Midterml Exam:l NRl 606/l NR606l (Latestl
2026/l 2027l Update)l Diagnosisl andl
Managementl inl Psychiatric-Mentall
Healthl IIl Practicuml Guide|l Q/Al |l Gradel
A|l 100%l Correctl (Verifiedl Answers)l -
Chamberlain
Q:l Discussl thel scoringl forl thel EPDl scalel alongl withl thel PMHNPl interventions
Answer:
·l Lessl thanl 8:l Depressionl notl likely:l continuel support
·l 9-11:l Depressionl possible.l Re-screenl inl 2-4l weeks
·l 12-13:l Fairlyl highl possibilityl ofl depression:l monitor,l supportl andl educate.l Referl tol
PCP
·l 14+:l POSITIVEl SCREENING.l IMMEDIATEl DISCUSSION,l REFERl TOl PMHNPl ORl
SPECIALIST
Q:l Howl oftenl shouldl thel PMHNPl screenl withl thel EPDl scale?
Answer:
Atl everyl wellnessl appointmentl postl pregnancyl 1,l 2,l 4l weekl andl thel 6l month.
Q:l Whatl isl thel pharmacologicall andl non-pharmacologicall treatmentl forl maternall
depression?
Answer:
SSRIl isl thel firstl linel treatmentl ONCEl Bipolarl isl ruledl out.l Tricyclicsl canl alsol bel usedl
andl arel deemedl safel forl treatment.
omega-3l fattyl acidsl mayl aidl withl depressivel symptoms
,CBT
Interpersonall Therapy
ECTl forl treatmentl resistantl depression
Q:l ______l isl anl IVl drugl thatl isl knownl tol treatl depressionl inl pregnantl women.l Thisl
drugl willl takel 60l hoursl tol administerl atl al healthcarel facility.l Thel motherl hasl tol
enrolledl inl al riskl evaluationl andl mitigationl strategyl program.
Answer:
Braxanolone
Q:l Whatl isl al HUGEEEEEl sidel effectl ofl SSRI'sl tol thel fetusl thatl ourl patient'sl shouldl
bel counseledl on?
Answer:
SSRIl &l SNRIl commonl adversel effectl isl neonatall withdrawall syndrome.l Neonatall
withdrawall syndromel orl postl natall abstinencel syndrome-l affectsl upl tol 30%l ofl babiesl
whosel mothersl takel thesel medicationsl andl symptomsl includel tremors,l highl pitchedl cryl
andl disturbedl sleep.l
Thesel symptomsl usuallyl peaksl froml 2-4l daysl afterl birth.l THEREl ISl NOl EVIDENCEl
THATl TAPERINGl DOSAGESl orl DISCONTINUINGl MEDICATIONSl WITHINl THEl
LASTl TRIMESTERl WILLl DECREASEl HARMl TOl THEl BABY.
Q:l Whatl isl thel firstl linel treatmentl forl depressionl inl al breastfeedingl mother?
Answer:
Thel first-linel treatmentl forl al breastfeedingl motherl withl mildl tol moderatel depressionl isl
psychotherapy.l Forl morel severel depression,l antidepressantsl mayl bel considered.
Q:l Isl itl safel forl motherl al breastfeedl whilel takingl anl SSRI?
Answer:
YESl shel can!l Theyl havel lowl transmissionl ratesl throughl thel breast
,Q:l Whatl arel thel mainl symptomsl ofl neonatall withdrawall symptom?
Answer:
tremors
highl pitchedl cry
andl disturbedl sleep!
Q:l Whyl isl itl importantl tol NOTl stopl orl decreasel anl SSRIl duringl pregnancy?
Answer:
THEREl ISl NOl EVIDENCEl THATl TAPERINGl DOSAGESl orl DISCONTINUINGl
MEDICATIONSl WITHINl THEl LASTl TRIMESTERl WILLl DECREASEl HARMl TOl
THEl BABY.
Thisl couldl dol morel harml tol thel mother.
Q:l Whatl isl thel DSM-5l criterial forl maternall anxiety?l Rememberl thatl withl peri-partuml
onsetl willl meanl thatl thel symptomsl startedl duringl pregnancyl upl untill 4l weeksl afterl
delivery
Answer:
EXCESSIVEl WORRYl aboutl theirl pregnancyl andl deliveryl complications,l infantl well-
being,l andl maternall orl partnerl illness.
irritability,l difficultyl sleeping,l difficulty,l tension,l concentrating,l andl easyl fatiguability.l
Ptl shouldl havel 3l orl morel symptoms
Q:l Whatl isl al HUGEl riskl factorl forl al womanl tol bel diagnosedl withl perinatall anxietyl
disorder?
