NR 547 Comprehensive Exam with
Complete Solutions
What is the HAM-D? - ✔✔Clinician administered depression rating scale that monitors the
severity of depression symptoms with a focus on psychological and physical aspects of
depression (scored 0-2 or 0-4).
What is the components of the HAM-D? - ✔✔Mood, guilt feelings, SI, insomnia, work and
activities, psychomotor agitation or retardation, anxiety, somatic symptoms, hypochondriasis,
loss of weight, insight
HAM-D score that indicates no depression? - ✔✔0-7
HAM-D score that indicates mild depression? - ✔✔8-16
HAM-D score that indicates moderate depression? - ✔✔17-23
HAM-D score that indicates severe depression? - ✔✔24 or >
What is the geriatric depression scale? - ✔✔Consists of yes/no questions that assess emotional,
cognitive, behavioral symptoms of depression in older adults. Avoid somatic symptoms that
may overlap with medical conditions
What are the components of the geriatric depression scale? - ✔✔Mood and enjoyment, energy
levels, social withdrawal, feelings of hopelessness, memory concerns, anxiety and worry,
suicidal thoughts (1 point of each depressed response)
What GDS score is normal? 30 point scale and 15 point scale - ✔✔0--4
,What GDS score is mild? 30 point scale and 15 point scale - ✔✔10--8
What GDS score is moderate? 30 point scale and 15 point scale - ✔✔20-30 (moderate to
severe) / 9-11
What GDS score is severe on the 15 point scale? - ✔✔12-15
What is the PHQ-9 scale? - ✔✔Self report tool for screening, diagnosing, and monitoring
depression. It evaluations symptom severity over the past 2 weeks
What are the components of the PHQ-9? - ✔✔Anhedonia, depressed mood, sleep problems,
fatigue, appetite changes, low self-worth, concentrations issues, psychomotor changes, suicidal
thoughts
What PHQ-9 score indicates none - ✔✔0-4
What PHQ-9 score indicates mild - ✔✔5-9
What PHQ-9 score indicates moderate - ✔✔10-14
What PHQ-9 score indicates moderately severe - ✔✔15-19
What PHQ-9 score indicates severe - ✔✔20-27
What is the mood disorder questionnaire? - ✔✔Screening tool used for bipolar disorder that
helps to differentiate bipolar from unipolar with 13 yes/no questions
,What are the components of the mood disorder questionnaire? - ✔✔Part 1: increased energy
and activity, euphoric mood or irritable mood, decreased need for sleep, unusual talkativeness
or pressured speech, racing thoughts, easily distracted, increase in goal-directed activities,
involvement in risky behaviors, unusual confidence or grandiosity, more outgoing/social than
usual, episodes lasting several days or longer, other people noticing these changes, symptoms
occurring together in the same time period
Part 2: "Have several of the above symptoms ever happened during the same period of time?"
Part 3: "How much did these problems cause difficulty in work, social, or family life?"
What is the criteria for the mood disorder questionnaire to be positive? - ✔✔7 or more "yes"
responses in Part 1, "Yes" in Part 2, OR moderate or serious impairment in Part 3
What is the criteria for the mood disorder questionnaire to be negative? - ✔✔Fewer than 7
"yes" response in Part 1 OR "no" in Part 2 OR "no/minor problems" in Part 3
Normal TSH - ✔✔0.4-4.0 (elevated TSH = hypo) / (low TSH = hyper)
Normal Hgb - ✔✔Men: 13.8-17.2 / Women: 12.1-15.1
Normal lithium / toxic - ✔✔0.6-1.2 / >1.5
Symptoms of lithium toxicity - ✔✔Confusion, seizures, tremors, coma
When should a lithium level be drawn? - ✔✔12 hours after last dose
What other labs should be checked when a patient is on lithium? - ✔✔Kidney function and
thyroid levels
Normal depakote (valproic acid) / toxic - ✔✔50-125 / >150
, Symptoms of depakote toxicity? - ✔✔Liver tox, pancreatitis, CNS depression
When should depakote be checked? - ✔✔Before next dose
What other labs should be drawn when a patient is on depakote? - ✔✔Liver enzymes, platelets,
ammonia
What is mild MDD - ✔✔Few symptoms beyond diagnostic criteria, manageable
What is moderate MDD - ✔✔More symptoms, significant impairment but manageable
What is severe MDD - ✔✔Many symptoms, major impairment in functioning
What is MDD with psychosis - ✔✔Hallucinations or delusions are present
What is MDD with mood congruent psychosis - ✔✔Delusions/hallucinations consistent with
depressive themes (guilt, worthlessness)
What is MDD with mood incongruent psychosis - ✔✔Psychotic features unrelated to mood
(paranoia)
What is MDD with anxious distress - ✔✔Feeling tense, restless, difficulty concentrating due to
worry, fear of losing control
* high risk of suicide and treatment resistance
What is MDD with mixed features - ✔✔Some manic/hypomanic symptoms present, but not
enough for bipolar disorder (increased energy, elevated mood, talkativeness)
Complete Solutions
What is the HAM-D? - ✔✔Clinician administered depression rating scale that monitors the
severity of depression symptoms with a focus on psychological and physical aspects of
depression (scored 0-2 or 0-4).
