NR 547 Final Study Guide – PMHNP Questions And Answers Top Score 2024.

NR 547 Final Study Guide – PMHNP Questions And Answers Top Score 2024. When ndo nyou nconsider nUnipolar nversus nBipolar ndepression n- n n n ncorrect nanswer.Unipolar nmajor ndepression n(major ndepressive ndisorder) nis ncharacterized nby na nhistory nof none nor nmore nmajor ndepressive nepisodes n(table n3) nand nno nhistory nof nmania n(table n1) nor nhypomania Geriatric nDepression nScale n(GDS) n- n n n ncorrect nanswer.Scoring nInstructions. nScore n1 npoint nfor neach nbolded nanswer. nA nscore nof n5 nor nmore nsuggests ndepression. Self-reporting ntool nthat nmay nbe nused nto ndiagnose nand ntreat ndepression Geriatric nDepression nScale n- n n n ncorrect nanswer.The nGeriatric nDepression nScale n(GDS) nis na nself-report nmeasure nof ndepression nin nolder nadults. nUsers nrespond nin na n"Yes/No" nformat. nThe nGDS nwas noriginally ndeveloped nas na n30-item ninstrument. nSince nthis nversion nproved nboth ntime-consuming nand ndifficult nfor nsome npatients nto ncomplete, na n15-item nversion nwas ndeveloped. nThe nshortened nform n(GDS-S) nis ncomprised nof n15 nitems nchosen nfrom nthe nGeriatric nDepression nScale-Long nForm n(GDS-L). nThese n15 nitems nwere nchosen nbecause nof ntheir nhigh ncorrelation nwith ndepressive nsymptoms nin nprevious nvalidation nstudies Geriatric nDepression nScale: nTargeted nPopulation n- n n n ncorrect nGDS nmay nbe nused nwith nhealthy, nmedically nill nand nmild nto nmoderately ncognitively nimpaired nolder nadults. nIt nhas nbeen nextensively nused nin ncommunity, nacute ncare, nand nlong-term ncare nsettings. Geriatric nDepression nScale n(GDS): nScore n- n n n ncorrect nanswer.Pharmacologic, npsychotherapeutic, nor ncombination ntreatment nindicated nof nthe n15 nitems, n10 nindicated nthe npresence nof ndepression nwhen nanswered npositively, nwhile nthe nrest n(question nnumbers n1, n5, n7, n11, n13) nindicated ndepression nwhen nanswered nnegatively. n Scores nof n0-4 nare nconsidered nnormal, ndepending non nage, neducation, nand ncomplaints; n(No nTreatment) 5-8 nindicate nmild ndepression; n(Pharmacologic nor npsychotherapeutic ntreatment nmay nbe nindicated Base ntreatment non nduration nof nsymptoms nand nfunctional nimpairment 9-11 nindicate nmoderate ndepression; n(Pharmacologic, npsychotherapeutic, nor ncombination ntreatment nindicated) 12-15 nindicate nsevere ndepression.(Pharmacologic, npsychotherapeutic, nor ncombination ntreatment nindicated Geriatric nDepression nScale n(GDS): nIndication nfor nIntervention n- n n n ncorrect nanswer.The npresence nof ndepression nwarrants nprompt nintervention nand ntreatment. nThe nGDS nmay nbe nused nto nmonitor ndepression nover ntime nin nall nclinical nsettings. n Any npositive nscore nabove n5 non nthe nGDS nShort nForm nshould nprompt nan nin-depth npsychological nassessment nand nevaluation nfor nsuicidality. Patient nHealth nQuestionnaire n[PHQ-9] n- n n n ncorrect nanswer.A nbrief n9-item nself-report nquestionnaire nused nas na nscreening ntool nto nassess nseverity nof ndepression; nwidely nused nby nhealth ncare nproviders, nin nvalidity nis nwell nestablished, nparticularly nfor nidentifying nsevere ndepression. The nBeck nDepression nInventory n(BDI) n- n n n ncorrect nanswer.Widely nused nto nscreen nfor ndepression nand nto nmeasure nbehavioral nmanifestations nand nseverity nof ndepression. n The nBDI