NR 547 Final Exam Questions with Verified Answers (Correct
Update)
Question 1: Treatment of depression in postpartum women
Answer: Mild depression Psychotherapy such as cognitive-behavioral therapy (CBT) OR interpersonal
therapy Mild Depression postpartum while breast-feeding Psychotherapy with or without antidepressant
(sertraline or paroxetine) Severe Depression Psychotherapy AND fluoxetine Alternative medications:
sertraline or tricyclic antidepressant. Severe Depression postpartum while breast-feeding Supportive
services AND sertraline Alternative medication: Paroxetine
Question 2: Medications for depression with MOA
Answer: Selective Serotonin Reuptake Inhibitors (SSRI's) inhibit 5-HT reuptake Serotonin
Norepinephrine Reuptake Inhibitors (SNRIs) inhibit 5-HT reuptakeinhibit NE reuptake ('energy, focus)
increase DA in prefrontal cortex ('cognition) Norepinephrine Dopamine Reuptake Inhibitors (NDRI)
inhibit DA reuptake ('alertness, motivation) inhibit NE reuptake ('energy)
Question 3: Prescribing Pearl: Escitalopram (Lexapro)
Answer: no known drug interactions
Question 4: Prescribing Pearl: Citalopram (Celexa)
Answer: mild antihistamine ettects
Question 5: Prescribing Pearl: Fluoxetine (Prozac)
Answer: longest half-life
Question 6: Prescribing Pearl: Paroxetine (Paxil)
Answer: also treats social anxiety and insomnia
Question 7: Prescribing Pearl: Fluvoxamine (Luvox)
Answer: treats anxious depression smokers require increased dose
Question 8: Prescribing Pearl: Sertraline (Zoloft)
Answer: also treats social anxiety and hypersomnolence
Question 9: Prescribing Pearl: Venlafaxine (Effexor)
Answer: treats both depression and anxiety disorders, ensure trial of higher dose before switching to a
ditterent medication
Page 1
,Question 10: Prescribing Pearl: Desvenlafaxine (Pristiq)
Answer: ettective for perimenopausal vasomotor symptoms
Question 11: Prescribing Pearl: Duloxetine (Cymbalta)
Answer: ettective for atypical pain at higher doses; appropriate for clients who present with somatic
symptoms of depression; ettective for atypical pain, such as fibromyalgia and diabetic neuropathy
Question 12: Prescribing Pearl: Bupropion (Wellbutrin)- NDRI
Answer: may improve energy, alertness, and motivation; not first line treatment for anxiety;
contraindicated in clients with a history of seizures
Question 13: Choosing an antidepressant:
Answer: 1) selection of primary agent (consider co-morbidities, past treatment response, side ettects,
etc.) 2) Gradually increase dose 3) Switch to a ditterent drug within the same class 4) Switch to a drug in
a ditterent class 5) Add a second medication and/or mood stabilizer
Question 14: depression
Answer: mood disorder characterized by depressive symptoms lasting longer than 2 weeks. It has been
tied to decreased activity of the prefrontal cortex (attention, mood, memory, personality) and an
imbalance of neurotransmitters.
Question 15: monoamine hypothesis of depression
Answer: depression occurs as a result of a deficiency of one or all three monoamine transmitters
(serotonin, norepinephrine, and dopamine), while mania may result from an excess
Question 16: (USPSTF) recommends depression screening for
Answer: adults 18 years of age or older and adolescents ages 12-18 years old.
Question 17: Geriatric Depression Scale
Answer: 1. Components of the GDS: The GDS is a self-report assessment specifically designed for older
adults. It often includes 15 yes/no questions addressing: General mood Feelings of helplessness Energy
levels Social withdrawal Personal satisfaction 2. GDS Scores Interpretation: 0-4 no depression 5-8 mild
9-11 moderate 12-15 severe
Question 18: American Academy of Pediatrics recommends maternal screening for postpartum
depression
Answer: at infants' 1, 2, and 4month visits.
