Nurs 663- Exam 1 Questions With Complete Solutions
all antidepressants carry what 5 warnings? Correct Answers -
increased risk of suicide (especially in children and young
adults)
- mania activation
- serotonin syndrome
-discontinuation syndrome
- bleeding risk
behavioral therapy Correct Answers focuses on changing
behavior by identifying problem behaviors, replacing them with
appropriate behaviors, and using rewards or other consequences
to make the changes
•Behavioural therapy is based on the concept that a deficit of
'reinforcers', such as pleasant activities and positive
interpersonal contacts, leaves patients vulnerable to depression
•Sample interventions: increase activity level, structured goal
setting, interpersonal skills training
Carbamazepine (Tegretol) Correct Answers mood stabilizer
indication: bipolar disorder
major side effects:
,CYP 450: (inducer- speeds up metabolism of other drugs)
patient education:
Case: 26 year old woman without a psychiatric history who
presents for treatment of depression after her mother died. It has
been over a year but she is still struggling with frequent bouts of
sadness, has lost 15 lbs in the last four months, is unable to sleep
past 4am, and is getting poor performance reviews at work due
to impaired concentration and memory. She feels like nothing in
life is enjoyable anymore.
diagnosis and medications to consider? Correct Answers MDD
-Sertraline
-Escitalopram
-Fluoxetine
-Mirtazapine
case: 35 year old woman with a history of major depressive
disorder who presents complaining of persistent depression
despite treatment with maximum dose sertraline and
escitalopram in the past. She has been depressed for over eight
months, and spends up to 16 hours per day lying in bed. She
reports that she doesn't have the energy to get up in the morning,
and that there is nothing that she enjoys doing, anyway. She has
gained 35 lbs in the last eight months, reports feeling like she
has failed everyone in her life, and states that she only leaves the
house about once a week to shop for groceries. Recently, she has
, begun hearing vague voices when she feels especially badly,
although she cannot make out specific words.
diagnosis and medications? Correct Answers MDD
-Bupropion
-Venlafaxine
-Duloxetine
-Maybe fluoxetine
case: 39 year old man with a history of PTSD and depression
who presents after returning from a recent deployment to
Afghanistan. He is having trouble sleeping because of
nightmares about combat, is unable to tolerate being in crowded
places, and visibly jumps at small noises during your interview.
His unwillingness to leave the house is exacerbated by a lower
spinal injury that has left him with chronic leg pain and a limp
that he thinks makes him look "like an easy target." He also
reports that he has difficulty sleeping through the night, is
having trouble enjoying doing anything with his family, feels
extremely guilty for the time that he was away from them while
deployed, has low energy and concentration, but adamantly
denies suicidal thoughts. He has tried maximum dose sertraline
and venlafaxine, but neither were helpful. He also tried
mirtazapine, but it was far too sedating and didn't work either.
diagnosis Correct Answers PTSD, MDD, Chronic Pain
-Nortriptyline or another TCA
-Duloxetine
-Escitalopram
all antidepressants carry what 5 warnings? Correct Answers -
increased risk of suicide (especially in children and young
adults)
- mania activation
- serotonin syndrome
-discontinuation syndrome
- bleeding risk
behavioral therapy Correct Answers focuses on changing
behavior by identifying problem behaviors, replacing them with
appropriate behaviors, and using rewards or other consequences
to make the changes
•Behavioural therapy is based on the concept that a deficit of
'reinforcers', such as pleasant activities and positive
interpersonal contacts, leaves patients vulnerable to depression
•Sample interventions: increase activity level, structured goal
setting, interpersonal skills training
Carbamazepine (Tegretol) Correct Answers mood stabilizer
indication: bipolar disorder
major side effects:
,CYP 450: (inducer- speeds up metabolism of other drugs)
patient education:
Case: 26 year old woman without a psychiatric history who
presents for treatment of depression after her mother died. It has
been over a year but she is still struggling with frequent bouts of
sadness, has lost 15 lbs in the last four months, is unable to sleep
past 4am, and is getting poor performance reviews at work due
to impaired concentration and memory. She feels like nothing in
life is enjoyable anymore.
diagnosis and medications to consider? Correct Answers MDD
-Sertraline
-Escitalopram
-Fluoxetine
-Mirtazapine
case: 35 year old woman with a history of major depressive
disorder who presents complaining of persistent depression
despite treatment with maximum dose sertraline and
escitalopram in the past. She has been depressed for over eight
months, and spends up to 16 hours per day lying in bed. She
reports that she doesn't have the energy to get up in the morning,
and that there is nothing that she enjoys doing, anyway. She has
gained 35 lbs in the last eight months, reports feeling like she
has failed everyone in her life, and states that she only leaves the
house about once a week to shop for groceries. Recently, she has
, begun hearing vague voices when she feels especially badly,
although she cannot make out specific words.
diagnosis and medications? Correct Answers MDD
-Bupropion
-Venlafaxine
-Duloxetine
-Maybe fluoxetine
case: 39 year old man with a history of PTSD and depression
who presents after returning from a recent deployment to
Afghanistan. He is having trouble sleeping because of
nightmares about combat, is unable to tolerate being in crowded
places, and visibly jumps at small noises during your interview.
His unwillingness to leave the house is exacerbated by a lower
spinal injury that has left him with chronic leg pain and a limp
that he thinks makes him look "like an easy target." He also
reports that he has difficulty sleeping through the night, is
having trouble enjoying doing anything with his family, feels
extremely guilty for the time that he was away from them while
deployed, has low energy and concentration, but adamantly
denies suicidal thoughts. He has tried maximum dose sertraline
and venlafaxine, but neither were helpful. He also tried
mirtazapine, but it was far too sedating and didn't work either.
diagnosis Correct Answers PTSD, MDD, Chronic Pain
-Nortriptyline or another TCA
-Duloxetine
-Escitalopram
