Question 1

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

Accepted Answer

Rationale: The nurse should identify drastic temperature and barometric pressure changes,a seasonal increase in social interactions,and/or variations in serotonergic functioning as contributing to the etiology of the client's symptoms.A number of studies have examined seasonal patterns associated with mood disorders and have revealed two prevalent periods of seasonal involvement: spring (March,April,May)and fall (September,October,November).

Question 2

After 6 months of taking imipramine (Tofranil)for depressive symptoms,a client complains that the medication doesn't seem as effective as before.Which question should the nurse ask to determine the cause of this problem?

Accepted Answer

Rationale: Imipramine is a tricyclic antidepressant.Smoking should be avoided while receiving tricyclic therapy.Smoking increases the metabolism of tricyclics,requiring an adjustment in dosage to achieve the therapeutic effect.Alcohol potentiates the effects of antidepressants.Tyramine is only an issue when MAOI medications are prescribed.Concomitant use of St.John's wort and SSRIs,not tricyclics,increases,not decreases the effects of the drug.

Question 3

Order the depressive disorders and their predominant affective symptoms according to level of severity.
________ Dysthymic disorder (pessimistic outlook,low self-esteem)
________ Grief (feelings of anger,anxiety,guilt,helplessness)
________ Major depressive episode (despair,worthlessness,flat affect,apathy,anhedonia)
________ Transient depression (sadness,dejection,feeling downhearted,having "the blues")

Accepted Answer

Rationale: Symptoms of transient depression are not necessarily dysfunctional.Affective symptoms include sadness,dejection,feeling downhearted,having the "blues." Symptoms at the mild level of depression are identified by those associated with uncomplicated grieving.Affective symptoms include denial of feelings,anger,anxiety,guilt,helplessness,hopelessness,sadness,despondency.Dysthymic disorder,which is an example of moderate depression,represents a more problematic disturbance.Affective symptoms include feelings of sadness,dejection,helplessness,powerlessness,hopelessness; gloomy and pessimistic outlook; low self-esteem; difficulty experiencing pleasure in activities.Severe depression is characterized by an intensification of the symptoms described for moderate depression.Examples of severe depression include major depressive episode.Affective symptoms include feelings of total despair,hopelessness,and worthlessness; flat (unchanging)affect,appearing devoid of emotional tone; prevalent feelings of nothingness and emptiness; apathy; loneliness; sadness; inability to feel pleasure. 1.Transient depression (sadness,dejection,feeling downhearted,having "the blues") 2.Grief (feelings of anger,anxiety,guilt,helplessness) 3.Dysthymic disorder (pessimistic outlook,low self-esteem) 4.Major depressive episode (despair,worthlessness,flat affect,apathy,anhedonia)

Question 4

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

Accepted Answer

Rationale: Mood is a pervasive and sustained emotion that may have a major influence on a person's perception of the world.Examples of mood include depression,joy,elation,anger,and anxiety.Affect is described as the emotional reaction associated with an experience.

Question 5

A client is prescribed phenelzine (Nardil).Which of the following statements by the client should indicate to a nurse that discharge teaching about this medication has been successful? (Select all that apply.)

Accepted Answer

Rationale: The nurse should evaluate that teaching has been successful when the client states that phenelzine should not be taken in conjunction with the use of alcohol or foods high in tyramine and should not be stopped abruptly.Phenelzine is an MAOI that can have negative interaction with other medications.The client needs to tell other physicians about taking MAOIs,because of the risk of drug interactions.

Question 6

A nursing instructor is teaching about the new DSM-5 diagnostic category of disruptive mood dysregulation disorder (DMDD).Which of the following information should the instructor include? (Select all that apply.)

Accepted Answer

Rationale: The APA has included a new diagnostic category in the Depressive Disorders chapter of the DSM-5.This childhood disorder is called disruptive mood dysregulation disorder.Criteria for the diagnosis include,but are not limited to,the following.Verbal rages or physical aggression toward people or property; temper outbursts must be present in at least two settings (at home,at school,or with peers).DMDD is characterized by severe recurrent temper outbursts.The temper outbursts are manifested both behaviorally and/or verbally.Symptoms of DMDD must be present for 12,not 18 or more months to meet diagnostic criteria.

Question 7

A nursing home resident has a diagnosis of dysthymic disorder.When planning care for this client,which of the following symptoms should a nurse expect the client to exhibit? (Select all that apply.)

Accepted Answer

Rationale: The nurse should anticipate that a client with a diagnosis of dysthymic disorder would experience a sad mood on most days for more than two years.The essential feature of dysthymia is a chronically depressed mood,which can have an early or late onset.

Quiz 16: Depressive Disorders

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

After 6 months of taking imipramine (Tofranil) for depressive symptoms,a client complains that the medication doesn't seem as effective as before.Which question should the nurse ask to determine the cause of this problem?

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

A client is prescribed phenelzine (Nardil) .Which of the following statements by the client should indicate to a nurse that discharge teaching about this medication has been successful? (Select all that apply.)

A nursing instructor is teaching about the new DSM-5 diagnostic category of disruptive mood dysregulation disorder (DMDD) .Which of the following information should the instructor include? (Select all that apply.)

A nursing home resident has a diagnosis of dysthymic disorder.When planning care for this client,which of the following symptoms should a nurse expect the client to exhibit? (Select all that apply.)