Deck 16: Depressive Disorders

Question 1

The nurse is preparing a staff education session about depression in adolescents. Which statement by a staff member indicates teaching has been effective?

A) "Adolescents are not likely to suffer from depression."
B) "Depressed adolescents normally seek immediate treatment."
C) "Many symptoms are attributed to normal adjustments of adolescents."
D) "Suicide is not common among depressed adolescents."

Answer 1

"Many symptoms are attributed to normal adjustments of adolescents."

Question 2

Which action should the nurse take when a depressed client refuses electroconvulsive therapy (ECT)?

A) Accept the client's decision
B) Inform the client that the procedure is mandatory
C) Tell the client that the signature verifies informed consent
D) Call the family to receive approval

Answer 2

Accept the client's decision

Question 3

The nurse is preparing an antidepressant medication for a 13-year-old client who is experiencing major depressive disorder. Which FDA-approved medication should the nurse administer?

A) Paroxetine (Paxil)
B) Sertraline (Zoloft)
C) Citalopram (Celexa)
D) Escitalopram (Lexapro)

Answer 3

Escitalopram (Lexapro)

Question 4

Which scale would a nurse practitioner use to assess a depressed client?

A) Zung Depression Scale
B) Hamilton Depression Rating Scale
C) Beck Depression Inventory
D) AIMS Depression Rating Scale

Question 5

The nurse is assisting with electroconvulsive therapy (ECT). What is the rationale for administering 100% oxygen to a client during and after ECT?

A) To prevent brain damage from the electrical impulse of the procedure
B) To prevent decreased blood pressure, pulse, and respiration owing to electrical stimulation
C) To prevent anoxia resulting from medication-induced paralysis of respiratory muscles
D) To prevent blocked airway, resulting from seizure activity

Question 6

The nurse discovers a client has a history of divorce, job loss, family estrangement, and cocaine abuse. Which theory explains the etiology of this client's depressive symptoms?

A) Psychoanalytic theory
B) Object loss theory
C) Learning theory
D) Cognitive theory

Question 7

The nurse performs a full physical health assessment on an older adult client admitted with a diagnosis of major depressive disorder. What is the rationale for the nurse's assessment?

A) The attention during the assessment is beneficial in decreasing social isolation in the elderly.
B) Depression can generate somatic symptoms that can mask actual physical disorders.
C) Physical health complications are likely to arise from antidepressant therapy.
D) Depressed geriatric clients avoid addressing physical health and ignore medical problems.

Question 8

The nurse assesses a client with major depressive disorder. Which assessment finding would the nurse observe?

A) Sadness subsides quickly
B) Promiscuous behaviors
C) Unable to feel any pleasure
D) Excessive spending sprees

Question 9

The nurse is caring for a client with a postpartum emotional disorder. Which postpartum disorder is correctly matched with its presenting symptoms?

A) Baby blues (lack of concentration, agitation, guilt, and an abnormal attitude toward bodily functions)
B) Moderate postpartum depression (irritability, loss of libido, sleep disturbances, expresses concern about inability to care for baby)
C) Maternity blues (overprotection of infant, severe guilt, depressed mood, lack of concentration)
D) Postpartum depression with psychotic features (transient depressed mood, decisive, abnormal fear of child abduction, suicidal ideations)

Question 10

A client is prescribed transdermal selegiline (Emsam) for depressive symptoms. Which action would the nurse take to administer this medication?

A) Apply new patch to the lower abdomen.
B) Apply new patch to inner surface of upper arm.
C) Place new patch on dry, intact skin.
D) Place direct heat to new patch for a tight seal.

Question 11

Which characteristic would help a nurse distinguish between dysthymia and major depressive disorder (MDD)?

A) Dysthymia is associated with the menstrual cycle.
B) Dysthymia is a chronically depressed mood.
C) MDD lasts for at least 2 years.
D) MDD does not have delusions or hallucinations.

Question 12

The client with major depressive episode is experiencing command hallucination for self-harm. Which intervention should be the nurse's priority at this time?

A) Obtaining an order for locked seclusion until client is no longer suicidal
B) Conducting 15-minute checks to ensure safety
C) Placing the client on one-to-one observation while continuing to monitor suicidal ideations
D) Encouraging client to express feelings related to suicide

Question 13

Which highest priority outcome would the nurse add to the plan of care for a depressed client?

A) The client will promise to remain safe.
B) The client will discuss feelings with staff and family by day three.
C) The client will establish a trusting relationship with the nurse.
D) The client will not harm self during hospital stay.

