INSTRUCTIONS Evaluation and management of pediatric and adolescent depression
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Evaluation and management of pediatric and adolescent depression
General Purpose: To provide NPs with a review of the diagnosis and management of depression in children and adolescents. Learning Objectives: After reading the preceding article and taking this test, the NP should be able to: 1. Discuss the epidemiology associated with depression in children and adolescents. 2. Describe the signs, symptoms, and diagnostic process for major depressive disorder (MDD) in children and adolescents. 3. Identify treatment options for pediatric and adolescent depression.
1. Males with MDD trend toward more
b. decreased self-esteem.
c. interpersonal problems.
d. negative moods.
2. Which statement about the incidence of MDD is accurate?
a. Middle-to-late adolescence is the most common age for the first episode.
b. The prevalence is estimated to be between 0.4%–2.5% of adolescents.
c. The male-to-female ratio in adolescents is 2:1.
d. The prevalence is approximately 0.4%–8.3% of children.
3. After the onset of MDD, 90% of episodes resolve within
a. 4 to 6 months.
b. 10 to 12 months.
c. 1.5 to 2 years.
d. 3 to 5 years.
4. A diagnosis of depression in children includes an irritable mood with anhedonia for at least
a. 5 days.
b. 7 days.
c. 10 days.
d. 14 days.
5. Compared to adults, adolescents with MDD tend to display more
a. sleep disturbances.
b. behavioral problems.
c. appetite disturbances.
d. problems with energy levels.
6. Youth report internalizing symptoms such as
c. suicidal thoughts.
d. loss of interest.
7. The Pediatric Symptom Checklist
a. identifies depression.
b. costs $75 for the manual and 25 record forms.
c. can confirm the diagnosis of bipolar disorder.
d. assists in a general screening for mental health disorders.
8. The “D” in the HEADSS screening tool stands for
a. Death of a loved one.
d. Deviant behavior.
9. Which statement about suicide assessment is accurate?
a. A prior suicide attempt is a major risk factor.
b. Asking about suicidal ideation increases the risk for suicide.
c. Substance abuse does not increase the risk for suicide.
d. The literature supports the efficacy of safety contracts.
10. What has been associated with 50% of suicides in youth with depression?
a. alcohol use
c. academic difficulties
11. The goal of preventing symptom relapse is appropriate in which phase of treatment?
a. evaluation phase
b. continuation phase
c. maintenance phase
d. acute phase
12. Psychosocial therapy can be used as first-line treatment for
a. mild-to-moderate depression.
b. severe depression.
c. a recurrent episode of mild-to-moderate depression.
d. an acute manic episode.
13. Which intervention is not a principle of cognitive behavioral therapy or interpersonal psychotherapy?
a. making a schedule of realistic goals for each week
b. teaching adolescents to engage in more pleasurable activities
c. incorporating antidepressant medications
d. practicing positive thinking
14. Medication may be considered first-line therapy in an adolescent with MDD and
a. suicidal tendencies.
b. mild appetite changes.
c. a first episode of mild-to moderate depression.
d. identifiable psychosocial stressors causing depression.
15. Which statement about the use of SSRIs in adolescents is accurate?
a. The incidence of suicidal ideation from SSRIs is 8%.
b. The risks outweigh the benefits.
c. The FDA advisory warning decreased the suicide risk in the U.S.
d. Treatment should gradually increase to an optimum therapeutic level.
16. The only FDA-approved drug for treating depression in children under the age of 12 is
17. For patients taking fluoxetine, the NP should be aware that
a. headaches or abdominal discomfort typically subside within a few days.
b. the patient should be seen every 2 weeks for the first month of treatment.
c. an increase in dose is made after 6 weeks.
d. the initial daily starting dose is 10 mg.
18. The patient least likely to need referral for specialist care is the one with
a. mild depression.
b. depression with substance abuse.
c. MDD with a high level of family discord.
d. suicidal ideation.