NR602 i-Human Case Week 6 Actual Exam
2026/2027 – Sarah Jamieson – Mood Assessment
– Chamberlain University – Detailed Rationales –
Pass Guaranteed – A+ Graded
History Taking & Mood Assessment
Q1: When screening adult patients for depression in primary care, the USPSTF
recommends which standardized tool as a valid and reliable instrument for initial
screening?
A. The Hamilton Depression Rating Scale (HAM-D) as the first-line screening tool
B. The Montgomery-Åsberg Depression Rating Scale (MADRS) for all primary care visits
C. The Patient Health Questionnaire-9 (PHQ-9) or PHQ-2 for routine screening
[CORRECT]
D. The Beck Depression Inventory-II (BDI-II) exclusively for adolescents
Correct Answer: C
Rationale: The USPSTF recommends the PHQ-9 (or brief PHQ-2) for depression
screening in adults. The HAM-D and MADRS are clinician-administered scales typically
used in research or psychiatric settings, not routine primary care screening. The BDI-II is
validated for adults but not specifically recommended by USPSTF as the primary
screening tool.
Q2: You are reviewing the components of a thorough mood history using the SIGECAPS
mnemonic. Which of the following represents the correct elements of this clinical
memory aid?
A. Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor changes, and
Suicidal ideation [CORRECT]
B. Sadness, Insomnia, Gastrointestinal symptoms, Euphoria, Cognition, Anxiety,
Paranoia, and Stress
C. Speech, Insight, Gait, Emotions, Coping, Affect, Perception, and Support systems
,D. Social history, Interests, Goals, Education, Career, Activities, Plans, and Sexual history
Correct Answer: A
Rationale: SIGECAPS is the classic mnemonic for assessing major depressive disorder
symptoms: Sleep (insomnia/hypersomnia), Interest (anhedonia), Guilt (worthlessness),
Energy (fatigue), Concentration, Appetite (change/weight), Psychomotor
(agitation/retardation), and Suicidal ideation. It covers the eight symptom domains from
DSM-5 criteria.
Q3: Sarah Jamieson presents for her annual well-woman visit and mentions she's been
feeling "down" lately. To properly assess the timeline of her symptoms, which question
best establishes the onset and duration criteria for major depressive disorder?
A. "Do you feel sad every single day without exception?"
B. "How long have you been feeling this way, and have these symptoms been present
most of the day, nearly every day, for at least two weeks?" [CORRECT]
C. "Did this start after a specific traumatic event last month?"
D. "Are your symptoms worse in the morning or evening?"
Correct Answer: B
Rationale: Major depressive disorder requires symptoms to be present for at least two
weeks, most of the day, nearly every day. This question establishes the critical duration
and frequency criteria. While trauma history and symptom patterns matter, the
two-week duration is essential for distinguishing MDD from normal sadness or
adjustment reactions.
Q4: When taking a medication history for a patient presenting with mood symptoms,
which class of medications is most commonly associated with inducing or
exacerbating depressive symptoms?
A. Proton pump inhibitors for GERD
B. Beta-blockers, corticosteroids, and certain antihypertensives [CORRECT]
C. Multivitamins and calcium supplements
D. Short-acting bronchodilators for asthma
Correct Answer: B
Rationale: Beta-blockers (lipophilic ones like propranolol), systemic corticosteroids, and
some antihypertensives (reserpine, methyldopa) are well-documented causes of
medication-induced depression. Always review current medications before attributing
, mood symptoms to a primary psychiatric disorder. PPIs and vitamins are not typically
associated with depression.
Q5: Data Snippet: Sarah Jamieson completes a PHQ-9 during her visit. Her responses
indicate: little interest or pleasure in doing things (2 - more than half the days), feeling
down, depressed, or hopeless (2 - more than half the days), trouble falling or staying
asleep (1 - several days), feeling tired or having little energy (2 - more than half the
days), poor appetite or overeating (1 - several days), feeling bad about yourself (1 -
several days), trouble concentrating (1 - several days), moving slowly or being fidgety (0
- not at all), and thoughts of self-harm (0 - not at all). What is her total PHQ-9 score and
corresponding severity level?
A. Score 8 - mild depression
B. Score 10 - moderate depression [CORRECT]
C. Score 15 - moderately severe depression
D. Score 18 - severe depression
Correct Answer: B
Rationale: Adding the scores: 2+2+1+2+1+1+1+0+0 = 10. PHQ-9 scoring: 0-4 minimal,
5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe. A score of 10
indicates moderate depression severity, typically warranting treatment consideration
and close follow-up.
Q6: You are assessing Sarah's sleep patterns as part of her mood evaluation. She
reports difficulty falling asleep, waking up at 3 AM unable to return to sleep, and never
feeling rested. Which type of insomnia pattern is most characteristic of major
depressive disorder?
A. Hypersomnia with excessive daytime sleepiness
B. Middle and terminal insomnia (difficulty maintaining sleep and early morning
awakening) [CORRECT]
C. Sleep apnea with snoring witnessed by partner
D. Delayed sleep phase syndrome (inability to fall asleep until late night)
Correct Answer: B
Rationale: While initial insomnia (difficulty falling asleep) occurs, middle insomnia
(frequent awakenings) and terminal insomnia (early morning awakening, typically 2-4
hours before usual wake time) are classic for depression. Hypersomnia occurs in
2026/2027 – Sarah Jamieson – Mood Assessment
– Chamberlain University – Detailed Rationales –
Pass Guaranteed – A+ Graded
History Taking & Mood Assessment
Q1: When screening adult patients for depression in primary care, the USPSTF
recommends which standardized tool as a valid and reliable instrument for initial
screening?
