GEORGETTE MODULE 3 CERTIFICATION
TEST SCRIPT FULL QUESTIONS AND
SOLUTIONS GRADED A
⩥ Second line for MDD. Answer: TCA
⩥ TCA & CV effects (3 things to note). Answer: -ECG
changes/dysrhythmias so must avoid in those susceptible!!!! (includes
fam hx)
-Monitor EKG BEFORE giving
-ANNUAL EKG for older adults
⩥ TCA key things to know. Answer: -ECG changes (so EKG in
everyone & yearly for elderly)
-Avoid abrupt withdrawal d/t discontinuation syndrome is
SIGNIFICANT
-Avoid in those at high risk for suicide (**easy to overdose**)
-High risk of serotonin syndrome
⩥ Why don't you prescribe TCA is those at high risk for suicide??
Answer: Lethal dose at only a weeks supply, so very easy to overdose
,⩥ Black box warning for antidepressants Answer: RISK FOR SUICIDE
up to 24 years--> monitor closely for suicidal
ideation/behavior/agitation/aggression in children
⩥ 2 main non-pharmacological management for MDD Answer: ECT &
CBT
⩥ what is ECT?? how does it work?? Answer: Inducing a GRAND
MAL SEIZURE to increase DNS (DA/NE/5HT) &
prolactin/TSH/Pituitary hormones/Endorphins/ACTH
⩥ course of ECT, how many treatments? Answer: 6-12
⩥ indications for ECT include Answer: **Treatment resistance
depression**
**MDD w/ psychotic fx**
-client preference
-need for rapid response d/t illness severity
-risk of other tx greater than ECT
⩥ Contraindications for ECT **KNOW THIS** Answer: Issues with
CV
PULM
BRAIN (tumor/injury)
, ANESTHESIA
⩥ Adverse effects of ECT include Answer: ****CV effects****
Systemic effects (HA/muscle aches/drowsy)
Cognitive effects (memory/confusion)
⩥ Always assume a client is _____when he/she vocalizes thoughts of
suicide and consider..... Answer: SERIOUS, consider hospitalization
⩥ What to know about "No Harm" contracts??? Answer: NOT enough
evidence that they reduce risk of suicide, so if this is an answer
choice...DON'T CHOOSE IT***
⩥ What helps to decrease the risk of suicide? Answer: Protective factors
Safety Plan
Coping Skills
⩥ if patient has cancer, which SSRIs has the least amount of drug-drug
interactions?? Answer: citalopram & escitalopram
⩥ SSRIs cause 3 S's which are... Answer: Sexual dysfunction
Serotonin Syndrome
Severe GI upset**
TEST SCRIPT FULL QUESTIONS AND
SOLUTIONS GRADED A
⩥ Second line for MDD. Answer: TCA
⩥ TCA & CV effects (3 things to note). Answer: -ECG
changes/dysrhythmias so must avoid in those susceptible!!!! (includes
fam hx)
-Monitor EKG BEFORE giving
-ANNUAL EKG for older adults
⩥ TCA key things to know. Answer: -ECG changes (so EKG in
everyone & yearly for elderly)
-Avoid abrupt withdrawal d/t discontinuation syndrome is
SIGNIFICANT
-Avoid in those at high risk for suicide (**easy to overdose**)
-High risk of serotonin syndrome
⩥ Why don't you prescribe TCA is those at high risk for suicide??
Answer: Lethal dose at only a weeks supply, so very easy to overdose
,⩥ Black box warning for antidepressants Answer: RISK FOR SUICIDE
up to 24 years--> monitor closely for suicidal
ideation/behavior/agitation/aggression in children
⩥ 2 main non-pharmacological management for MDD Answer: ECT &
CBT
⩥ what is ECT?? how does it work?? Answer: Inducing a GRAND
MAL SEIZURE to increase DNS (DA/NE/5HT) &
prolactin/TSH/Pituitary hormones/Endorphins/ACTH
⩥ course of ECT, how many treatments? Answer: 6-12
⩥ indications for ECT include Answer: **Treatment resistance
depression**
**MDD w/ psychotic fx**
-client preference
-need for rapid response d/t illness severity
-risk of other tx greater than ECT
⩥ Contraindications for ECT **KNOW THIS** Answer: Issues with
CV
PULM
BRAIN (tumor/injury)
, ANESTHESIA
⩥ Adverse effects of ECT include Answer: ****CV effects****
Systemic effects (HA/muscle aches/drowsy)
Cognitive effects (memory/confusion)
⩥ Always assume a client is _____when he/she vocalizes thoughts of
suicide and consider..... Answer: SERIOUS, consider hospitalization
⩥ What to know about "No Harm" contracts??? Answer: NOT enough
evidence that they reduce risk of suicide, so if this is an answer
choice...DON'T CHOOSE IT***
⩥ What helps to decrease the risk of suicide? Answer: Protective factors
Safety Plan
Coping Skills
⩥ if patient has cancer, which SSRIs has the least amount of drug-drug
interactions?? Answer: citalopram & escitalopram
⩥ SSRIs cause 3 S's which are... Answer: Sexual dysfunction
Serotonin Syndrome
Severe GI upset**