ncan nbe nused nfor nages n13 nto n80. nThe ninventory ncontains n21 nself-report nitems nwhich nindividuals ncomplete nusing nmultiple nchoice nresponse nformats. n The nBDI ntakes napproximately n10 nminutes nto ncomplete. nValidity nand nreliability nof nthe nBDI nhas nbeen ntested nacross npopulations, nworldwide. Center nfor nEpidemiologic nStudies nDepression nScale n(CES-D) n- n n n ncorrect nanswer.Designed nfor nuse nin nthe ngeneral npopulation nand nis nnow nused nas na nscreener nfor ndepression nin nprimary ncare nsettings. n It nincludes n20 nself-report nitems, nscored non na n4-point nscale, nwhich nmeasure nmajor ndimensions nof ndepression nexperienced nin nthe npast nweek. The nCES-D ncan nbe nused nfor nchildren nas nyoung nas n6 nand nthrough nolder nadulthood. nIt nhas nbeen ntested nacross ngender nand ncultural npopulations nand nmaintains nconsistent nvalidity nand nreliability. nThe nscale ntakes nabout n20 nminutes nto nadminister, nincluding nscoring. EQ-5D n- n n n ncorrect nanswer.The nEQ-5D nis na nstandardized, nnon-disease nspecific ninstrument nfor ndescribing nand nevaluating nhealth-related nquality nof nlife. nThe ninstrument nmeasures nquality nof nlife nin nfive ndimensions: nmobility, nself-care, nusual nactivities, npain/discomfort nand nanxiety/depression. Hamilton nDepression nRating nScale n(HAM-D) n- n n n ncorrect nanswer. Mood nDisorders: nDepression n- n n n ncorrect nanswer.Sadness, nlethargy, ninactivity nand nfeelings nof nhelplessness nand nhopelessness Genetic nlink Behavioral nchanges: nslower nmotor nreactions Cognitive nchanges: ncognitive ndistortions Physical nchanges: nalters nimmune nfunctioning PQ9 nScores n- n n n ncorrect nanswer.Depression nSeverity 5 n- n9Mild 10 n- n14Moderate 15 n- n19Moderately nSevere 20 n- n27Severe scores ncurrent ndepression nseverity nand nto nfollow nup ntreatment nresponse. Depression: nAnxious ndistress nModifier n- n n n ncorrect nanswer.Depression nwith nunusual nrestlessness nor nworry nabout npossible nevents nor nloss nof ncontrol Depression: nMixed nfeatures n- n n n ncorrect nanswer.Simultaneous ndepression nand nmania, nwhich nincludes nelevated nself-esteem, ntalking ntoo nmuch nand nincreased nenergy Depression: nMelancholic nfeatures n- n n n ncorrect nanswer.Severe ndepression nwith nlack nof nresponse nto nsomething nthat nused nto nbring npleasure nand nassociated nwith nearly nmorning nawakening, nworsened nmood nin nthe nmorning, nmajor nchanges nin nappetite, nand nfeelings nof nguilt, nagitation nor nsluggishness Depression: nAtypical nfeatures n- n n n ncorrect nanswer.Depression nthat nincludes nthe nability nto ntemporarily nbe ncheered nby nhappy nevents, nincreased nappetite, nexcessive nneed nfor nsleep, nsensitivity nto nrejection, nand na nheavy nfeeling nin nthe narms nor nlegs Depression: nPsychotic nFeatures n- n n n ncorrect nanswer.Depression naccompanied nby ndelusions nor nhallucinations, nwhich nmay ninvolve npersonal ninadequacy nor nother nnegative nthemes Depression: nCatatonic nFeatures n- n n n ncorrect nanswer.Depression nthat nincludes nmotor nactivity nthat ninvolves neither nuncontrollable nand npurposeless nmovement nor nfixed nand ninflexible nposture Bipolar nI nand nII ndisorders n- n n n ncorrect nanswer.These nmood ndisorders ninclude nmood nswings nthat nrange nfrom nhighs n(mania) nto nlows n(depression). nIt's nsometimes ndifficult nto ndistinguish nbetween