Question 1

A depressed client reports to the nurse a history of divorce,job loss,family estrangement,and cocaine abuse.According to learning theory,which is the cause of this client's symptoms?

Accepted Answer

According to learning theory, depression can be seen as a result of repeated failures. This perspective suggests that experiencing continuous failures or negative outcomes can lead to learned helplessness, where the individual feels unable to change their situation, potentially leading to depression.

Question 2

A client is admitted to the psychiatric unit with a diagnosis of MDD.The client is unable to concentrate,has no appetite,and is experiencing insomnia.Which should be included in this client's plan of care?

Accepted Answer

A simple, structured daily schedule with limited choices of activities can help a client with MDD who is struggling with concentration and appetite, as well as insomnia, to create a sense of predictability and stability in their day-to-day routine. Too many or complex choices and socialization opportunities may lead to overwhelming feelings of indecision and social anxiety. Mandatory activities may also increase feelings of pressure and may not be effective in promoting engagement in clients experiencing severe symptoms.

Question 3

A client who is diagnosed with MDD asks the nurse what causes depression.Which is the nurse's most accurate response?

Accepted Answer

While neurotransmitter deficiencies and genetics may contribute to depression, the exact cause is not yet fully understood. A combination of factors, including environmental and biochemical influences, may contribute to the development of depressive disorders. Option C and D are not accurate explanations for the cause of depression.

Question 4

A psychiatrist prescribes an MAOI for a client.Which foods should the nurse teach the client to avoid?

Accepted Answer

MAOIs interact with tyramine, which is found in high concentrations in aged, fermented, pickled, smoked, and processed foods such as pepperoni pizza and red wine. Consuming these foods while taking MAOIs can lead to hypertensive crisis.

Question 5

A client is diagnosed with Persistent Depressive Disorder (PDD)(dysthymia).Which should the nurse classify as an affective symptom of this disorder?

Accepted Answer

A gloomy and pessimistic outlook on life is a classic affective symptom of PDD. Social isolation with a focus on self may be a behavioral symptom, low energy level may be a vegetative symptom, and difficulty concentrating may be a cognitive symptom.

Question 6

The nurse is implementing a one-on-one suicide observation level with a client diagnosed MDD.The client states,"I'm feeling a lot better,so you can stop watching me.I have taken up too much of your time already." Which is the best nursing reply?

Accepted Answer

The nurse's priority is the safety of the client. By stating that they will continue to observe the client because they are concerned about their safety, the nurse is acknowledging the client's request while also emphasizing the importance of their safety. Option A may come across as dismissive and Option C may make the client feel like their request is not important. Option D is also noncommittal and may make the client feel like they are being passed off to someone else to make a decision.

Question 7

An isolative client was admitted 4 days ago with a diagnosis of MDD.Which nursing statement would best motivate this client to attend a therapeutic group being held in the milieu?

Accepted Answer

The statement "I'll walk with you to the day room. Group is about to start" is the best choice as it shows support and encouragement for the client to attend the group. It also gives the client a sense of structure and routine, which can be beneficial for individuals with depression. Option A assumes the client will eventually be ready for the group, while Option C sympathizes with the client's feelings of hopelessness. Option D may be effective for some clients, but for an isolative client who is resistant to attending group, walking with them to the day room is more likely to be effective.

Question 8

The nurse reviews the laboratory data of a 29-year-old client suspected of having MDD.Which laboratory value would potentially rule out this diagnosis?

Accepted Answer

A TSH level of 6.2 U/mL may indicate hypothyroidism, which can cause symptoms similar to depression. Therefore, ruling out hypothyroidism is important in diagnosing MDD. The other laboratory values fall within normal ranges and would not rule out a diagnosis of MDD.

Question 9

What is the priority reason for the nurse to perform a full physical health assessment on a client admitted with a diagnosis of MDD?

Accepted Answer

Depression may be a symptom of several medical conditions such as thyroid abnormalities or cancer. Conducting a full physical health assessment will help rule out any underlying medical conditions that may be contributing to the depression or impacting the client's treatment.

Question 10

A client diagnosed with MDD states,"I've been feeling 'down' for 3 months.Will I ever feel like myself again?" Which statement by the nurse best assesses this client's affective symptoms?

Accepted Answer

Option D directly asks the client to elaborate on their feeling of being "down," which can help to assess their emotional state and symptoms more accurately. Option A asks about physical diagnoses, which may not be relevant to the client's current emotional state. Option B asks about the client's history but does not address current symptoms. Option C may be true for some individuals but does not address the client's specific emotional state or symptoms.

