1|Page
Advanced Pathophysiology NURS 6501 Final Exam
Prep Questions and Correct Answers/ Nurs 6501
Final Exam Week 11
What is the role of the primary care provider in mental
health? - ...ANSWER...✓✓ - Screen for mental health
issues
- Improve outcomes and reduce health care costs
- Assess and give care to mild-moderate disorders or
patients with stable severe mental disorders
- From strong links with mental health specialty care for
complex cases
Sharing patient info (ex: meds used)
about PHQ2
- what does it screen for, what are the questions, scoring
- ...ANSWER...✓✓ - Screens for MDD
- It is the first two questions of the PHQ9
- In the last two week, have you been feeling these (not at
all, several days, more than half the day, nearly
everyday):
,2|Page
- Little interest or pleasure in doing things?
- Feeling down, depressed, or hopeless?
Scoring:
A single yes or score >3 (out of 0-6) = possible clinical
depression ⇒ due the PHQ9
If the pt screens (+) ⇒ continue to eval with the PHQ9
about PHQ9
- what its used for, questions, scoring - ...ANSWER...✓✓
Used for screening, diagnosing, and treating
- It asks about functioning impairments which is needed
for the DSM-based diagnosis
Includes asking about suicide or hurting self
Scoring:
0-27 available
0-4: Minimal/none
Monitor; may not require treatment
5-9: Mild
,3|Page
Use clinical judgment; follow-up in one month
10-14: Moderate
Use clinical judgment; may need meds if functionally
impaired
15-19: Moderately Severe
Warrants active treatment with psychotherapy, meds, or
combo
20-27: Severe
Warrants active treatment with psychotherapy, meds, or
combo
What is the appropriate initiation dose for fluoxetine for
adults and geriatric adults? - ...ANSWER...✓✓ 20mg PO
once daily in the AM
- May ↑ daily dose after several weeks if inadequate
response
- Full therapeutic effect may be delayed 4 weeks or
longer
- Max dose: 80mg/day
What labs would be appropriate to draw if you initiate
fluoxetine in a geriatric patient? - ...ANSWER...✓✓ Sodium
levels
, 4|Page
- Baseline screening & after 3-4 weeks in high-risk
patients (> 65yrs, previous hx of antidepressant-induced
hyponatremia, low body weight, concomitant use of
thiazides or other hyponatremia-inducing agents)
- monitor regularly in the elderly
What are potential side effects of SSRI medications?
- what are the common SSRIs, LEAP of them, and zoloft
AE - ...ANSWER...✓✓ Common SSRIs:
Lexapro, celexa, paxil, zoloft, prozac
L = decreased libido and sleep
E = Neutral effect on energy
A = neural effect on addiction
P = celexa may stop working after awhile (increase or
switch)
Zoloft AE:
Insomnia, somnolence, fatigue, abnormal ejaculation,
suicidal thoughts
Advanced Pathophysiology NURS 6501 Final Exam
Prep Questions and Correct Answers/ Nurs 6501
Final Exam Week 11
What is the role of the primary care provider in mental
health? - ...ANSWER...✓✓ - Screen for mental health
issues
- Improve outcomes and reduce health care costs
- Assess and give care to mild-moderate disorders or
patients with stable severe mental disorders
- From strong links with mental health specialty care for
complex cases
Sharing patient info (ex: meds used)
about PHQ2
- what does it screen for, what are the questions, scoring
- ...ANSWER...✓✓ - Screens for MDD
- It is the first two questions of the PHQ9
- In the last two week, have you been feeling these (not at
all, several days, more than half the day, nearly
everyday):
,2|Page
- Little interest or pleasure in doing things?
- Feeling down, depressed, or hopeless?
Scoring:
A single yes or score >3 (out of 0-6) = possible clinical
depression ⇒ due the PHQ9
If the pt screens (+) ⇒ continue to eval with the PHQ9
about PHQ9
- what its used for, questions, scoring - ...ANSWER...✓✓
Used for screening, diagnosing, and treating
- It asks about functioning impairments which is needed
for the DSM-based diagnosis
Includes asking about suicide or hurting self
Scoring:
0-27 available
0-4: Minimal/none
Monitor; may not require treatment
5-9: Mild
,3|Page
Use clinical judgment; follow-up in one month
10-14: Moderate
Use clinical judgment; may need meds if functionally
impaired
15-19: Moderately Severe
Warrants active treatment with psychotherapy, meds, or
combo
20-27: Severe
Warrants active treatment with psychotherapy, meds, or
combo
What is the appropriate initiation dose for fluoxetine for
adults and geriatric adults? - ...ANSWER...✓✓ 20mg PO
once daily in the AM
- May ↑ daily dose after several weeks if inadequate
response
- Full therapeutic effect may be delayed 4 weeks or
longer
- Max dose: 80mg/day
What labs would be appropriate to draw if you initiate
fluoxetine in a geriatric patient? - ...ANSWER...✓✓ Sodium
levels
, 4|Page
- Baseline screening & after 3-4 weeks in high-risk
patients (> 65yrs, previous hx of antidepressant-induced
hyponatremia, low body weight, concomitant use of
thiazides or other hyponatremia-inducing agents)
- monitor regularly in the elderly
What are potential side effects of SSRI medications?
- what are the common SSRIs, LEAP of them, and zoloft
AE - ...ANSWER...✓✓ Common SSRIs:
Lexapro, celexa, paxil, zoloft, prozac
L = decreased libido and sleep
E = Neutral effect on energy
A = neural effect on addiction
P = celexa may stop working after awhile (increase or
switch)
Zoloft AE:
Insomnia, somnolence, fatigue, abnormal ejaculation,
suicidal thoughts