nbipolar ndisorder nand ndepression. Cyclothymic nDisorder n(Cyclothymia) n- n n n ncorrect nanswer.Involves nhighs nand nlows nthat nare nmilder nthan nthose nof nbipolar ndisorder. mood ndisorders n- n n n ncorrect nanswer.Psychological ndisorders ncharacterized nby nemotional nextremes nthat noccur nacross na nspectrum nfrom ndepression nto nmania. Disruptive nMood nDysregulation nDisorder n(DMDD) n- n n n ncorrect nanswer.This nmood ndisorder nin nchildren nincludes nchronic nand nsevere nirritability nand nanger nwith nfrequent nextreme ntemper noutbursts. nThis ndisorder ntypically ndevelops ninto ndepressive ndisorder nor nanxiety ndisorder nduring nthe nteen nyears nor nadulthood. Persistent nDepressive nDisorder n(Dysthymia) n- n n n ncorrect nanswer.Less nsevere nbut nmore nchronic nform nof ndepression. nWhile nit's nusually nnot ndisabling, npersistent ndepressive ndisorder ncan nprevent nyou nfrom nfunctioning nnormally nin nyour ndaily nroutine nand nfrom nliving nlife nto nits nfullest. Depressed nmood, nfor nmore ndays nthan nnot, nfor n≥2 nyears. nImpairment ncompared nwith nmajor ndepressive ndisorder nmay nbe nless nsevere. nDuring nthe n2 nyears, nthe npatient nhas nnever nbeen nwithout nsymptoms nfor nmore nthan n2 nmonths nat na ntime. Premenstrual ndysphoric ndisorder n(PMDD) n- n n n ncorrect nanswer.Depression nsymptoms nassociated nwith nhormone nchanges nthat nbegin na nweek nbefore nand nimprove nwithin na nfew ndays nafter nthe nonset nof nyour nperiod, nand nare nminimal nor ngone nafter ncompletion nof nyour nperiod. Depression nPrevalence nin nolder nadults n- n n n ncorrect nanswer.Depression nis nthe nsecond nleading ncause nof ndisability nin nolder nadults nafter ncardiovascular ndisease nand nimpacts naround n7% nof nthe ngeriatric npopulation Biologic nfactors, nincluding nchanges nin nbrain nstructure nand nneurotransmitters nafter na ncerebrovascular naccident n(CVA) nor nwith na nneurodegenerative ndisease nsuch nas nParkinson's nor nAlzheimer's ndisease, nmay nincrease nthe nrisk nof ndepression. nExamine nthe nimage nbelow nfor nadditional nrisk nfactors. Depression nin nOlder nAdults n- n n n ncorrect nanswer.Depression nis nthe nsecond nleading ncause nof ndisability nin nolder nadults nafter ncardiovascular ndisease nand nimpacts naround n7% nof nthe ngeriatric npopulation. Depression noften npresents nas na ncomorbidity nwith nother nphysical nor ncognitive ndisease nprocesses nin nolder nadults nand nmay npresent ndifferently nthan nin nadolescents nor nyounger nadults. Depression nrisk nfactors n- n n n ncorrect nanswer.Chronic nillness Disability/ nloss nof nmobility Change nin nliving nsituation Role ntransitions Loss nof nindependence Bereavement Economic nhardships Pertinent nInformation nfor nan nInterview: nDepression n- n n n ncorrect lization, nincluding nrecent nchanges nor nloss ability nto ncomplete nactivities nof ndaily nliving n(ADLs) typical nphysical nactivity appetite nchanges weight nloss nor ngain psychotic nsymptoms suicidal nthoughts nor nideations Independent nrisk nfactor nfor ndementia n- n n n ncorrect nanswer.Depression ntherefore nit nis nimportant nto nevaluate ncognitive nfunction nwhen ndepression nis nsuspected. nOlder nclients nmay nhave nassociated nmemory nloss, nslowed nprocessing, nor nimpaired nexecutive nfunctioning. Assessing nDepression nin nPatients nwith nDementia n- n n n ncorrect nanswer.Self-reporting