Geriatric Depression Scale
A 76 y/o F presents to the clinic with the following symptoms: insomnia, loss of appetite, social withdrawal, and during her most recent hospitalization, received a nursing diagnosis of risk for ineffective coping. Pt denies self-harm, SI, and HI. Pt lost her spouse of 47 years 11 months ago. Which depression assessment is MOST appropriate?

What is the number one nursing priority during the continuation phase in a person with BP I? What nursing interventions occur during this stage?

A patient presents to the ED with auditory hallucinations. He states, "I can hear the sirens, they are coming for me. I need to hide!" The patient's current pharmocological treatment is Haloperidol (Haldol). Why (or why not) is this a good treatment for this Pt?

What is the #1 most important question a nurse can ask someone who may be experiencing SI?

Are you having thoughts of suicide?
If yes, do you have a plan?
BE DIRECT.

A patient in crisis presents to the ED on July 10th. He wants to admit himself due to "PTSD-related symptoms." He reports increased alcohol abuse, depressed mood, and extreme anxiety since the 4th of July. Upon further investigation of his chart, the Pt's diagnosis of PTSD is secondary to his time serving in the military during the Iraq war. What type of crisis is this patient most likely experiencing and which phase?

No. There was no specification on the longevity of symptoms (must be > 2 weeks) and anhedonia / depressed mood was not reported.
A 17 y/o patient is being cared for on a med-surg floor after an appendectomy. The pt has reported hypersomnia, increased agitation, decreased ability to concentrate, and anergia to the staff. Does the client meet the DSM V criteria to be diagnosed with MDD?

What is the pharmacological first-line treatment for patients with BP I and what education is required with this Rx?

Compare positive and negative signs of Schizophrenia
Positive: hallucinations, delusions, paranoia
Negative: flat affect, lack of energy, inability to enjoy ADL

What are nursing interventions teritiary levels of care in regards to suicide?

Tertiary care occurs after a patient dies by suicide. The primary role of the nurse in tertiary care is supported to significant others following the death of someone by suicide.
-Refer pts to support groups
-Provide emotional care, education on the stages of grief
-preventing copy-cat suicides

What is the focus during the primary level of crisis interventions?

1. Promoting mental health and wellness
2. Identifying effective coping skills
3. Identifying possible triggers and educating on how to avoid them to decrease the likelihood of a crisis situation.

Are you having thoughts of harming yourself (SI) or your baby (HI)?
A G3 T2 P0 A0 L2 mother is being seen at the clinic for her baby's 2-month wellness check. Pt has no hx of postpartum depression with her first pregnancy. Pt is exhibiting signs of agitation towards her baby when she cannot be soothed after her vaccinations. Pt reports insomnia, fatigue, decreased interest in her roles as a mother and is having difficulty following education provided by nursing staff. What is your first screening question for this mother?

A 17 y/o F patient with a Hx of MDD, GAD, and active SI presents to the ED with her parents. In addition to SI, the patients' parents report the patient has not been sleeping, has been violent towards her family, and demands that she "needs to talk to the social worker." Pt is becoming increasingly aggressive the longer the social worker takes. Pt does not expand further on this need. What is this patient likely experiencing and what nursing intervention is necessary?

Name 2 neurobiological effects of Schizophrenia:
1. Dysfxn of GABA interneurons
2. Acetylcholine deficit

You are a nurse at a university's student health center. Your client is an 18 y/o M who has been experiencing an increased level of anxiety since moving in. He reports that to make his anxiety better he tried face timing his family every day between classes. This technique was not effective, and the client states that he goes home 1-2 x/week now, even though his family lives 4 hours away. "It's the only thing that makes me feel better," he states. He reports negative a change in his grades since his anxiety began. What type of crisis is this patient experiencing and in which phase is he in?

A 37 y/o patient with a Hx of GAD, c-PTSD, MDD, and epilepsy has received a referral for ECT to treat her pharmacological resistant MDD. Her first session is tomorrow at 12 pm. What education is a priority?

The 17 y/o Pt has a Hx of hypothyroidism. With this diagnosis, which treatment for BP I is unavailable? What other pharmacological treatment can be initiated next?

Describe the presentation of patients with Schizoid personality disorder.

Which demographic of the population is at the highest risk for death by suicide?

Adult males over the age of 75.

A 44 y/o client with MDD has been prescribed an MAOI 1 week ago due to failed attempts to control symptoms with SSRIs, SNRIs, and Tricyclic Antidepressants. Which statement requires intervention by the nurse?
a. My parents own a Chinese restaurant, we eat there most nights.
b. My sex drive has declined since beginning treatment.
c. I have episodes of nausea and diarrhea 1-2 x/ week
d. I know if I have a cold I need to consult with my physician about OTC treatment options.

Of the following medications, which is an anticonvulsant?
a. Zyprexa
b. Lorazepam
c. Ziprasidone
d. Tegretol

A 24 y/o male presents to the clinic, he has been brought in by his wife. The patient's wife reports that has been experiencing active hallucinations, that are often followed by "periods of social withdrawal" and very little interest in ADLs. The patient has lost the ability to work due to these symptoms that have been present for 5 months. What diagnosis is anticipated?

Schizophreniform disorder. The pt is exhibiting s/s of schizophrenia but has not met the longevity of the diagnosis criteria, which is > 6 months.

Name 3 risk factors that contribute to suicidality and 3 protective factors that aid in prevention of suicide:

A community has been struck by an F5 Tornado. Many people have lost their belongings, homes, and loved ones. The community has designated shelters for those who have lost their homes, has provided mental health professionals trained in crisis management, and has allocated enough food and water to endure the upcoming phases of disaster management. What type of crisis has this community endured and what phase of the disaster management continuum is next?