Question 14

The nurse determines that a depressed client is using the cognitive distortion of "automatic thoughts." Which client statement is evidence of the "automatic thought" of discounting positives?

A) "It's all my fault for trusting him."
B) "I don't play games. I never win."
C) "She never visits, because she thinks I don't care."
D) "Growing plants is so easy. Any old fool can grow a rose."

Question 15

The nurse is caring for a client with major depressive disorder who is withdrawn, uncommunicative, and secludes self in room. Which nursing diagnosis should the nurse add to the plan of care?

A) Spiritual distress
B) Social isolation
C) Low self-esteem
D) Powerlessness

Question 16

The depressed client is receiving light therapy. Which instruction would the nurse share with the client?

A) "White LED lights will be used with protective glasses to block ultraviolet rays."
B) "You will sit in front of the light box with your eyes open."
C) "The light sessions will start out at 5 minutes and work up to 30 minute intervals."
D) "Vagal stimulation from the light waves will help release melatonin in the brain."

Question 17

The nurse is teaching the depressed client about bupropion (Wellbutrin). Which statement by the client indicates effective teaching?

A) "I will begin to wear short sleeves when outdoors."
B) "I will not take two pills if I miss a dose."
C) "I will discontinue the medication when my depression is gone."
D) "I will stand up smoothly and quickly to keep my balance."

Question 18

The nurse is preparing a presentation about Beck's cognitive theory. Which cognitive distortion would the nurse include in the teaching session?

A) Negative expectation of the environment
B) Negative expectation of the present
C) Negative expectation of the career
D) Negative expectation of the family

Question 19

Which statement by a client who is beginning tricyclic antidepressant therapy indicates successful teaching?

A) "I will continue to take this medication even if the symptoms have not subsided."
B) "I will start to see results in about 2 weeks."
C) "I will continue to smoke."
D) "I will start to cut down on my alcohol intake and have only one glass of wine at supper."

Question 20

A client is taking phenelzine (Nardil). Which statement by the client should cause the nurse to intervene?

A) "I cannot use over-the-counter medications for my colds."
B) "I have to cut out eating my raisin bran every morning."
C) "I will have to avoid pepperoni pizza when eating with my friends."
D) "I am taking diet pills to lose weight for my friend's wedding."

Question 21

The nurse is teaching about the diagnosis disruptive mood dysregulation disorder (DMDD). Which information should the nurse include? (Select all that apply.)

A) Symptoms include verbal rages or physical aggression toward people or property.
B) Temper outbursts must be present in at least two settings (at home, at school, or with peers).
C) DMDD is characterized by severe recurrent temper outbursts.
D) The temper outbursts are manifested only behaviorally.
E) Symptoms of DMDD must be present for 18 or more months to meet diagnostic criteria.

Question 22

An older adult client has a diagnosis of dysthymic disorder. Which signs and symptoms should the nurse expect the client to exhibit? (Select all that apply.)

A) Sad mood on most days
B) Mood rating of 2 out of 10 for the past 6 months
C) Labile mood
D) Sad mood for the past 3 years after spouse's death
E) Pressured speech when communicating

Question 23

After 5 months of taking nortriptyline (Aventyl) for depressive symptoms, a client reports that the medication doesn't seem as effective as before. Which question should the nurse ask to determine the cause of this problem?

A) "Are you consuming foods high in tyramine?"
B) "How many packs of cigarettes do you smoke daily?"
C) "Do you drink any alcohol?"
D) "When did you last eat yogurt?"

Question 24

____________________ is a pervasive and sustained emotion that may have a major influence on a person's perception of the world.

Question 25

The client experiences sadness and melancholia in September continuing through November. Which factors should a nurse identify as most likely to contribute to the etiology of these symptoms? (Select all that apply.)

A) Gender differences in social opportunities
B) Increased production of melatonin
C) Hyposecretion of cortisol
D) Less exposure to natural sunlight
E) Blockade of histamine reuptake

Question 26

The depressed client is prescribed a monoamine oxidase inhibitor (MAOI). Which statements by the client should indicate to a nurse that the discharge teaching about this medication has been successful? (Select all that apply.)

A) "I'll have to let my surgeon know about this medication before I have my cholecystectomy."
B) "I guess I will have to give up my glass of red wine with dinner."
C) "I'll have to be very careful about reading food labels."
D) "I'm going to drink my caffeinated coffee in the morning."
E) "I'll be sure not to stop this medication abruptly."