nscales, nsuch nas nthe nGDS, nmay nbe ninappropriate. Cornell nScale nfor nDepression nin nDementia ncan nbe nused nto nscreen nnot ndiagnose. The ngoal nof ntreatment nfor nolder nadults nexperiencing ndepression n- n n n ncorrect nanswer.Symptom nremission First nChoice nof nTreating nDepression nin nOlder nAdults n- n n n ncorrect nanswer.SSRI n& nSNRI's Escitalopram, ncitalopram, nand nsertraline nhave nfewer ndrug-drug ninteractions nthan nother nmedications nand nare nappropriate nchoices nfor ninitial ntherapy nin nolder nadults ntaking nmultiple nmedications. Clinical npearls nfor nadjusting nand ndiscontinuing npharmacotherapy nfor ndepression nin nolder nadults n- n n n ncorrect nanswer.Dose nchanges: n start nlow, ngo nslow 4-8 nweeks nfor nsymptom nrelief reassess if npartial nimprovement, nconsider nadding nsecond ndrug if nno nimprovement, nconsider nchanging nto na nnew ndrug nclass maintain npharmacotherapy nfor nat nleast n1 nyear nafter nremission nto nprevent nrelapse discontinue ntherapy ngradually nto nreduce nwithdrawal nsyndrome n(dizziness, nanxiety, nheadache) Nonpharmacologic nInterventions: nDepression nOlder nAdult n- n n n ncorrect nanswer.Engagement Social nsupport Exercise Relaxation Mini-Cog nTest n- n n n ncorrect nanswer.Assess nDementia: Step n1: nThree nWord nRegistration. n Step n2: nClock nDrawing. n Step n3: nThree nWord nRecall. If nabnormal, nscreen nfurther nw/MMSE Children's nDepression nInventory n- n n n ncorrect nbe nused nin nboth neducational nand nclinical nsettings nto nevaluate ndepressive nsymptoms nin nchildren nand nadolescents n(7-17 nyears nold) CDI n2 ncan naid nin nthe nearly nidentification nof ndepressive nsymptoms, nthe ndiagnosis nof ndepression nand nrelated ndisorders, nas nwell nas, nthe nmonitoring nof ntreatment neffectiveness Edinburgh nPostnatal nDepression nScale n(EPDS) n- n n n ncorrect nanswer.Screening ntest nused nto nidentify ndepression nduring npregnancy nor nin nthe npostpartum nperiod ASQ nscreening n- n n n ncorrect nanswer.The nAsk nSuicide-Screening nQuestions n(ASQ) ntool nis na nbrief nvalidated ntool nfor nuse namong nboth nyouth nand nadults. DSM5-TR nDiagnostic nCriteria nfor nDepression n- n n n ncorrect nanswer.MDD, nfive nor nmore nof nthe nsymptoms nbelow nneed nto nbe npresent nfor nat nleast n2 nweeks ncontinuously. n(5/9) feeling nlow nmost nof nthe nday nfor nmost ndays decreased ninterest nin nactivities substantial nweight nloss, nsignificant nchange nin nappetite fidgeting, nrandom nmovement n(i.e. npacing) decreased nenergy sense nof nguilt nor nworthlessness lack nof nfocus nor nability nto nmake ndecisions repeated nthoughts nof ndeath nand nsuicide Depressed nmood nand/or nLoss nof ninterest/pleasure nmust nbe npresent. MDD nstatistics n- n n n ncorrect nanswer.An nestimated n4 npercent nof nthe nUnited nStates' nadult npopulation nhas nexperienced nat nleast none nmajor ndepressive nepisode. The ncondition nis nmore nprevalent nin nwomen nthan nin nmen. It nis nthree ntimes nmore nlikely nfor npeople nbetween nthe nages nof n18-25 nto nexperience ndepression nas ncompared nto nadults n60 nand nover. MDD nfrequently noccurs nwith nother nmedical nor npsychological nconditions nlike nsubstance nabuse, nanxiety, nhypothyroidism nand ndiabetes. People nwho nhave nexperienced ncancer, na nheart nattack, npost-traumatic nstress ndisorder nor nParkinson's nDisease nare nlikely nto nbe ndiagnosed nwith nMDD. MDD