Scales Assignment Name: _______________________________________ Date:_________________ Hamilton Anxi

Scales Assignment Name: _______________________________________ Date:_________________ Hamilton Anxiety Rating Scale (HAM-A) 1. What does the score of the patient on the provided HAM-A indicate? a. No anxiety b. Mildly severe anxiety c. Mildly to moderately severe anxiety d. Moderately to severe anxiety 2. True or false. The HAM-A is completed by the patient? a. True b. False Cornell Scale for Depression in Dementia (CSDD) 3. What does the score of the patient on the provided CSDD indicate? a. No depression b. Probably major depressive episode c. Definite major depressive episode 4. Which sign or symptom was unable to be evaluated as indicated on the CSDD? a. Multiple physical complaints b. Lack of energy c. Suicide d. Pessimism Patient Health Questionnaire – 9 (PHQ-9) 5. What does the score of the patient on the provided PHQ-9 indicate? a. Minimal depression b. Mild depression c. Moderate depression d. Moderately severe depression e. Severe depression 6. How difficult have the depressive symptoms made it for this patient to function at work, home, and in interpersonal relationships? a. Not difficult at all b. Somewhat difficult c. Very difficult d. Extremely difficult 7. Is this patient having suicidal thoughts? a. No, not at all b. Yes, several days c. Yes, more than half the days d. Yes, nearly every day Edinburgh Postnatal Depression Scale (EPDS) The EPDS is validated in both pregnancy and postpartum (peripartum). The EPDS is the preferred scale in peripartum women because it does not ask or carefully asks questions about the physical symptoms of depression that are common and expected in the peripartum, like changes in sleep, appetite, and energy. 8. What does the score of the patient on the provided EPDS indicate? a. No risk for perinatal depression b. Unlikely perinatal depression c. Likely perinatal depression d. Postpartum psychosis 9. Did this patient report having suicidal thoughts? a. No b. Yes, hardly ever c. Yes, sometimes d. Yes, quite often 10. What intervention would be best for this patient? a. None, she is not having any symptoms b. Send her home because the provider c. Complete a suicide risk assessment d. Take her baby from her and call 911 Geriatric Depression Scale (GDS) 11. What does the score of the patient on the provided GDS indicate? a. No depression b. Suggests depression c. Suggests dementia 12. Does the patient feel helpless? a. Yes b. No c. Several days d. More than half of the days Montgomery and Asberg Depression Rating Scale (MADRS) 13. What does the score of the patient on the provided MADRS indicate? a. No symptoms b. Mild depression c. Moderate depression d. Severe depression 14. Which symptom is the patient experiencing most severely? a. Difficulty concentrating b. Instability to feel c. Lassitude d. Inner tension Generalized Anxiety Disorder Assessment (GAD-7) 15. What does the score of the patient on the provided GAD-7 indicate? a. Minimal anxiety b. Mild anxiety c. Moderate anxiety d. Severe anxiety 16. Which on the GAD-7 would require follow up? a. 2 b. 4 c. 6 d. 7 17. How difficult have the anxious symptoms made it for this patient to function at work, home, and in interpersonal relationships? a. Not difficult at all b. Somewhat difficult c. Very difficult d. Extremely difficult Screen for Child Anxiety Related Disorders (SCARED) – Child Version Note that parent version is also included for review 18. What does the total score of the patient on the provided SCARED – Child Version indicate? a. No anxiety b. Anxiety disorder 19. Which of the following disorders does the scale indicate that further assessment is not needed? a. Panic Disorder/Somatic Symptoms b. Generalized Anxiety Disorder c. Separation Anxiety Disorder d. Social Anxiety Disorder e. School avoidance 20. The SCARED – Child Version assesses symptoms over what length of time? a. 1 week b. 2 weeks c. 3 months d. 1 year PTSD Checklist for DSM-5 (PCL-5) 21. What does the score of the patient on the provided PCL-5 indicate? a. No further screening or assessment is needed b. Provisional diagnosis of PTSD c. Definite PTSD diagnosis 22. The provider wants to know if the patient is experiencing avoidance symptoms. Which questions on the PCL-5 measure avoidance symptoms? a. 1-5 b. 6-7 c. 8-14 d. 15-20 23. The provider wants to know if the patient is experiencing negative alterations in cognition and mood. Which questions on the PCL-5 measure negative alterations in cognition and mood? a. 1-5 b. 6-7 c. 8-14 d. 15-20 Dissociative Experiences Scale – II (DES) 24. What is the DES score of this patient? a. 2.92 b. 8.2 c. 29.28 d. 82 25. What percent of the time does the patient reports being in a familiar place but finding it strange and unfamiliar? a. 0% b. 10% c. 40% d. 50% 26. True or false? It is very likely this patient has dissociative identify disorder. a. True b. False 27. What is the average DES score in research of eating disorder populations? a. 5.4 b. 7.0 c. 15.8 d. 31 Positive and Negative Syndrome