NFDN UNIT 6 EXAM QUESTIONS AND
ANSWERS
Biologic Domain Assessment of Depressive Disorder -Answer- -physical assessment
-history of problems
-special attention to CNS function
-changes in appetite/sleep patterns
-suicide risk
Psychological Theories: Psychodynamic/Behavioral/ Developmental Factors of
Depressive disorder -Answer- -early lack of love, care, warmth and protection, resulting
in anger, guilt, and helplessness
-presents with avoidant coping styles
-distorted negative beliefs
-result of severe reduction in rewarding activity
-loss of parent or lack emotionally adequate parenting
Social Theories of Depressive Diorder: Family and Social -Answer- : maladaptive
"circular" patterns in family interaction
: traumatic life events
Interdisciplinary Treatment of Depressive Disorder -Answer- -treated within primary care
setting not psychiatric
-reduce/control symptoms
-improve occupational/social functioning
-reduce likelihood of relapse
Priority Care Issue of Depressive Disorder -Answer- Safety; suicide risk
3 Most important assessments for Depressive disorder -Answer- 1) Appetite and weight
change
2) Sleep disturbances
3) Decreased energy, tiredness, and fatigue
Pharmacological intervention for depressive disorder -Answer- -antidepressant regimen
dependent on phase of illness
Acute Phase of DD -Answer- Primary goal is symptom reduction or remission
careful monitoring for response to meds
Continuation Phase of DD -Answer- goal is to decrease risk for relapse (return of
current episode of depression)
, Maintenance Phase of DD -Answer- high risk or recurrent the optimal duration of
maintenance treatment is unknown but measured in yrs
Discontinuation of medication use in DD -Answer- -based on frequency and severity of
past episodes
-based on persistence of dysthymic symptoms after recovery
-Many patients continue taking meds lifelong
Antidepressant drug Categories -Answer- Cyclic (include tricyclics [TCA's])
Selective Serotonin Reuptake Inhibitors (SSRI's) which currently include Lexapro,
Prozac, Zoloft, Luvox, Paxil, and Celexa
Monoamine Oxidase Inhibitors (MAOIs) which include Nardil and Parnate
Atypical antidepressants include Desyrel, Wellbutrin, Effexor and Remeron
This type of antidepressant is reserved for patients whose depression fails to respond to
other antidepressents -Answer- MAOIs
Serotonin Syndrome -Answer- -potentially life-threatening drug reaction; occur following
therapeutic drug use
-excess serotonergic activity at CNS and peripheral serotonin receptors
-excess serotonin activity produces cognitive, autonomic, and somatic effects
-Symptom onset rapid, occurring in minutes
-increased heart rate, shivering, sweating, dilated pupils, myoclonus (intermittent tremor
or twitching), over-responsive reflexes
-hyperactive bowel sounds, high blood pressure and hyperthermia, hypervigilance and
agitation
-Severe symptoms include severe increases in heart rate and blood pressure that may
lead to shock
Most common side effect with TCAs and MAOIs are -Answer- antihistaminic side effects
(sedation and weigh gain)
anticholinergic side effects (potentiating CNS drugs, blurred vision, dry mouth,
constipation, urinary retention, sinus tachycardia, decreased memory)
TCA's should not be prescribed for at risk of suicide patients why -Answer- Lethal dose
of TCAs are only three to five times the therapeutic dose; more than 1 gram is often
toxic and fatal
Most common side effect of MAOIs are -Answer- headache, drowsiness, dry mouth,
constipation, blurred vision, and orthostatic hypotension
Second generation Antidepressants: SSRIs and Atypical antidepresseants -Answer-
serotonin syndrome caused by serotonin build up when more than one drug acting on
serotonergic system
ANSWERS
Biologic Domain Assessment of Depressive Disorder -Answer- -physical assessment
-history of problems
-special attention to CNS function
-changes in appetite/sleep patterns
-suicide risk
Psychological Theories: Psychodynamic/Behavioral/ Developmental Factors of
Depressive disorder -Answer- -early lack of love, care, warmth and protection, resulting
in anger, guilt, and helplessness
-presents with avoidant coping styles
-distorted negative beliefs
-result of severe reduction in rewarding activity
-loss of parent or lack emotionally adequate parenting
Social Theories of Depressive Diorder: Family and Social -Answer- : maladaptive
"circular" patterns in family interaction
: traumatic life events
Interdisciplinary Treatment of Depressive Disorder -Answer- -treated within primary care
setting not psychiatric
-reduce/control symptoms
-improve occupational/social functioning
-reduce likelihood of relapse
Priority Care Issue of Depressive Disorder -Answer- Safety; suicide risk
3 Most important assessments for Depressive disorder -Answer- 1) Appetite and weight
change
2) Sleep disturbances
3) Decreased energy, tiredness, and fatigue
Pharmacological intervention for depressive disorder -Answer- -antidepressant regimen
dependent on phase of illness
Acute Phase of DD -Answer- Primary goal is symptom reduction or remission
careful monitoring for response to meds
Continuation Phase of DD -Answer- goal is to decrease risk for relapse (return of
current episode of depression)
, Maintenance Phase of DD -Answer- high risk or recurrent the optimal duration of
maintenance treatment is unknown but measured in yrs
Discontinuation of medication use in DD -Answer- -based on frequency and severity of
past episodes
-based on persistence of dysthymic symptoms after recovery
-Many patients continue taking meds lifelong
Antidepressant drug Categories -Answer- Cyclic (include tricyclics [TCA's])
Selective Serotonin Reuptake Inhibitors (SSRI's) which currently include Lexapro,
Prozac, Zoloft, Luvox, Paxil, and Celexa
Monoamine Oxidase Inhibitors (MAOIs) which include Nardil and Parnate
Atypical antidepressants include Desyrel, Wellbutrin, Effexor and Remeron
This type of antidepressant is reserved for patients whose depression fails to respond to
other antidepressents -Answer- MAOIs
Serotonin Syndrome -Answer- -potentially life-threatening drug reaction; occur following
therapeutic drug use
-excess serotonergic activity at CNS and peripheral serotonin receptors
-excess serotonin activity produces cognitive, autonomic, and somatic effects
-Symptom onset rapid, occurring in minutes
-increased heart rate, shivering, sweating, dilated pupils, myoclonus (intermittent tremor
or twitching), over-responsive reflexes
-hyperactive bowel sounds, high blood pressure and hyperthermia, hypervigilance and
agitation
-Severe symptoms include severe increases in heart rate and blood pressure that may
lead to shock
Most common side effect with TCAs and MAOIs are -Answer- antihistaminic side effects
(sedation and weigh gain)
anticholinergic side effects (potentiating CNS drugs, blurred vision, dry mouth,
constipation, urinary retention, sinus tachycardia, decreased memory)
TCA's should not be prescribed for at risk of suicide patients why -Answer- Lethal dose
of TCAs are only three to five times the therapeutic dose; more than 1 gram is often
toxic and fatal
Most common side effect of MAOIs are -Answer- headache, drowsiness, dry mouth,
constipation, blurred vision, and orthostatic hypotension
Second generation Antidepressants: SSRIs and Atypical antidepresseants -Answer-
serotonin syndrome caused by serotonin build up when more than one drug acting on
serotonergic system
