MIDTERM EXAM NR 572 ADVANCED ACUTE
CARE MANAGEMENT GUIDE 2026 FINAL
ASSESSMENT TESTED CONTENT WITH
ACCURATE SOLUTIONS
◉ PSPIKES: Empathy. Answer: Identify cause of emotions;
empathize with feelings
◉ PSPIKES: Summary. Answer: Outline next steps and plans; help
reduce uncertainty
◉ Contraindications to SSRIs. Answer: MAOIs or TCAs; avoid
alcohol; caution with liver/renal dysfunction, seizures, GI bleed,
prolonged QT, MI
◉ SSRI examples. Answer: Fluoxetine, Sertraline, Fluvoxamine,
Citalopram, Escitalopram
◉ Tricyclic antidepressants examples. Answer: Amitriptyline,
nortriptyline, imipramine, desipramine, clomipramine, doxepin,
amoxapine
,◉ MAOI examples. Answer: Nardil, Parnate (require special diet,
avoid cheese, chocolate, fish, caffeine)
◉ Screening tools for depression. Answer: QIDS Clinician, QIDS
SelfReport, PHQ9
◉ PHQ-9. Answer: 9item selfreport for depression severity; useful
for identifying severe depression
◉ QIDS Clinician Report. Answer: 16item depression scale: 0-5:
none, 6-10: mild, 11-15: moderate, 16-20: severe, 21+: very severe
◉ Non-psychiatric management of psychosis. Answer: OK if
chronic/stable and psych consult unavailable; continue previous
treatment
◉ Benzodiazepine side effects. Answer: Sedation; paradoxical
agitation; dependence; withdrawal
◉ Benzodiazepine precautions. Answer: Avoid with CNS
depressants; caution in liver disease, elderly, mentally ill, respiratory
disease
, ◉ Assessing substance-abuse and depression. Answer:
Antidepressants can be dangerous with alcohol; assess for sedative
abuse; use labs and collateral
◉ Treatment for substance-abuse with depression. Answer: Stop
intoxicant; treat only after sobriety; consider 4 weeks before starting
meds
◉ Postpartum depression (PPD). Answer: MDD with postpartum
onset within 1 month of childbirth; use Edinburgh scale
◉ Risk factors for PPD. Answer: Depression history; PMS; stress;
poor support; low income; young age; immigration
◉ Medications for PPD. Answer: Sertraline, paroxetine, nortriptyline,
imipramine
◉ Unsafe PPD meds. Answer: Doxepin (sedation, respiratory
depression, contraindicated in breastfeeding)
◉ Central vs Obstructive Sleep Apnea. Answer: Central = no effort to
breathe, no snoring; brain doesn't send signal
CARE MANAGEMENT GUIDE 2026 FINAL
ASSESSMENT TESTED CONTENT WITH
ACCURATE SOLUTIONS
◉ PSPIKES: Empathy. Answer: Identify cause of emotions;
empathize with feelings
◉ PSPIKES: Summary. Answer: Outline next steps and plans; help
reduce uncertainty
◉ Contraindications to SSRIs. Answer: MAOIs or TCAs; avoid
alcohol; caution with liver/renal dysfunction, seizures, GI bleed,
prolonged QT, MI
◉ SSRI examples. Answer: Fluoxetine, Sertraline, Fluvoxamine,
Citalopram, Escitalopram
◉ Tricyclic antidepressants examples. Answer: Amitriptyline,
nortriptyline, imipramine, desipramine, clomipramine, doxepin,
amoxapine
,◉ MAOI examples. Answer: Nardil, Parnate (require special diet,
avoid cheese, chocolate, fish, caffeine)
◉ Screening tools for depression. Answer: QIDS Clinician, QIDS
SelfReport, PHQ9
◉ PHQ-9. Answer: 9item selfreport for depression severity; useful
for identifying severe depression
◉ QIDS Clinician Report. Answer: 16item depression scale: 0-5:
none, 6-10: mild, 11-15: moderate, 16-20: severe, 21+: very severe
◉ Non-psychiatric management of psychosis. Answer: OK if
chronic/stable and psych consult unavailable; continue previous
treatment
◉ Benzodiazepine side effects. Answer: Sedation; paradoxical
agitation; dependence; withdrawal
◉ Benzodiazepine precautions. Answer: Avoid with CNS
depressants; caution in liver disease, elderly, mentally ill, respiratory
disease
, ◉ Assessing substance-abuse and depression. Answer:
Antidepressants can be dangerous with alcohol; assess for sedative
abuse; use labs and collateral
◉ Treatment for substance-abuse with depression. Answer: Stop
intoxicant; treat only after sobriety; consider 4 weeks before starting
meds
◉ Postpartum depression (PPD). Answer: MDD with postpartum
onset within 1 month of childbirth; use Edinburgh scale
◉ Risk factors for PPD. Answer: Depression history; PMS; stress;
poor support; low income; young age; immigration
◉ Medications for PPD. Answer: Sertraline, paroxetine, nortriptyline,
imipramine
◉ Unsafe PPD meds. Answer: Doxepin (sedation, respiratory
depression, contraindicated in breastfeeding)
◉ Central vs Obstructive Sleep Apnea. Answer: Central = no effort to
breathe, no snoring; brain doesn't send signal