Answer:
Al previousl diagnosisl ofl anl anxietyl disorder
Q:l Whatl isl thel pharmacologicall andl non-pharmacologicall treatmentl forl anxietyl withinl
pregnantl women?
, Answer:
SSRI'sl arel thel FIRSTl linel treatment.
SNRI's,l buproprion,l andl tricyclicsl arel consideredl safe.
Non-pharmacological:l
CBT
interpersonall therapy
Q:l Whyl arel benzodiazepinesl notl consideredl thel first-linel orl evenl second-linel
treatmentl amongstl pregnantl women?
Answer:
Benzodiazepinesl mayl bel takenl withl cautionl forl anxietyl duringl pregnancy;l however,l al
riskl ofl newbornl toxicityl mustl bel consideredl andl monitoredl ifl used.l
Symptomsl includel sedation,l floppyl musclel tone,l andl potentiall breathingl issuesl atl birth.
Q:l Whatl isl thel DSM-5l diagnosisl ofl peri-natall PTSD?
Answer:
Presencel ofl onel (orl more)l ofl thel followingl intrusionl symptomsl associatedl withl thel
traumaticl event(s),l beginningl afterl thel traumaticl event(s)l occurredl FORl MOREl THANl 1l
MONTHl &l causesl significantl distress.
1.)l Recurrent,l involuntary,l andl intrusivel distressingl memoriesl ofl thel traumaticl event(s).
2.)l Recurrentl distressingl dreamsl inl whichl thel contentl and/orl affectl ofl thel dreaml arel
relatedl tol thel traumaticl event(s).
3.)l Dissociativel reactionsl (e.g.,l flashbacks)l inl whichl thel individuall feelsl orl actsl asl ifl
thel traumaticl event(s)l werel recurring.
4.)l Intensel orl prolongedl psychologicall distressl atl exposurel tol internall orl externall cuesl
thatl symbolizel orl resemblel anl aspectl ofl thel traumaticl event(s
5.)l Markedl physiologicall reactionsl tol internall orl externall cuesl thatl symbolizel orl
resemblel anl aspectl ofl thel traumaticl event(s).
6.)l 1.l Avoidancel ofl orl effortsl tol avoidl distressingl memories,l thoughts,l orl feelingsl aboutl
orl closelyl associatedl withl thel traumaticl event(s).
2026/l 2027l Update)l Diagnosisl andl
Managementl inl Psychiatric-Mentall
Healthl IIl Practicuml Guide|l Q/Al |l Gradel
A|l 100%l Correctl (Verifiedl Answers)l -
Chamberlain
Q:l Discussl thel scoringl forl thel EPDl scalel alongl withl thel PMHNPl interventions
Answer:
·l Lessl thanl 8:l Depressionl notl likely:l continuel support
·l 9-11:l Depressionl possible.l Re-screenl inl 2-4l weeks
·l 12-13:l Fairlyl highl possibilityl ofl depression:l monitor,l supportl andl educate.l Referl tol
PCP
·l 14+:l POSITIVEl SCREENING.l IMMEDIATEl DISCUSSION,l REFERl TOl PMHNPl ORl
SPECIALIST
Q:l Howl oftenl shouldl thel PMHNPl screenl withl thel EPDl scale?
Answer:
Atl everyl wellnessl appointmentl postl pregnancyl 1,l 2,l 4l weekl andl thel 6l month.
Q:l Whatl isl thel pharmacologicall andl non-pharmacologicall treatmentl forl maternall
depression?
Answer:
SSRIl isl thel firstl linel treatmentl ONCEl Bipolarl isl ruledl out.l Tricyclicsl canl alsol bel usedl
andl arel deemedl safel forl treatment.
omega-3l fattyl acidsl mayl aidl withl depressivel symptoms
,CBT
Interpersonall Therapy
ECTl forl treatmentl resistantl depression
Q:l ______l isl anl IVl drugl thatl isl knownl tol treatl depressionl inl pregnantl women.l Thisl
drugl willl takel 60l hoursl tol administerl atl al healthcarel facility.l Thel motherl hasl tol
enrolledl inl al riskl evaluationl andl mitigationl strategyl program.
Answer:
Braxanolone
Q:l Whatl isl al HUGEEEEEl sidel effectl ofl SSRI'sl tol thel fetusl thatl ourl patient'sl shouldl
bel counseledl on?
