PMH-C Assessment and Screening 4 — Questions and Answers
Question 1: A nurse completing an EPDS screening notes that a patient answered 'yes, quite often' to item 10. What is the highest priority response?
- Document the response and notify the next available provider
- Immediately conduct a suicide risk assessment (Correct answer)
- Ask the patient to call a crisis line when she gets home
- Administer the full PHQ-9 before taking any action
Correct answer: Immediately conduct a suicide risk assessment
Any positive response to EPDS item 10 (thoughts of self-harm) requires an immediate and direct suicide risk assessment before other clinical steps.
Question 2: Which of the following is the most accurate statement about screening for perinatal mental health conditions?
- A negative screen rules out the presence of a perinatal mood disorder
- Screening identifies risk and is not a diagnosis (Correct answer)
- Screening is only appropriate for patients with a psychiatric history
- The EPDS is the only validated tool for perinatal populations
Correct answer: Screening identifies risk and is not a diagnosis
Screening tools identify individuals who may warrant further evaluation; a positive screen indicates elevated risk, not a confirmed diagnosis.
Question 3: A clinician wants to screen for birth trauma following a complicated delivery. Which tool is most appropriate?
- EPDS
- City Birth Trauma Scale (City BiTS) (Correct answer)
- GAD-7
- MDQ
Correct answer: City Birth Trauma Scale (City BiTS)
The City Birth Trauma Scale (City BiTS) is a validated tool specifically designed to assess PTSD symptoms related to the birth experience.
Question 4: A patient reports she is 'fine' but her EPDS score is 15. How should the clinician proceed?
- Accept the patient's self-report and discharge with routine follow-up
- Explore the discrepancy between the score and self-report through clinical interview (Correct answer)
- Repeat the EPDS in 2 weeks before acting on the score
- Discard the score since patient denial overrides the tool
Correct answer: Explore the discrepancy between the score and self-report through clinical interview
When there is a discrepancy between a patient's verbal report and screening score, the clinician should explore this through direct, compassionate clinical interviewing.
Question 5: Which population-level finding underscores the importance of including fathers and partners in perinatal mental health screening?
- Partners rarely develop depression in the perinatal period
- Paternal perinatal depression affects approximately 10% of fathers and impacts infant development (Correct answer)
- Partner mental health is legally not the responsibility of obstetric providers
- Paternal depression only occurs after maternal depression resolves
Correct answer: Paternal perinatal depression affects approximately 10% of fathers and impacts infant development
Research indicates paternal perinatal depression occurs in about 10% of fathers and is associated with adverse outcomes for children and family functioning.
Question 6: Which of the following barriers most commonly prevents perinatal mental health screening from occurring in obstetric settings?
- Lack of patient interest in being screened
- Time constraints during prenatal visits and unclear follow-up protocols (Correct answer)
- Unavailability of validated screening tools in English
- Insurance refusal to reimburse for mental health screening
Correct answer: Time constraints during prenatal visits and unclear follow-up protocols
Time pressure during prenatal visits combined with unclear clinical pathways for positive screens are among the most commonly cited system-level barriers to routine screening.
Question 7: The Antenatal Risk Questionnaire (ANRQ) is primarily used to assess which type of risk in pregnancy?
- Obstetric complications
- Psychosocial risk factors for perinatal mental health disorders (Correct answer)
- Fetal growth restriction
- Gestational diabetes
Correct answer: Psychosocial risk factors for perinatal mental health disorders
The ANRQ assesses psychosocial risk factors — including past mental health history, social support, and stressors — that predict perinatal mental health disorders.
PMH-C Assessment and Screening 4
A nurse completing an EPDS screening notes that a patient answered 'yes, quite often' to item 10.
What is the highest priority response?