Page 2
, Question 19: A limitation of the Hamilton Depression Rating Scale
Answer: atypical symptoms of depression (e.g., hypersomnia, hyperphagia) are not assessed
Question 20: Baseline labs help rule out a medical diagnosis or other condition
Answer: comprehensive metabolic panel, complete blood count, vitamin B12 level, vitamin D level,
thyroid function tests, or a toxicology screen.
Question 21: Medical conditions that commonly preficiency, sent with symptoms that mimic
depression include
Answer: hypothyroidism, vitamin D deficiency, hypoglycemia, anemia, vitamin B12 dechronic fatigue
syndrome, and hypotension
Question 22: Medications with side effects mimicking depression include
Answer: cannabis, alcohol, clonidine, antidepressants, anticonvulsants, antimigraine agents,
corticosteroids, contraceptives, and varenicline (Chantix).
-Withdrawal from certain substances, such as cocaine or catteine, can also lead to depressive symptoms.
Question 23: PHQ-9 screening tool for depression
Answer: 1. Components of the PHQ-9: The PHQ-9 consists of 9 items that reflect the DSM-IV criteria
for depression. Each item is scored from 0 (not at all) to 3 (nearly every day), covering: Interest or
pleasure in doing things Feeling down, depressed, or hopeless Trouble sleeping or sleeping too much
Feeling tired or having little energy Poor appetite or overeating Feeling bad about oneself Trouble
concentrating Moving or speaking slowly, or being fidgety/restless Thoughts of self-harm or suicide 2.
PHQ-9 Scores Interpretation: 0-4: Minimal depression 5-9: Mild depression 10-14: Moderate depression
15-19: Moderately severe depression 20-27: Severe depression
Question 24: Screening for depression in postpartum women
Answer: at infant months 1,2, & 4 Edinburgh Postnatal Depression Scale (EPDS)
-Each answer is given a score of 0 to 3 . The maximum score is 30.
-score of more than 10 suggests minor or major depression may be present. Further evaluation is
recommended.
Question 25: brain imaging in bipolar disorder
Answer: white matter hyperintensities, reduction in gray matter volume, increased ventricular size, and
decreased frontal cortical area volumes
Page 3
Update)
Question 1: Treatment of depression in postpartum women
Answer: Mild depression Psychotherapy such as cognitive-behavioral therapy (CBT) OR interpersonal
therapy Mild Depression postpartum while breast-feeding Psychotherapy with or without antidepressant
(sertraline or paroxetine) Severe Depression Psychotherapy AND fluoxetine Alternative medications:
sertraline or tricyclic antidepressant. Severe Depression postpartum while breast-feeding Supportive
services AND sertraline Alternative medication: Paroxetine
Question 2: Medications for depression with MOA
Answer: Selective Serotonin Reuptake Inhibitors (SSRI's) inhibit 5-HT reuptake Serotonin
Norepinephrine Reuptake Inhibitors (SNRIs) inhibit 5-HT reuptakeinhibit NE reuptake ('energy, focus)
increase DA in prefrontal cortex ('cognition) Norepinephrine Dopamine Reuptake Inhibitors (NDRI)
inhibit DA reuptake ('alertness, motivation) inhibit NE reuptake ('energy)
Question 3: Prescribing Pearl: Escitalopram (Lexapro)
Answer: no known drug interactions
Question 4: Prescribing Pearl: Citalopram (Celexa)
Answer: mild antihistamine ettects
Question 5: Prescribing Pearl: Fluoxetine (Prozac)
Answer: longest half-life
Question 6: Prescribing Pearl: Paroxetine (Paxil)
Answer: also treats social anxiety and insomnia
Question 7: Prescribing Pearl: Fluvoxamine (Luvox)
Answer: treats anxious depression smokers require increased dose
Question 8: Prescribing Pearl: Sertraline (Zoloft)
Answer: also treats social anxiety and hypersomnolence
Question 9: Prescribing Pearl: Venlafaxine (Effexor)
Answer: treats both depression and anxiety disorders, ensure trial of higher dose before switching to a
ditterent medication
Page 1
,Question 10: Prescribing Pearl: Desvenlafaxine (Pristiq)
Answer: ettective for perimenopausal vasomotor symptoms
Question 11: Prescribing Pearl: Duloxetine (Cymbalta)
Answer: ettective for atypical pain at higher doses; appropriate for clients who present with somatic
symptoms of depression; ettective for atypical pain, such as fibromyalgia and diabetic neuropathy
Question 12: Prescribing Pearl: Bupropion (Wellbutrin)- NDRI
Answer: may improve energy, alertness, and motivation; not first line treatment for anxiety;
contraindicated in clients with a history of seizures
Question 13: Choosing an antidepressant:
Answer: 1) selection of primary agent (consider co-morbidities, past treatment response, side ettects,
etc.) 2) Gradually increase dose 3) Switch to a ditterent drug within the same class 4) Switch to a drug in
a ditterent class 5) Add a second medication and/or mood stabilizer
Question 14: depression
Answer: mood disorder characterized by depressive symptoms lasting longer than 2 weeks. It has been
tied to decreased activity of the prefrontal cortex (attention, mood, memory, personality) and an
imbalance of neurotransmitters.