n(major ndepressive ndisorder) n- n n n ncorrect nanswer.5 nsymptoms nduring nthe nsame ntwo nweek nperiod nthat nare na nchange nfrom nprevious nfunctioning; n depressed nmood nand/or nloss nof ninterest/pleasure nmust nbe npresent; n exclude nsymptoms nclearly nattributable nto nanother nmedical ncondition Adjustment ndisorder nwith ndepressed nmood n- n n n ncorrect nanswer.Adjustment nDisorder nwith nDepressed nMood, nalso ncalled nSituational nDepression, nmay nsometimes nfeel nnearly nas nbleak nas nMDD, nbut na nmajor ndifference nis nthat nit ndoes nnot narise nout nof nthe nblue. n Rather, nsituational ndepression noccurs nafter nthere nis na nspecific ntrauma-divorce, naccident, ndeath nof nloved none, na nmajor nlife nchange... Depression nEducation: nOlder nAdult n- n n n ncorrect nanswer.Emphasize nthat nmedications nshould nbe ntaken nas nprescribed nbut nthat nthey nmay nnot n"cure" ndepression; nremission nof nsymptoms nis nthe ngoal nbut nchanges nto ntherapy nmay nneed nto noccur nto nachieve nremission. n Medications ntake n4-8 nweeks nto nalleviate nsymptoms nin nolder nadults. n To nbest ntreat ndepression, nconcurrent nnonpharmacologic ninterventions nare nindicated. The nUnited nStates nPreventive nServices nTask nForce n(USPSTF) nrecommends ndepression nscreening n- n n n ncorrect nanswer.·Adults n18 nyears nof nage nor nolder nand nadolescents nages n12-18 nyears nold. The nAmerican nAcademy nof nFamily nPhysicians nRecommendation n- n n n ncorrect nanswer.Screening nfor ndepression nin nthe ngeneral nadult npopulation, nincluding npregnant nand npost-partum nwomen. The nAmerican nAcademy nof nPediatrics nRecommendation n- n n n ncorrect nanswer.Maternal nscreening nfor npostpartum ndepression nat ninfants' n1, n2, nand n4- nmonth nvisits. Bright nFutures nprogram nrecommends nannual nscreening nin nadolescent nclients nfor nemotional nand nbehavioral nproblems Medicaid's nchild nhealth ncomponent, nthe nEarly nand nPeriodic nScreening, nDiagnosis nand nTreatment nprogram n- n n n ncorrect ning nto ndetect nphysical nand nmental nconditions nat nvarious nage nintervals. nIf na nrisk nis nidentified, nthe nprovider nshould nfollow nup nwith ndiagnosis nand ntreatment. Cause nof nDepression n- n n n ncorrect nanswer.Though nthe nexact ncause nis nunknown, ndepression nis ninfluenced nby ngenetic nand nenvironmental nfactors. n Stressful nlife nevents, nsuch nas ngiving nbirth nor nexperiencing nemotional ntrauma, ncan ncontribute nto nthe ndevelopment nof ndepression. Neurotransmitters ninvolved nin nDepression n- n n n ncorrect nanswer.An nimbalance nof nspecific nneurotransmitters, nincluding ndopamine, nserotonin, nand nnorepinephrine, ncan ninfluence nbrain nactivity nand nresult nin ndepression. lower nlevels nof ndopamine, nserotonin, nand nnorepinephrine nand nreceptor nbinding Depressed npatients noften nhave ndecreased nneurotransmitter nactivity nin nthe nprefrontal ncortex n(PFC) nregion nof nthe nbrain. nThe nprefrontal ncortex ncontrols nattention, nmood, nand npersonality, namong nother nfunctions. Symptoms nof ndepression n- n n n ncorrect nanswer.Depressed nmood nand na nloss nof ninterest nor npleasure. n Physical nsymptoms, nincluding nfatigue, ninattention, npoor nappetite, ndecreased nlibido, npsychomotor nretardation, nor nagitation. nClients nwith ndepression noften nreport ndifficulty nsleeping, nlack nof nmotivation, nor ntrouble ncompleting ntasks. n