NR 547 Final Exam Questions And
Answers
A 68-year-old male presents to your clinic with his daughter, who expresses
concern about his recent lack of interest in hobbies, decreased energy, and
complaints of feeling "down." He denies any history of manic or hypomanic
episodes. Which of the following depression screening tools would be most
appropriate for initial assessment in this patient?
A) HAM-D B) Mood Disorder Questionnaire (MDQ)
C) Geriatric Depression Scale (GDS)
D) PHQ-9
A) HAM-D (Hamilton Depression Rating Scale): While the HAM-D is a valid and widely
used depression scale, it is a clinician-rated tool. This means a trained clinician
administers it and rates the patient's symptoms. While it could be used, the question
asks for the "most appropriate for initial assessment," and for an older adult, a self-
report specific to their age group is often preferred for initial screening, especially when
family is presenting the concern.
B) Mood Disorder Questionnaire (MDQ): The MDQ is specifically designed as a
screening tool for bipolar disorder. The patient denies any history of manic or
hypomanic episodes, and while it's good to keep bipolar disorder in mind, the primary
concern here is depression in an older adult. It would not be the most appropriate initial
screening tool for depression.
C) Geriatric Depression Scale (GDS): This is the most appropri
A 35-year-old female is diagnosed with Major Depressive Disorder (MDD) with
atypical features. Which of the following symptoms is characteristic of MDD with
atypical features?
A) Profound despondency and anhedonia
B) Significant weight loss and early morning awakening
C) Mood reactivity and hypersomnia
D) Psychomotor retardation and excessive guilt
A) Profound despondency and anhedonia: These symptoms are characteristic of Major
Depressive Disorder with melancholic features. Melancholia typically involves a
profound loss of pleasure in all or almost all activities and severe despondency, often
with non-reactive mood.
B) Significant weight loss and early morning awakening: These are also classic
symptoms associated with Major Depressive Disorder with melancholic features. People
with melancholic depression often experience severe insomnia (early morning
awakening) and significant appetite/weight loss.
Answers
A 68-year-old male presents to your clinic with his daughter, who expresses
concern about his recent lack of interest in hobbies, decreased energy, and
complaints of feeling "down." He denies any history of manic or hypomanic
episodes. Which of the following depression screening tools would be most
appropriate for initial assessment in this patient?
A) HAM-D B) Mood Disorder Questionnaire (MDQ)
C) Geriatric Depression Scale (GDS)
D) PHQ-9
A) HAM-D (Hamilton Depression Rating Scale): While the HAM-D is a valid and widely
used depression scale, it is a clinician-rated tool. This means a trained clinician
administers it and rates the patient's symptoms. While it could be used, the question
asks for the "most appropriate for initial assessment," and for an older adult, a self-
report specific to their age group is often preferred for initial screening, especially when
family is presenting the concern.
B) Mood Disorder Questionnaire (MDQ): The MDQ is specifically designed as a
screening tool for bipolar disorder. The patient denies any history of manic or
hypomanic episodes, and while it's good to keep bipolar disorder in mind, the primary
concern here is depression in an older adult. It would not be the most appropriate initial
screening tool for depression.
C) Geriatric Depression Scale (GDS): This is the most appropri
A 35-year-old female is diagnosed with Major Depressive Disorder (MDD) with
atypical features. Which of the following symptoms is characteristic of MDD with
atypical features?
A) Profound despondency and anhedonia
B) Significant weight loss and early morning awakening
C) Mood reactivity and hypersomnia
D) Psychomotor retardation and excessive guilt
A) Profound despondency and anhedonia: These symptoms are characteristic of Major
Depressive Disorder with melancholic features. Melancholia typically involves a
profound loss of pleasure in all or almost all activities and severe despondency, often
with non-reactive mood.
B) Significant weight loss and early morning awakening: These are also classic
symptoms associated with Major Depressive Disorder with melancholic features. People
with melancholic depression often experience severe insomnia (early morning
awakening) and significant appetite/weight loss.
