Clinical PMHNP Exam 1 study
questions
Which theory of depression was developed based on observing that patients who were being treated
for Hep C developed depressive symptoms?
A. The monoamine theory
B. The inflammation theory
C. The HPA axis theory
D. The stress-diathesis theory - ✔✔b. The inflammation theory
Which of the following health conditions have a high co-morbidity with depression?
A. Hypertension
B. Asthma
C. Diabetes mellitus
D. Cardiovascular disease
E. Celiac disease
F. Cognitive impairment
G. Obesity
H. Cancer - ✔✔A. Hypertension
C. Diabetes Mellitus
D. Cardiovascular disease
F. Cognitive impairment
G. Obesity
H. Cancer
In the Cutler video on depression, he highlights that there are 200 different ways to meet the
diagnostic criteria for depression.
A. True
B. False - ✔✔A. True
,You have diagnosed a 53-year-old male with moderate MDD and he has declined psychotherapy but
has agreed to pharmacotherapy. He has diagnoses of Type 2 D.M. with a BMI of 32.1. Which of the
following antidepressants would provide a dual benefit for this patient?
A. Sertraline
B. Fluoxetine
C. Duloxetine
D. Mirtazapine - ✔✔C. Duloxetine
Your patient was started on fluoxetine and after ten weeks of treatment his PhQ 9 score is 9. What is
your assessment of the efficacy of treatment based on this score?
A. The patient is in remission
B. The response is adequate but not in remission
C. The response is possibly inadequate
D. The response is inadequate - ✔✔B. The response is adequate but not in remission
In the Star*D trial what percentage of patients treated for depression failed to respond to initial
pharmacotherapy?
A. 20%
B. 30%
C. 40%
D. 50% - ✔✔D. 50%
In the Star D trial for patients that achieved remission what percentage relapsed after 4.4 months?
A. 25%
B. 33%
C. 42%
D. 53% - ✔✔B. 33%
When should adjunctive therapy be considered in treating MDD? (select all that apply)
A. Already tried 3 or > antidepressants
B. Initial antidepressant well tolerated
, C. Partial response (>50% improvement)
D. Specific residual symptoms or side effects that can be targeted
E. Severity of depression, more functional impairment
F. Patient preference - ✔✔B. Initial antidepressant well tolerated
D. Specific residual symptoms or side effects that can be targeted
E. Severity of depression, more functional impairment
F. Patient preference
Rates of remission increased with each additional change in therapy, especially when switching.
A. True
B. False - ✔✔B. False
You have diagnosed your patient with Major Depressive Disorder and after six weeks of being treated
with fluoxetine 20 mg there is no treatment response. According to the VA/DoD Guidelines for
treatment of MDD what is the next step?
A. Switch to another monotherapy either an antidepressant or psychotherapy.
B. Switch to a different antidepressant
C. Augment with a second antidepressant
D. Augment with a second medication or psychotherapy
A. A, C
B. B
C. C
D. A, D - ✔✔D. A,D
Your patient has experienced her first episode of MDD and is in remission. How long should the
antidepressant be continued after remission has been achieved to reduce the risk of relapse?
A. 2 months
B. 4 months
C. 6 months
D. One year - ✔✔C. 6 months
questions
Which theory of depression was developed based on observing that patients who were being treated
for Hep C developed depressive symptoms?
A. The monoamine theory
B. The inflammation theory
C. The HPA axis theory
D. The stress-diathesis theory - ✔✔b. The inflammation theory
Which of the following health conditions have a high co-morbidity with depression?
A. Hypertension
B. Asthma
C. Diabetes mellitus
D. Cardiovascular disease
E. Celiac disease
F. Cognitive impairment
G. Obesity
H. Cancer - ✔✔A. Hypertension
C. Diabetes Mellitus
D. Cardiovascular disease
F. Cognitive impairment
G. Obesity
H. Cancer
In the Cutler video on depression, he highlights that there are 200 different ways to meet the
diagnostic criteria for depression.
A. True
B. False - ✔✔A. True
,You have diagnosed a 53-year-old male with moderate MDD and he has declined psychotherapy but
has agreed to pharmacotherapy. He has diagnoses of Type 2 D.M. with a BMI of 32.1. Which of the
following antidepressants would provide a dual benefit for this patient?
A. Sertraline
B. Fluoxetine
C. Duloxetine
D. Mirtazapine - ✔✔C. Duloxetine
Your patient was started on fluoxetine and after ten weeks of treatment his PhQ 9 score is 9. What is
your assessment of the efficacy of treatment based on this score?
A. The patient is in remission
B. The response is adequate but not in remission
C. The response is possibly inadequate
D. The response is inadequate - ✔✔B. The response is adequate but not in remission
In the Star*D trial what percentage of patients treated for depression failed to respond to initial
pharmacotherapy?
A. 20%
B. 30%
C. 40%
D. 50% - ✔✔D. 50%
In the Star D trial for patients that achieved remission what percentage relapsed after 4.4 months?
A. 25%
B. 33%
C. 42%
D. 53% - ✔✔B. 33%
When should adjunctive therapy be considered in treating MDD? (select all that apply)
A. Already tried 3 or > antidepressants
B. Initial antidepressant well tolerated
, C. Partial response (>50% improvement)
D. Specific residual symptoms or side effects that can be targeted
E. Severity of depression, more functional impairment
F. Patient preference - ✔✔B. Initial antidepressant well tolerated
D. Specific residual symptoms or side effects that can be targeted
E. Severity of depression, more functional impairment
F. Patient preference
Rates of remission increased with each additional change in therapy, especially when switching.
A. True
B. False - ✔✔B. False
You have diagnosed your patient with Major Depressive Disorder and after six weeks of being treated
with fluoxetine 20 mg there is no treatment response. According to the VA/DoD Guidelines for
treatment of MDD what is the next step?
A. Switch to another monotherapy either an antidepressant or psychotherapy.
B. Switch to a different antidepressant
C. Augment with a second antidepressant
D. Augment with a second medication or psychotherapy
A. A, C
B. B
C. C
D. A, D - ✔✔D. A,D
Your patient has experienced her first episode of MDD and is in remission. How long should the
antidepressant be continued after remission has been achieved to reduce the risk of relapse?
A. 2 months
B. 4 months
C. 6 months
D. One year - ✔✔C. 6 months
