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Exam (elaborations)

Psychosocial/Psych Questions and Answers (100% Pass)

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  • Psychosocial/Psych

A 76 year-old depressed patient is started on an SSRI. When should another antidepressant be tried if there is no response? 8-12 weeks Most learned authorities agree that if there is no response by 8-12 weeks at a maximal therapeutic dose, a different antidepressant should be tried. The...

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  • November 10, 2024
  • 46
  • 2024/2025
  • Exam (elaborations)
  • Questions & answers
  • Psychosocial/Psych
  • Psychosocial/Psych
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Psychosocial/Psych Questions and
Answers (100% Pass)
A 76 year-old depressed patient is started on an SSRI. When should another

antidepressant be tried if there is no response?


✓ 8-12 weeks



✓ Most learned authorities agree that if there is no response by 8-12

weeks at a maximal therapeutic dose, a different antidepressant

should be tried. The 8-12 week period is the correct time frame

because it will take this long to increase the dose and attempt to

reach maximal dose for therapeutic response. 4-6 weeks is nearing the

appropriate time frame, but this may be too short a period of time to

reach and evaluate therapeutic dose.




Which patient is most likely to exhibit depression related to his illness? A

patient with:




Master01 | October, 2024/2025 | Latest update

, 1|Page | © copyright 2024/2025 | Grade A+

✓ Parkinson's disease



✓ Diseases associated with the central nervous system are associated

with high rates of depression. These include stroke, Parkinson's disease,

multiple sclerosis, and dementia. Other illnesses associated with high

rates of depression are cancer and cardiovascular illnesses like

myocardial infarction. Depression worsens the outcome of any physical

illness.




A patient with an eating disorder may concomitantly exhibit:


✓ Anxiety disorders



✓ Affective disorders, anxiety disorders, and substance abuse issues are

common in patients who have eating disorders. Obsessive-compulsive

disorder is also commonly observed. Patients with eating disorders are

more likely to have a first or second degree relative with an eating

disorder, affective disorder, or alcohol abuse. There is no evidence that

patients with eating disorders exhibit a higher incidence of sleep

disorders or liver disease. Thyroid disease should always be assessed in

patients with eating disorders, but this does not represent the reason for

weight loss when eating disorder is present.




Master01 | October, 2024/2025 | Latest update

, 1|Page | © copyright 2024/2025 | Grade A+

Which criterion below is a criterion for Alzheimer's Disease?


✓ Impairment of executive function



✓ The diagnostic criteria for Alzheimer's disease (AD) was established by

DSM V and other organizations. The criteria are similar. Criteria include

a gradual onset of cognitive decline. A rapid onset usually indicates

another etiology, perhaps, delirium. Other criteria include impairment

of recent memory, difficulty with language or finding words, the

inability to execute skilled motor activities, disturbances of visual

processing or disturbances in executive function that includes abstract

reasoning and concentration. Focal neurologic signs are consistent

with a vascular dementia. Radiologic evidence is not a criterion for

diagnosis, though it may support the diagnosis of AD. There is no

laboratory evidence of AD.




An 80 year old adult has begun to use over the counter diphenhydramine to

help him fall asleep. What common side effect can occur in older adults with

use of this medication?




Master01 | October, 2024/2025 | Latest update

, 1|Page | © copyright 2024/2025 | Grade A+

✓ Next day sleepiness



✓ Diphenhydramine should be avoided in older adults. Diphenhydramine

exhibits potent anti-cholinergic effects in patients who take this, but

especially in older adults. Urinary retention is common (not

incontinence) in older men with benign prostatic hyperplasia, but

retention occurs in women too. Diphenhydramine is contraindicated in

patients with glaucoma. The most serious side effect is cognitive

impairment, like daytime sleepiness. Visual disturbances can occur as

well as annoying side effects like dry mouth and constipation.




A 69 year-old female patient reports feelings of anhedonia for the last month.

What should be part of the nurse practitioner's assessment?


✓ Depression



✓ Anhedonia is the loss of pleasure or interest in things that have always

brought pleasure or interest. If this is the case, this patient should be

screened for depression. Anhedonia is a red flag for depression.




A 70 year-old male patient has an elevated MCV with an anemia. His

triglycerides are 420. What should be suspected?




Master01 | October, 2024/2025 | Latest update

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