
SA issue?
Predisposing Factors:
- Unhealthy use of one substance increases the likelihood of unhealthy use of other
substances
- Family history
- Social history
- Partner or friends with SA, living in a community with poverty, violence, and/or
high ETOH/drug use
QUESTIONS AND CORRECT ANSWERS
RATED A+
- 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 ⇒ due the
PHQ9
If the pt screens (+) ⇒ continue to eval with the PHQ9
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
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)
About PHQ2
What is discontinuation syndrome (from ssris)?
"FINISH"
2-3 days after stopping ssris abruptly
F: flu-like SS
I: insomnia
N: nausea
I: imbalance
S: sensory disturbances
H: hyperarousal
Bupropion
- MOA
- BENFITS
AE
CONTRA
, MOA
- act to inhibit reuptake of NE, dopamine, and serotonin
BENFIT
- Depression
- Smoking cessation
- Seasonal affective disorder
- Treat sexual dysfunction relative to SSRI therapy
AE
- weight loss
- increases libido ⇒ combine with SSRI
- can cause seizures by lowering the seizure threshold
CONTRA
- History of seizures
- Do not prescribe to pts with psych disorders ⇒ ↑ risk for delusions or
hallucinations
RF for ETOH abuse 4
Younger adults (18-29 yrs)
Men > women
Native americans
Genetics (low response to ETOH), environment (peer influences), specific
personality traits (impulsivity, extroversion), cognitive fxn
What are predisposing factors impacting the likelihood of someone developing a
SA issue?
Predisposing Factors:
- Unhealthy use of one substance increases the likelihood of unhealthy use of other
substances
- Family history
- Social history
- Partner or friends with SA, living in a community with poverty, violence, and/or
high ETOH/drug use