Answer:
SSRIl &l SNRIl commonl adversel effectl isl neonatall withdrawall syndrome.l Neonatall
withdrawall syndromel orl postl natall abstinencel syndrome-l affectsl upl tol 30%l ofl babiesl
whosel mothersl takel thesel medicationsl andl symptomsl includel tremors,l highl pitchedl cryl
andl disturbedl sleep.l
Thesel symptomsl usuallyl peaksl froml 2-4l daysl afterl birth.l THEREl ISl NOl EVIDENCEl
THATl TAPERINGl DOSAGESl orl DISCONTINUINGl MEDICATIONSl WITHINl THEl
LASTl TRIMESTERl WILLl DECREASEl HARMl TOl THEl BABY.
Q:l Whatl isl thel firstl linel treatmentl forl depressionl inl al breastfeedingl mother?
Answer:
Thel first-linel treatmentl forl al breastfeedingl motherl withl mildl tol moderatel depressionl isl
psychotherapy.l Forl morel severel depression,l antidepressantsl mayl bel considered.
Q:l Isl itl safel forl motherl al breastfeedl whilel takingl anl SSRI?
Answer:
YESl shel can!l Theyl havel lowl transmissionl ratesl throughl thel breast
,Q:l Whatl arel thel mainl symptomsl ofl neonatall withdrawall symptom?
Answer:
tremors
highl pitchedl cry
andl disturbedl sleep!
Q:l Whyl isl itl importantl tol NOTl stopl orl decreasel anl SSRIl duringl pregnancy?
Answer:
THEREl ISl NOl EVIDENCEl THATl TAPERINGl DOSAGESl orl DISCONTINUINGl
MEDICATIONSl WITHINl THEl LASTl TRIMESTERl WILLl DECREASEl HARMl TOl
THEl BABY.
Thisl couldl dol morel harml tol thel mother.
Q:l Whatl isl thel DSM-5l criterial forl maternall anxiety?l Rememberl thatl withl peri-partuml
onsetl willl meanl thatl thel symptomsl startedl duringl pregnancyl upl untill 4l weeksl afterl
delivery
Answer:
EXCESSIVEl WORRYl aboutl theirl pregnancyl andl deliveryl complications,l infantl well-
being,l andl maternall orl partnerl illness.
irritability,l difficultyl sleeping,l difficulty,l tension,l concentrating,l andl easyl fatiguability.l
Ptl shouldl havel 3l orl morel symptoms
Q:l Whatl isl al HUGEl riskl factorl forl al womanl tol bel diagnosedl withl perinatall anxietyl
disorder?
Answer:
Al previousl diagnosisl ofl anl anxietyl disorder
Q:l Whatl isl thel pharmacologicall andl non-pharmacologicall treatmentl forl anxietyl withinl
pregnantl women?
, Answer:
SSRI'sl arel thel FIRSTl linel treatment.
SNRI's,l buproprion,l andl tricyclicsl arel consideredl safe.
Non-pharmacological:l
CBT
interpersonall therapy
Q:l Whyl arel benzodiazepinesl notl consideredl thel first-linel orl evenl second-linel
treatmentl amongstl pregnantl women?
Answer:
Benzodiazepinesl mayl bel takenl withl cautionl forl anxietyl duringl pregnancy;l however,l al
riskl ofl newbornl toxicityl mustl bel consideredl andl monitoredl ifl used.l
Symptomsl includel sedation,l floppyl musclel tone,l andl potentiall breathingl issuesl atl birth.
Q:l Whatl isl thel DSM-5l diagnosisl ofl peri-natall PTSD?
Answer:
Presencel ofl onel (orl more)l ofl thel followingl intrusionl symptomsl associatedl withl thel
traumaticl event(s),l beginningl afterl thel traumaticl event(s)l occurredl FORl MOREl THANl 1l
MONTHl &l causesl significantl distress.
1.)l Recurrent,l involuntary,l andl intrusivel distressingl memoriesl ofl thel traumaticl event(s).
2.)l Recurrentl distressingl dreamsl inl whichl thel contentl and/orl affectl ofl thel dreaml arel
relatedl tol thel traumaticl event(s).
3.)l Dissociativel reactionsl (e.g.,l flashbacks)l inl whichl thel individuall feelsl orl actsl asl ifl
thel traumaticl event(s)l werel recurring.
4.)l Intensel orl prolongedl psychologicall distressl atl exposurel tol internall orl externall cuesl
thatl symbolizel orl resemblel anl aspectl ofl thel traumaticl event(s
5.)l Markedl physiologicall reactionsl tol internall orl externall cuesl thatl symbolizel orl
resemblel anl aspectl ofl thel traumaticl event(s).
6.)l 1.l Avoidancel ofl orl effortsl tol avoidl distressingl memories,l thoughts,l orl feelingsl aboutl
orl closelyl associatedl withl thel traumaticl event(s).
