NURS 663 UPDATED EXAM SCRIPT QUESTIONS AND
ANSWERS GRADED A+
✔✔What is the DSM criteria for Major Depressive Disorder? - ✔✔**no history of mania,
hypo, or mixed symptoms
symptoms >2 weeks
must have: sadness, anhedonia (loss pleasure/interest)
4 of following: - appetite/sleep changes, psychomotor retardation, lack of energy,
guilt/worthlessness, issues w/ concentration, thoughts suicide/death
✔✔What are the "frequency" modifiers for MDD? - ✔✔episodic: symptoms dissipate
over time
recurrent: likely to reappear in future
subclinical: sadness + 3 symptoms > 10 days (full criteria not met)
✔✔how is the severity of depression rated? - ✔✔- Mild: no suicidal thoughts/death
wishes
- Moderate: some thoughts of death/self-harm
- Severe: plan/attempted
✔✔what other modifiers might be present with diagnosis of MDD? - ✔✔- With psychotic
features: hallucinations, paranoia
- In partial remission: some symptoms still present, but full criteria not met; period
without any significant
symptoms lasting less than 2 months
- In full remission: no signs/symptoms >2 months
- Unspecified: symptoms vague, hard to tell
✔✔DSM 5 for bipolar I disorder - ✔✔depression + mania
✔✔DSM 5 for bipolar 2 disorder - ✔✔depression + hypomania
✔✔what is the #1 predictor of suicide? - ✔✔Hopelessness and loneliness
✔✔what are risk factors for suicide? - ✔✔- Gender: men are more likely to complete
suicide
- Age: men 45 years +; women 55 years +
, o Suicide is the 3rd leading cause of death in 15-24-year-olds
- Race: Caucasian, Native American, Alaskan native, and immigrants
- Divorce
- Widows
- High-ranking jobs and unemployment
- Physicians
- MDD most common mental illness associated, schizophrenia, and alcohol use
disorder
- Past suicide attempt (might be the best indicator)
✔✔what is the criteria for involuntary commitment? - ✔✔Danger to self (suicide)
Danger to others (homicide)
Gravely disabled d/t mental illness (unable to provide food, clothing, shelter)
- Courts must have probable case hearing within 96 hours of admission
✔✔What is vagus nerve stimulation? - ✔✔--For Tx of treatment-resistant MDD
implantation of a device that causes intermittent electrical stimulation of vagus nerve
✔✔What is TMS (transcranial magnetic stimulation)? - ✔✔noninvasive procedure for
treatment resistant depression, uses magnetic pulses
✔✔what is ECT used for? - ✔✔severe depression
mania
catatonia
severe agitation in dementia
✔✔How is ECT performed? - ✔✔premedication with atropine, followed by general
anesthesia and administration of a muscle relaxant. a generalized seizure is then
induced by passing a current of electricity across the brain.
seizure lasts <1min
- 8 treatments over 2-3 weeks
✔✔Side effects of ECT - ✔✔temporary memory loss and confusion, headache
can increase HR and BP
✔✔what are distinguishing characteristics of serotonin syndrome? - ✔✔Hyperreflexia
Clonus
Dilated pupils (mydriasis)
✔✔MAOIs - ✔✔Block enzyme monoamine oxidase
MAO break down monoamines into inactive metabolites
ANSWERS GRADED A+
✔✔What is the DSM criteria for Major Depressive Disorder? - ✔✔**no history of mania,
hypo, or mixed symptoms
symptoms >2 weeks
must have: sadness, anhedonia (loss pleasure/interest)
4 of following: - appetite/sleep changes, psychomotor retardation, lack of energy,
guilt/worthlessness, issues w/ concentration, thoughts suicide/death
✔✔What are the "frequency" modifiers for MDD? - ✔✔episodic: symptoms dissipate
over time
recurrent: likely to reappear in future
subclinical: sadness + 3 symptoms > 10 days (full criteria not met)
✔✔how is the severity of depression rated? - ✔✔- Mild: no suicidal thoughts/death
wishes
- Moderate: some thoughts of death/self-harm
- Severe: plan/attempted
✔✔what other modifiers might be present with diagnosis of MDD? - ✔✔- With psychotic
features: hallucinations, paranoia
- In partial remission: some symptoms still present, but full criteria not met; period
without any significant
symptoms lasting less than 2 months
- In full remission: no signs/symptoms >2 months
- Unspecified: symptoms vague, hard to tell
✔✔DSM 5 for bipolar I disorder - ✔✔depression + mania
✔✔DSM 5 for bipolar 2 disorder - ✔✔depression + hypomania
✔✔what is the #1 predictor of suicide? - ✔✔Hopelessness and loneliness
✔✔what are risk factors for suicide? - ✔✔- Gender: men are more likely to complete
suicide
- Age: men 45 years +; women 55 years +
, o Suicide is the 3rd leading cause of death in 15-24-year-olds
- Race: Caucasian, Native American, Alaskan native, and immigrants
- Divorce
- Widows
- High-ranking jobs and unemployment
- Physicians
- MDD most common mental illness associated, schizophrenia, and alcohol use
disorder
- Past suicide attempt (might be the best indicator)
✔✔what is the criteria for involuntary commitment? - ✔✔Danger to self (suicide)
Danger to others (homicide)
Gravely disabled d/t mental illness (unable to provide food, clothing, shelter)
- Courts must have probable case hearing within 96 hours of admission
✔✔What is vagus nerve stimulation? - ✔✔--For Tx of treatment-resistant MDD
implantation of a device that causes intermittent electrical stimulation of vagus nerve
✔✔What is TMS (transcranial magnetic stimulation)? - ✔✔noninvasive procedure for
treatment resistant depression, uses magnetic pulses
✔✔what is ECT used for? - ✔✔severe depression
mania
catatonia
severe agitation in dementia
✔✔How is ECT performed? - ✔✔premedication with atropine, followed by general
anesthesia and administration of a muscle relaxant. a generalized seizure is then
induced by passing a current of electricity across the brain.
seizure lasts <1min
- 8 treatments over 2-3 weeks
✔✔Side effects of ECT - ✔✔temporary memory loss and confusion, headache
can increase HR and BP
✔✔what are distinguishing characteristics of serotonin syndrome? - ✔✔Hyperreflexia
Clonus
Dilated pupils (mydriasis)
✔✔MAOIs - ✔✔Block enzyme monoamine oxidase
MAO break down monoamines into inactive metabolites