A. The Hamilton Depression Rating Scale (HAM-D) as the first-line screening tool
B. The Montgomery-Åsberg Depression Rating Scale (MADRS) for all primary care visits
C. The Patient Health Questionnaire-9 (PHQ-9) or PHQ-2 for routine screening
[CORRECT]
D. The Beck Depression Inventory-II (BDI-II) exclusively for adolescents
Correct Answer: C
Rationale: The USPSTF recommends the PHQ-9 (or brief PHQ-2) for depression
screening in adults. The HAM-D and MADRS are clinician-administered scales typically
used in research or psychiatric settings, not routine primary care screening. The BDI-II is
validated for adults but not specifically recommended by USPSTF as the primary
screening tool.
Q2: You are reviewing the components of a thorough mood history using the SIGECAPS
mnemonic. Which of the following represents the correct elements of this clinical
memory aid?
A. Sleep, Interest, Guilt, Energy, Concentration, Appetite, Psychomotor changes, and
Suicidal ideation [CORRECT]
B. Sadness, Insomnia, Gastrointestinal symptoms, Euphoria, Cognition, Anxiety,
Paranoia, and Stress
C. Speech, Insight, Gait, Emotions, Coping, Affect, Perception, and Support systems
,D. Social history, Interests, Goals, Education, Career, Activities, Plans, and Sexual history
Correct Answer: A
Rationale: SIGECAPS is the classic mnemonic for assessing major depressive disorder
symptoms: Sleep (insomnia/hypersomnia), Interest (anhedonia), Guilt (worthlessness),
Energy (fatigue), Concentration, Appetite (change/weight), Psychomotor
(agitation/retardation), and Suicidal ideation. It covers the eight symptom domains from
DSM-5 criteria.
Q3: Sarah Jamieson presents for her annual well-woman visit and mentions she's been
feeling "down" lately. To properly assess the timeline of her symptoms, which question
best establishes the onset and duration criteria for major depressive disorder?
A. "Do you feel sad every single day without exception?"
B. "How long have you been feeling this way, and have these symptoms been present
most of the day, nearly every day, for at least two weeks?" [CORRECT]
C. "Did this start after a specific traumatic event last month?"
D. "Are your symptoms worse in the morning or evening?"
Correct Answer: B
Rationale: Major depressive disorder requires symptoms to be present for at least two
weeks, most of the day, nearly every day. This question establishes the critical duration
and frequency criteria. While trauma history and symptom patterns matter, the
two-week duration is essential for distinguishing MDD from normal sadness or
adjustment reactions.
Q4: When taking a medication history for a patient presenting with mood symptoms,
which class of medications is most commonly associated with inducing or
exacerbating depressive symptoms?
A. Proton pump inhibitors for GERD
B. Beta-blockers, corticosteroids, and certain antihypertensives [CORRECT]
C. Multivitamins and calcium supplements
D. Short-acting bronchodilators for asthma
Correct Answer: B
Rationale: Beta-blockers (lipophilic ones like propranolol), systemic corticosteroids, and
some antihypertensives (reserpine, methyldopa) are well-documented causes of
medication-induced depression. Always review current medications before attributing
, mood symptoms to a primary psychiatric disorder. PPIs and vitamins are not typically
associated with depression.
Q5: Data Snippet: Sarah Jamieson completes a PHQ-9 during her visit. Her responses
indicate: little interest or pleasure in doing things (2 - more than half the days), feeling
down, depressed, or hopeless (2 - more than half the days), trouble falling or staying
asleep (1 - several days), feeling tired or having little energy (2 - more than half the
days), poor appetite or overeating (1 - several days), feeling bad about yourself (1 -
several days), trouble concentrating (1 - several days), moving slowly or being fidgety (0
- not at all), and thoughts of self-harm (0 - not at all). What is her total PHQ-9 score and
corresponding severity level?
A. Score 8 - mild depression
B. Score 10 - moderate depression [CORRECT]
C. Score 15 - moderately severe depression
D. Score 18 - severe depression
Correct Answer: B
Rationale: Adding the scores: 2+2+1+2+1+1+1+0+0 = 10. PHQ-9 scoring: 0-4 minimal,
5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe. A score of 10
indicates moderate depression severity, typically warranting treatment consideration
and close follow-up.
Q6: You are assessing Sarah's sleep patterns as part of her mood evaluation. She
reports difficulty falling asleep, waking up at 3 AM unable to return to sleep, and never
feeling rested. Which type of insomnia pattern is most characteristic of major
depressive disorder?
A. Hypersomnia with excessive daytime sleepiness
B. Middle and terminal insomnia (difficulty maintaining sleep and early morning
awakening) [CORRECT]
C. Sleep apnea with snoring witnessed by partner
D. Delayed sleep phase syndrome (inability to fall asleep until late night)
Correct Answer: B
Rationale: While initial insomnia (difficulty falling asleep) occurs, middle insomnia
(frequent awakenings) and terminal insomnia (early morning awakening, typically 2-4
hours before usual wake time) are classic for depression. Hypersomnia occurs in
