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Clinical PMHNP Exam 1 study questions and answers with complete
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Clinical PMHNP Exam 1 study questionsand answers with complete
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
-For patients that respond to treatment with pharmacotherapy but are at
high risk for recurrent depressive episodes, howe long should maintenance
pharmacotherapy be continued?
A. At least 6 months
B. At least 12 months
C. At least 24 months
Indefinitely - -B. At least 12 months
-Having a patient sign a "no suicide contract" has demonstrated efficacy in
reducing suicides among those who sign these "contracts".
A. True
B. False - -B. False
-When de-escalating a patient what is the recommended closest distance
that you should stand from the patient?
A. 1 arm length
B. 2 arms length
C. six feet
D. 10 feet - -2 arms length
-In order to assess agitation in a patient the practitioner should:
A. Use past experiences with patients to compare to this patient
B. Use an objective scale such as the Behavioral Activity Rating Scales
C. Find the most experienced person with assessing agitation
D. Avoid jumping to conclusions and monitor the patient over time - -B. Use
an objective scale such as the Behavioral Activity Rating Scales
-You walk into the room of a patient in an acute care facility where you have
been asked to consult with due to the patient's bizarre behavior. The patient
is a 6'5" former body builder who is pacing the room, talking loudly and
hurling verbal threats about wanting to hurt someone. You are fearful as the
last time you encountered a patient such as this you were assaulted and
ended up needing several stitches. Your decision would be to:
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