They nmay nuse nwords nlike n"sad," n"down," nor n"blue" nto ndescribe ntheir nfeelings. nIn nsevere ncases, ndepressed nclients nmay nreport ndelusions nor nhallucinations. n Depression nmay neven npresent nas ncatatonia. Hamilton nDepression nRating nScale n(HDRS) nLimitations n- n n n ncorrect nanswer.Atypical nsymptoms nof ndepression n(e.g., nhypersomnia, nhyperphagia) nare nnot nassessed HDRS nScoring n- n n n ncorrect nanswer.0-7 nis ngenerally naccepted nto nbe nwithin nthe nnormal nrange n(or nin nclinical nremission), nwhile na nscore nof n20 nor nhigher n(indicating nat nleast nmoderate nseverity) nis nusually nrequired nfor nentry ninto na nclinical ntrial Immuno-Psychiatry n- n n n ncorrect nanswer.Macrophages nare nthe ncenturions nof nthe nimmune nsystem. n Macrophages nwarn nthe nimmune nsystem nof na npotential nthreat nby nsecreting ncytokines nalerting nmore nmacrophages nto ncome nto nthe ninjured nsite. n These nmacrophages n"eat" nthe ninfection nand noutput nbacterial nfragments nand ndigestive nremnants ninto nthe nsurrounding ntissues, nleading nto ninflammation. How ndoes nyour ndiet naffect nyour nmood? n- n n n ncorrect nanswer.Cytokines n(inflammatory nproteins nin nthe nblood) ncan nsend nsignals nacross nthe nblood-brain nbarrier. Nerve ncells nexposed nto ncytokines nare nmore nlikely nto ndie nthan nregenerate. In nrat nstudies, nrats ninjected nwith ncytokines nexhibited nsocial nwithdrawal, nless nmovement, nand naltered nsleeping nand neating npatterns. Inflamed nnerve ncells ncannot neffectively ntransmit n5-hydroxytryptamine n(5HT) nor nserotonin nreceptors. Persons nwith ninflammatory nconditions nare nsignificantly nmore ndepressed nthan nthe ngeneral npopulation. Eating nfoods nknown nto ncause ninflammation n(carbs) nwill nmore nlikely nto nexhibit ndepressive nsymptoms ndue nto nimflammation. Medical nDiagnoses nthat nMimic nDepressive nDisorders n- n n n ncorrect nanswer.Hypothyroidism, nvitamin nD ndeficiency, nhypoglycemia, nanemia, nvitamin nB12 ndeficiency, nchronic nfatigue nsyndrome, nand nhypotension. Medications nwith nside neffects nmimicking ndepression n- n n n ncorrect nanswer.Cannabis, nalcohol, nclonidine, nantidepressants, nanticonvulsants, nantimigraine nagents, ncorticosteroids, ncontraceptives, nand nvarenicline n(Chantix). n Withdrawal nfrom ncertain nsubstances, nsuch nas ncocaine nor ncaffeine, ncan nalso nlead nto ndepressive nsymptoms. Antidepressant nmedications nused nto ntreat ndepressive nsymptoms n- n n n ncorrect nanswer.SSRI SNRI TCS MAOI's SSRI: nAction, nType nand nside neffects nused nfor nDepression n- n n n ncorrect nanswer.Action: ninhibits nthe nreuptake nof nserotonin Examples: ncitalopram, nescitalopram, nfluoxetine, nparoxetine, nsertraline Common nSide nEffects: nnausea, nagitation, nheadache, nand nsexual ndysfunction SNRI: nAction, nType nand nside neffects nused nfor nDepression n- n n n ncorrect nanswer.Action: ninhibits nthe nreuptake nof nserotonin nand nnorepinephrine Examples: ndesvenlafaxine, nduloxetine, nlevomilnacipran, nvenlafaxine Common nSide nEffects: nnausea, nsweating, ninsomnia, ntremors, nsexual ndysfunction TCA's: nAction, nType nand nside neffects nused nfor nDepression n- n n n ncorrect nanswer.Action: ninhibits nthe nreuptake nof nserotonin nand nnorepinephrine; nblocks nnorepinephrine, nhistamine, nand nacetylcholine nreceptors Examples: namitriptyline, nclomipramine, ndesipramine, ndoxepin