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Mr. Greene is an 85-year-old male placed on a 5150 by the crisis team after his nurse called them. He has taken a fall in his driveway after his dialysis. He has end-stage kidney disease, diabetes, and a history of myocardial infarction 4 years ago. He was living alone until his home health nurse found him crying out in pain, clutching onto his leg in the kitchen. “I’m so tired,” he says.Some yes or no questions on the geriatric depression scale may include (select all that apply):

A.

Do you feel your life is empty?

B.

Are you on a low cholesterol diet?

C.

Have you dropped your activities or interests?

D.

Do you feel happy most of the time?

Question Solution

Correct Answer : A,C,D

Choice A reason:

“Do you feel your life is empty?” is a relevant question on the geriatric depression scale. Feelings of emptiness can indicate depression, especially in older adults who may experience significant life changes and losses.

 

Choice B reason:

“Are you on a low cholesterol diet?” is not a relevant question for assessing depression. This question pertains to dietary habits and cardiovascular health rather than mental health.

 

Choice C reason:

“Have you dropped your activities or interests?” is a pertinent question on the geriatric depression scale. A loss of interest in activities that were once enjoyable is a common symptom of depression.

 

Choice D reason:

“Do you feel happy most of the time?” is a relevant question on the geriatric depression scale. Assessing overall happiness helps identify depressive symptoms, as individuals with depression often report feeling unhappy or sad most of the time.


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Correct Answer is A

Explanation

Choice A reason:

Duloxetine (Cymbalta) is an SNRI antidepressant commonly used for both chronic pain and depression. It works by increasing the levels of serotonin and norepinephrine in the brain, which helps improve mood and alleviate pain. Duloxetine is often prescribed for conditions such as fibromyalgia, diabetic neuropathy, and chronic musculoskeletal pain, in addition to its use in treating major depressive disorder.

Choice B reason:

Sertraline (Zoloft) is an SSRI antidepressant used primarily to treat depression, anxiety disorders, and other mood disorders. While it is effective for these conditions, it is not specifically indicated for chronic pain management.

Choice C reason:

Fluoxetine (Prozac) is another SSRI antidepressant used to treat depression, anxiety disorders, and certain eating disorders. Like sertraline, it is not typically used for chronic pain management.

Choice D reason:

Citalopram (Celexa) is also an SSRI antidepressant used to treat depression. It is not indicated for chronic pain management and is primarily used to improve mood and alleviate symptoms of depression.

Correct Answer is B

Explanation

Choice A reason:

Saying “If you don’t stop this, you are going to get an infection and I will have to call the doctor” is not an effective way to address Tiffany’s behavior. This statement is likely to increase her anxiety and does not help her understand or manage her triggers.

Choice B reason:

Asking “Can you tell me about what increases your anxiety?” is the best approach. This question is open-ended and non-judgmental, encouraging Tiffany to share her thoughts and feelings. Understanding her triggers is essential for developing effective coping strategies and interventions.

Choice C reason:

Ignoring the behavior and asking other questions is not appropriate. It is important to address Tiffany’s anxiety and compulsive behaviors directly to provide appropriate support and interventions.

Choice D reason:

Asking “Why do you keep washing your hands? They are starting to bleed!” is likely to be perceived as critical and may increase Tiffany’s anxiety. It is important to approach the topic with empathy and understanding, focusing on identifying triggers and developing coping strategies.

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