Question 11

A confused client has recently been prescribed sertraline (Zoloft).The client's spouse is taking paroxetine (Paxil).The client presents with restlessness,tachycardia,diaphoresis,and tremors.Which complication does the nurse suspect,and what could be its possible cause?

Accepted Answer

The symptoms described suggest serotonin syndrome, which can occur when two or more serotonergic medications are taken together, such as two different SSRIs. It is important to monitor and educate clients and their families about the potential risks of taking multiple medications that affect serotonin levels.

Question 12

The nurse admits an older client who is experiencing memory loss,confused thinking,and apathy.A psychiatrist suspects depression.What is the rationale for performing a mini-mental status examination?

Accepted Answer

The mini-mental status examination is used to assess cognitive functioning and can help diagnose neurocognitive disorders such as dementia, Alzheimer's disease, and other conditions that can cause memory and cognitive impairment. It is not used to diagnose bipolar disorder, schizophrenia, or personality disorders.

Question 13

Which client statement expresses typical underlying feelings of clients diagnosed with MDD?

Accepted Answer

Clients with Major Depressive Disorder often feel hopeless and helpless, leading them to believe that nothing can help them feel better. They may experience a pervasive sense of sadness that is difficult to shake, leading to a lack of motivation or energy. A client who makes statement D may be indicating that they are struggling with feelings of hopelessness and despair, which are common symptoms of MDD.

Question 14

A client who has been taking fluvoxamine (Luvox)without significant improvement asks the nurse,"I heard about something called MAOI.Can't my doctor add that to my medications?" Which is the most appropriate nursing reply?

Accepted Answer

The combination of an MAOI and fluvoxamine can lead to a potentially life-threatening hypertensive crisis. Therefore, it is not appropriate to recommend this combination to the client. Option A is incorrect as delirium tremens is associated with alcohol withdrawal, not this combination of medications. Option C is incorrect as there is no evidence to support the combination of these two drugs. Option D is incorrect as the cost of medication is not the primary concern in this situation.

Question 15

The nurse assesses a client suspected of having MDD.Which client symptom would eliminate this diagnosis?

Accepted Answer

Major Depressive Disorder (MDD) is characterized by a persistent feeling of sadness or a lack of interest in external stimuli. The symptoms listed in options A, B, and C (being disheveled and malodorous, refusing to interact with others, and being unable to feel any pleasure) are consistent with depression. However, option D describes behaviors (maxing out charge cards and exhibiting promiscuous behaviors) that are more characteristic of a manic episode, which would not eliminate but rather suggest a different diagnosis, such as Bipolar Disorder, not MDD.

Question 16

A client is diagnosed with Major Depressive Disorder (MDD).Which nursing diagnosis should the nurse assign to the client to address a behavioral symptom of this disorder?

Accepted Answer

The behavioral symptom described in the question is social isolation, which is best addressed by the nursing diagnosis of Social isolation R/T poor self-esteem AEB secluding self in room. The other answer options do not address this specific behavioral symptom.

Question 17

The nurse is providing counseling to clients diagnosed with MDD.The nurse chooses to help the clients alter their mood by learning how to change the way they think.The nurse is functioning under which theoretical framework?

Accepted Answer

The nurse is helping clients alter their mood by changing the way they think, which is a key component of cognitive theory. Psychoanalytic theory focuses on unconscious conflicts and early childhood experiences, while interpersonal theory focuses on the client's relationships with others. Behavioral theory emphasizes the role of reinforcements and consequences in shaping behavior.

Question 18

The nurse is planning care for a child who is experiencing depression.Which medication is approved by the U.S.Food and Drug Administration (FDA)for the treatment of depression in children and adolescents?

Accepted Answer

Fluoxetine (Prozac) is approved by the FDA for the treatment of depression in children and adolescents. While other antidepressants may be used off-label for this purpose, only Fluoxetine has FDA approval for use in this population.

Question 19

A newly admitted client is diagnosed with MDD with suicidal ideations.Which is the priority nursing intervention for this client?

Accepted Answer

The priority nursing intervention for a client with MDD with suicidal ideations is careful and unobtrusive observation on the basis of assessed data at varied intervals around the clock to ensure the client's safety. This is done to assess and monitor the client's mood, behavior, and level of suicidal ideation. It is important to ensure the client's safety before any other interventions can be implemented.

Question 20

Which client information does the nurse need to assess prior to initiating medication therapy with phenelzine (Nardil)?

Accepted Answer

Phenelzine (Nardil) is a monoamine oxidase inhibitor (MAOI) used to treat depression. It is crucial for the nurse to assess the client's cognitive ability to understand information about the medication, as MAOIs have significant dietary and drug interaction restrictions that the client must comprehend to avoid potentially dangerous side effects.

Quiz 25: Depressive Disorders