Scale (PANSS) 28. Which symptom is the patient experiencing least severely? a. Guilt b. Conceptual disorganization c. Poor rapport d. Active social avoidance 29. What is the composite scale score for this patient? a. -9 b. 31 c. 40 d. 71 30. Does this patient have more positive or negative symptoms? a. Positive b. Negative c. Equal amounts of both VAMC Saint Louis University Mental Status Examination (SLUMS) 31. What does the score of the patient on the provided SLUMS indicate? a. Normal b. Mild neurocognitive disorder c. Dementia 32. If a patient scored a 25 with an 8th grade education, what would the score indicate? a. Normal b. Mild neurocognitive disorder c. Dementia 33. If a patient scored a 25 with a high school education, what would the score indicate? a. Normal b. Mild neurocognitive disorder c. Dementia Quality of Life Scale (QOL) 34. The article by Burckhardt and Anderson (2003) indicates that the average total QOL score for a health population is? a. 60 b. 70 c. 80 d. 90 35. The article by Burckhardt and Anderson (2003) indicates that the average total QOL score of 70 is common in which disease group? a. Rheumatoid arthritis b. Urinary incontinence c. Fibromyalgia d. Chronic obstructive pulmonary disease Adverse Childhood Experience (ACE) Questionnaire 36. Does the patient believe that their adverse experiences has impacted their health? a. No, not much b. Yes, some c. Yes, a lot 37. Did the patient report living with someone who went to jail or prison before age 18? a. Yes b. No Parent Version of Young Mania Rating Scale (P-YMRS) 38. The score of the patient on the provided P-YMRS is consistent with? a. Depression b. Hypomania c. Mania d. Cyclothymia NICHQ – Vanderbilt Assessment Scale – Parent Informant Note that these were scanned in the wrong order. Note at the top if it indicates Assessment Scale or Follow-up in reverse bold. The teacher informant scale was also included for review. 39. The patient meets criteria on the Assessment Scale for which of the following? (select all that apply) a. Predominately Inattentive Subtype of ADHD b. Predominately Hyperactive/Impulsive Subtype of ADHD c. ADHD Combined Inattention/Hyperactivity d. Oppositional-Defiant Disorder e. Conduct Disorder f. Anxiety/Depression 40. The Average Performance Score from the assessment to the follow-up decreased by? a. 0.525 b. 1.125 c. 2.625 d. 3.75 41. The Total Symptom Score from the assessment to the follow-up decreased by? a. 5 b. 15 c. 19 d. 34 42. The assessment indicates that the patient has the most difficulty in performance of which of the following? a. Overall school performance b. Reading c. Writing d. Math 43. Which side effects is the patient experiencing? (select all that apply) a. Headache b. Stomachache c. Change of appetite d. Trouble sleeping e. Irritability 44. Based on the change from the assessment to the follow-up, which of the following is indicated? a. No symptom improvement b. Mild symptom improvement c. Significant symptom improvement Adult ADHD Self-Report Scale (ASRS-v1.1) Symptom Checklist 45. A score of 4 on Part B of the ASRS-v1.1 is most consistent with ADHD in adults a. True b. False 46. Which of the following symptoms does the patient indicate has not occurred in the past 6 months? a. Talking too much in social situations b. Misplacing or having difficulty finding things at home or work c. Being distracted by activity or noises d. Leaving seat in meeting or other situation where expected to remain seated Michigan Alcohol Screening Test (MAST) 47. Which score would indicate hazardous drinking or alcohol dependence with further evaluation by a healthcare professional recommended? a. 1 b. 2 c. 4 d. 8 48. How accurate is the MAST in identifying dependent drinkers? a. 25% b. 50% c. 78% d. 98% 49. Has the patient that completed the MAST been arrested more than once for driving under the influence of alcohol? a. Yes b. No Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar) 50. What does the score of the patient on the provided CIWA-Ar indicate? a. No symptoms b. Mild to moderate alcohol withdrawal c. Severe withdrawal 51. What would be the most likely intervention for this patient? a. No intervention is needed at the present time b. Administer IV Ativan c. Administer SL Suboxone d. Discharge the patient from the hospital as symptoms have resolved Clinical Opiate Withdrawal Scale (COWS) 52. What does the score of the patient on the provided COWS at 1600 indicate? a. No withdrawal b. Mild withdrawal c. Moderate withdrawal d. Moderately severe withdrawal e. Severe withdrawal 53. What does the score of the patient on the provided COWS at 0000 indicate? a. No withdrawal b. Mild withdrawal c. Moderate withdrawal d. Moderately severe withdrawal e. Severe withdrawal 54. What is the pulse of the patient on the provided COWS at 2000? a. 94 b. 100 c. 108 d. 118 This is an assignment about SCALES used in mental health – i have trouble with questions 39 and 21-23 . Let me know if you need more information. SCIENCE HEALTH SCIENCE NURSING DNP 664

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