NURS 663 Exam 1 – Questions With Solutions
Patient comes in with symptoms of mania followed by periods of
depression; what is it? ✔️Ans - bipolar 1
patient comes in with hypomania/regular mood (euthymic) followed by
periods of depression, what is it? ✔️Ans - bipolar 2
how many symptoms of mania must you have to have "full" mania?
✔️Ans - seven of thirteen
what is the difference between mania and hypomania? ✔️Ans -
hypomania has less severe symptoms; 3 symptoms over shorter period of
time (hypomania)
Cyclothymia ✔️Ans - a disorder that consists of mood swings from
moderate depression to hypomania and lasts two years or more
moods are always irregular- not ever to a full extreme
Dysthymia ✔️Ans - a form of depression that is not severe enough to be
diagnosed as major depression
"eeyore" always kind of down and depressed
SIADH ✔️Ans - syndrome of inappropriate antidiuretic hormone
will retain water
hyponatremia will be observed
what is something you should watch out for if a patient is on multiple
antidepressants? ✔️Ans - SIADH
what medical problems mimic mood disorders? ✔️Ans - hypothyroid-
depression
hyperthyroid- mania
,involuntary admission ✔️Ans - hurt yourself
hurt someone else
inability to care for self
Carbamazepine (Tegretol) ✔️Ans - mood stabilizer
indication: bipolar disorder
major side effects:
CYP 450: (inducer- speeds up metabolism of other drugs)
patient education:
what 3 medications must have blood draws associated with them? ✔️Ans
- carbamazepine, lithium, valproic acid
Mood Disorder Questionnaire ✔️Ans - Screens for Bipolar Disorder
7+ is a positive screening
4-5 might be hypomania
how is the PHQ-9 scored ✔️Ans - 1-4 minimal depression
5-9 mild depression
10-14 moderate depression
15-19 moderately severe
20 + severe
PHQ-9 ✔️Ans - assessment that evaluates the degree of depression
What is the DSM criteria for Major Depressive Disorder? ✔️Ans - **no
history of mania, hypo, or mixed symptoms
symptoms >2 weeks
must have: sadness, anhedonia (loss pleasure/interest)
, 4 of following: - appetite/sleep changes, psychomotor retardation, lack of
energy, guilt/worthlessness, issues w/ concentration, thoughts
suicide/death
What are the "frequency" modifiers for MDD? ✔️Ans - episodic:
symptoms dissipate over time
recurrent: likely to reappear in future
subclinical: sadness + 3 symptoms > 10 days (full criteria not met)
how is the severity of depression rated? ✔️Ans - - Mild: no suicidal
thoughts/death wishes
- Moderate: some thoughts of death/self-harm
- Severe: plan/attempted
what other modifiers might be present with diagnosis of MDD? ✔️Ans -
- With psychotic features: hallucinations, paranoia
- In partial remission: some symptoms still present, but full criteria not
met; period without any significant
symptoms lasting less than 2 months
- In full remission: no signs/symptoms >2 months
- Unspecified: symptoms vague, hard to tell
DSM 5 for bipolar I disorder ✔️Ans - depression + mania
what is the #1 predictor of suicide? ✔️Ans - Hopelessness and
loneliness
what are risk factors for suicide? ✔️Ans - - Gender: men are more likely
to complete suicide
- Age: men 45 years +; women 55 years +
o Suicide is the 3rd leading cause of death in 15-24-year-olds
- Race: Caucasian, Native American, Alaskan native, and immigrants
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