What is the components of the HAM-D? - ✔✔Mood, guilt feelings, SI, insomnia, work and
activities, psychomotor agitation or retardation, anxiety, somatic symptoms, hypochondriasis,
loss of weight, insight
HAM-D score that indicates no depression? - ✔✔0-7
HAM-D score that indicates mild depression? - ✔✔8-16
HAM-D score that indicates moderate depression? - ✔✔17-23
HAM-D score that indicates severe depression? - ✔✔24 or >
What is the geriatric depression scale? - ✔✔Consists of yes/no questions that assess emotional,
cognitive, behavioral symptoms of depression in older adults. Avoid somatic symptoms that
may overlap with medical conditions
What are the components of the geriatric depression scale? - ✔✔Mood and enjoyment, energy
levels, social withdrawal, feelings of hopelessness, memory concerns, anxiety and worry,
suicidal thoughts (1 point of each depressed response)
What GDS score is normal? 30 point scale and 15 point scale - ✔✔0--4
,What GDS score is mild? 30 point scale and 15 point scale - ✔✔10--8
What GDS score is moderate? 30 point scale and 15 point scale - ✔✔20-30 (moderate to
severe) / 9-11
What GDS score is severe on the 15 point scale? - ✔✔12-15
What is the PHQ-9 scale? - ✔✔Self report tool for screening, diagnosing, and monitoring
depression. It evaluations symptom severity over the past 2 weeks
What are the components of the PHQ-9? - ✔✔Anhedonia, depressed mood, sleep problems,
fatigue, appetite changes, low self-worth, concentrations issues, psychomotor changes, suicidal
thoughts
What PHQ-9 score indicates none - ✔✔0-4
What PHQ-9 score indicates mild - ✔✔5-9
What PHQ-9 score indicates moderate - ✔✔10-14
What PHQ-9 score indicates moderately severe - ✔✔15-19
What PHQ-9 score indicates severe - ✔✔20-27
What is the mood disorder questionnaire? - ✔✔Screening tool used for bipolar disorder that
helps to differentiate bipolar from unipolar with 13 yes/no questions
,What are the components of the mood disorder questionnaire? - ✔✔Part 1: increased energy
and activity, euphoric mood or irritable mood, decreased need for sleep, unusual talkativeness
or pressured speech, racing thoughts, easily distracted, increase in goal-directed activities,
involvement in risky behaviors, unusual confidence or grandiosity, more outgoing/social than
usual, episodes lasting several days or longer, other people noticing these changes, symptoms
occurring together in the same time period
Part 2: "Have several of the above symptoms ever happened during the same period of time?"
Part 3: "How much did these problems cause difficulty in work, social, or family life?"
What is the criteria for the mood disorder questionnaire to be positive? - ✔✔7 or more "yes"
responses in Part 1, "Yes" in Part 2, OR moderate or serious impairment in Part 3
What is the criteria for the mood disorder questionnaire to be negative? - ✔✔Fewer than 7
"yes" response in Part 1 OR "no" in Part 2 OR "no/minor problems" in Part 3
Normal TSH - ✔✔0.4-4.0 (elevated TSH = hypo) / (low TSH = hyper)
Normal Hgb - ✔✔Men: 13.8-17.2 / Women: 12.1-15.1
Normal lithium / toxic - ✔✔0.6-1.2 / >1.5
Symptoms of lithium toxicity - ✔✔Confusion, seizures, tremors, coma
When should a lithium level be drawn? - ✔✔12 hours after last dose
What other labs should be checked when a patient is on lithium? - ✔✔Kidney function and
thyroid levels
Normal depakote (valproic acid) / toxic - ✔✔50-125 / >150
, Symptoms of depakote toxicity? - ✔✔Liver tox, pancreatitis, CNS depression
When should depakote be checked? - ✔✔Before next dose
What other labs should be drawn when a patient is on depakote? - ✔✔Liver enzymes, platelets,
ammonia
What is mild MDD - ✔✔Few symptoms beyond diagnostic criteria, manageable
What is moderate MDD - ✔✔More symptoms, significant impairment but manageable
What is severe MDD - ✔✔Many symptoms, major impairment in functioning
What is MDD with psychosis - ✔✔Hallucinations or delusions are present
What is MDD with mood congruent psychosis - ✔✔Delusions/hallucinations consistent with
depressive themes (guilt, worthlessness)
What is MDD with mood incongruent psychosis - ✔✔Psychotic features unrelated to mood
(paranoia)
What is MDD with anxious distress - ✔✔Feeling tense, restless, difficulty concentrating due to
worry, fear of losing control
* high risk of suicide and treatment resistance
What is MDD with mixed features - ✔✔Some manic/hypomanic symptoms present, but not
enough for bipolar disorder (increased energy, elevated mood, talkativeness)