Question 15: monoamine hypothesis of depression
Answer: depression occurs as a result of a deficiency of one or all three monoamine transmitters
(serotonin, norepinephrine, and dopamine), while mania may result from an excess
Question 16: (USPSTF) recommends depression screening for
Answer: adults 18 years of age or older and adolescents ages 12-18 years old.
Question 17: Geriatric Depression Scale
Answer: 1. Components of the GDS: The GDS is a self-report assessment specifically designed for older
adults. It often includes 15 yes/no questions addressing: General mood Feelings of helplessness Energy
levels Social withdrawal Personal satisfaction 2. GDS Scores Interpretation: 0-4 no depression 5-8 mild
9-11 moderate 12-15 severe
Question 18: American Academy of Pediatrics recommends maternal screening for postpartum
depression
Answer: at infants' 1, 2, and 4month visits.
Page 2
, Question 19: A limitation of the Hamilton Depression Rating Scale
Answer: atypical symptoms of depression (e.g., hypersomnia, hyperphagia) are not assessed
Question 20: Baseline labs help rule out a medical diagnosis or other condition
Answer: comprehensive metabolic panel, complete blood count, vitamin B12 level, vitamin D level,
thyroid function tests, or a toxicology screen.
Question 21: Medical conditions that commonly preficiency, sent with symptoms that mimic
depression include
Answer: hypothyroidism, vitamin D deficiency, hypoglycemia, anemia, vitamin B12 dechronic fatigue
syndrome, and hypotension
Question 22: Medications with side effects mimicking depression include
Answer: cannabis, alcohol, clonidine, antidepressants, anticonvulsants, antimigraine agents,
corticosteroids, contraceptives, and varenicline (Chantix).
-Withdrawal from certain substances, such as cocaine or catteine, can also lead to depressive symptoms.
Question 23: PHQ-9 screening tool for depression
Answer: 1. Components of the PHQ-9: The PHQ-9 consists of 9 items that reflect the DSM-IV criteria
for depression. Each item is scored from 0 (not at all) to 3 (nearly every day), covering: Interest or
pleasure in doing things Feeling down, depressed, or hopeless Trouble sleeping or sleeping too much
Feeling tired or having little energy Poor appetite or overeating Feeling bad about oneself Trouble
concentrating Moving or speaking slowly, or being fidgety/restless Thoughts of self-harm or suicide 2.
PHQ-9 Scores Interpretation: 0-4: Minimal depression 5-9: Mild depression 10-14: Moderate depression
15-19: Moderately severe depression 20-27: Severe depression
Question 24: Screening for depression in postpartum women
Answer: at infant months 1,2, & 4 Edinburgh Postnatal Depression Scale (EPDS)
-Each answer is given a score of 0 to 3 . The maximum score is 30.
-score of more than 10 suggests minor or major depression may be present. Further evaluation is
recommended.
Question 25: brain imaging in bipolar disorder
Answer: white matter hyperintensities, reduction in gray matter volume, increased ventricular size, and
decreased frontal cortical area volumes
Page 3
