SHADOW HEALTH NICOLE DIAZ- PTSD TEST EXAM 2023/2024

SHADOW HEALTH NICOLE DIAZ- PTSD TEST EXAM 2023/2024 Established chief complaint - CORRECT ANSWER-Reports sleep problems Asked about onset and frequency of sleep problems - CORRECT ANSWER-Reports sleep problems for the past 10+ years Reports having problems sleeping most nights of the week Asked about sleep quality and characteristics - CORRECT ANSWER-Reports recent sleep problems include nightmares. Reports falling asleep often takes more than an hour. Reports waking up two or three times during the night for "at least ten minutes" Reports waking in the morning feeling "out of it" and not rested. Reports frequent snoring. Asked about sleep habits - CORRECT ANSWER-Reports going to be "around midnight", but feeling "too nervous" to sleep. Reports actually falling asleep around 2 or 3am Reports checking her windows and doors twice before going to bed. Reports no screen use (tv or computer) before bed. Reports average wake up time of 7am. Reports sleeping an average of 4 or 5 hours a night. Reports sleeping alone in a quiet room. Asked about patterns for sleep problems. - CORRECT ANSWER-Reports that stress and anxiety exacerbate sleep problems. Asked about existing health conditions - CORRECT ANSWER-Reports hypertension diagnosis Followed up on hypertension diagnosis - CORRECT ANSWER-Diagnosed at age 45 Asked about history of mental health - CORRECT ANSWER-Reports PTSD diagnosis Followed up about symptoms of PTSD diagnosis - CORRECT ANSWER-Reports depression accompanies PTSD diagnosis. Reports anxiety as a symptom of PTSD. Reports sleep problems are a symptom of PTSD diagnosis. Followed up on onset of PTSD - CORRECT ANSWER-Reports diagnosed at age 35. Reports PTSD cause is military sexual assault. Reports MST was at age 23. Reports even involved commanding officer and ostracization from unit. Reports left military at 28, but did not seek immediate care. Followed up on aggravating factors for PTSD. - CORRECT ANSWER-Reports stress triggers PTSD symptoms. Reports avoiding crowds or most social situations. Reports fear of "losing control" of a situation. Reports discussing event is triggering. Reports difficulties with relationships and emotional/physical intimacy. Asked about non-medication coping strategies - CORRECT ANSWER-Reveals belief that she has a moderate level of self-care. Reports therapy dog helps. Reports smoking helps. Reports avoiding stimulating environments when anxious or stressed. Asked about suicidal ideation and self-harm. - CORRECT ANSWER-Reports occasional feelings that "sometimes I feel like like is not worth living" Denies active suicidal ideation or self-harm. Followed up on suicide planning. - CORRECT ANSWER-Denies suicide planning. Reports suicidal ideation is a symptom of depression. Asked about past suicide attempts - CORRECT ANSWER-Denies past suicide attempts. Asked about homicidal ideation - CORRECT ANSWER-Denies homicidal ideation. Asked about previous psychiatric hospitalizations. - CORRECT ANSWER-Denies past psychiatric admissions. Asked about home medications - CORRECT ANSWER-Reports medication for hypertension. Reports medication for depression. Reports medication for anxiety. Denies taking vitamins. Denies taking herbal supplements. Asked about medication regimen adherence - CORRECT ANSWER-Reports using a smartphone app to manage medication. Denies missing doses of medications. Denies difficulty obtaining medications because of finances. Denies difficulty obtaining medications because of transportation. Followed up on last dose of home medications. - CORRECT ANSWER-Reports taking all medications as scheduled today. Denies taking blood pressure medication today- not scheduled until evening. Reports taking medication for depression this morning as scheduled. Reports taking medication for anxiety this morning as scheduled. Followd up on medication for hypertension. - CORRECT ANSWER-Reports taking losartan Reports taking losartan dosage: 100 mg. Reports losartan frequency: 1xdaily. Denies losartan side effects Followed up on medication for anxiety. - CORRECT ANSWER-Reports taking buspirone HCL. Reports buspirone HCL dosage: 30 mg. Reports buspirone HCL frequency: 15 mg pill twice daily. Denies buspirone HCL side effects. Reports taking buspirone for 1 year. Reports buspirone HCL is effective in reducing anxiety. Followed up on medication for depression - CORRECT ANSWER-Reports taking bupropion HCL. Reports bupropion HCL dosage: 150 mg Reports bupropion HCL frequency: twice daily Denies bupropion HCL side effects Reports taking bupropion HCL for 1 year. Reports taking various antidepressants in the past. Reports bupropion HCL is effective for treating depression. Asked about occupation and education. - CORRECT ANSWER-Reports working as a grant writer. Reports undergraduate degree in English. Asked about illicit drug use - CORRECT ANSWER-Denies illicit drug use. Asked about alcohol use - CORRECT ANSWER-Reports rare alcohol use. Followed up on alcohol use - CORRECT ANSWER-Reports drinking less than once a month. Reports drinking 1-2 drinks in a sitting. Asked about tobacco and nicotine use. - CORRECT ANSWER-Reports cigarette smoking. Followed up on cigarette smoking - CORRECT ANSWER-Reports smo