common issues in mental health quiz Flashcards
Match the following. An item can be used more than once.
Most energizing SSRI
Most sedating SSRI
Dose limitation due to potential QT prolongation
Least drug interaction potential
Longest T½
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Correct answers:
Most energizing SSRI – Fluoxetine
Most sedating SSRI – Paroxetine
Dose limitation due to potential QT prolongation – Citalopram
Least drug interaction potential – Escitalopram
Longest T½ – Fluoxetine
You see a 45-year-old woman with major depressive disorder (MDD) who started taking standard dose sertraline one week ago. She returns today with a chief complaint of “not really feeling any better. In fact, I think I might feel worse. I have this on-and-off headache right over my eyes since I started the medication.” Results of physical examination reveal the following: Well-groomed and appropriately dressed for the occasion, PERLA, fundi WNL, CN 2–12 intact, clear, fluid speech. Today, you provide the following advice, choosing two of the following responses.
The sertraline dose is likely inadequate and needs to be increased.
She should be switched to a SNRI such as venlafaxine.
Due to her headache report, the sertraline should be immediately discontinued.
A lag of a number of weeks in the onset of SSRI therapeutic effect is expected.
Frontal headache is a common short-term problem with early SSRI use.
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Correct answers:
- A lag of a number of weeks in the onset of SSRI therapeutic effect is expected.
- Frontal headache is a common short-term problem with early SSRI use.
Ms. Yancy is a 56-year-old woman with a history of depression and has been taking citalopram for about 6 months. Four days ago, she decided to discontinue the citalopram as she states her depressive symptoms have been much improved. Today, she presents with “not feeling well,” with a 2-day history of persistent frontal headache. When assessing Ms. Yancy for additional findings of antidepressant discontinuation syndrome, the NP anticipates that Ms. Yancy will report all of the following except:
Nausea.
Fever.
Flu-like symptoms.
Anxiety.
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Correct answer: Fever
Which of the following tests should be periodically checked while on olanzapine (Zyprexa®)?
BUN and creatinine
Creatine kinase and potassium
Complete blood count and platelet count
Blood sugar and lipid profile
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Correct answer: Blood sugar and lipid profile
Which of the following provides the most accurate information on assessing for alcohol abuse in a 55-year-old man who states, “I drink 5‒6 beers every night but I get to work every day.”
Elevated ALT/AST to ≥6 times upper limit of normal
Positive response to two items on the CAGE questionnaire
Modest RBC macrocytosis
Elevated serum triglycerides
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Correct answer: Positive response to two items on the CAGE questionnaire
The use of opioid analgesia is most appropriate in which of the following clinical situations?
A 40-year-old man with acute low back pain × 2 days
A 28-year-old woman with a 24-hour history of migraine headache
A 48-year-old woman who is 1 day postoperative after abdominal hysterectomy
A 54-year-old woman with 5-year history of fibromyalgia
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Correct answer: A 48-year-old woman who is 1 day postoperative after abdominal hysterectomy
Select components of substance use disorder include all of the following except:
Craving or a strong desire to use the problematic substance.
Over time, diminished effect with the same amount of the substance.
Set of characteristic withdrawal symptoms.
Social or occupational function remains intact.
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Correct answer: Social or occupational function remains intact
