Question 1

In caring for a patient with major depression, the nurse knows that the patient needs:

Accepted Answer

Structured interactions provide a sense of predictability and security for patients with major depression, helping them to manage their symptoms more effectively at the beginning of treatment.

Question 2

Which of the following would be the most effective intervention for a depressed patient?

Accepted Answer

Establishing one small, achievable goal can provide a sense of accomplishment and can be a positive step in managing depression. It's a practical approach that can help improve mood and motivation.

Question 3

Your depressed patient is just started on duloxetine (Cymbalta). Which statement by the spouse tells you that family teaching has been effective?

Accepted Answer

Duloxetine (Cymbalta) is an antidepressant that can take several weeks to show its full effects. Immediate changes are not expected, and there is no need for weekly blood tests or dietary restrictions related to aged cheese, which is more relevant to MAOI antidepressants.

Question 4

The nurse knows that the two factors that often differentiate major depression from dysthymic disorder are:

Accepted Answer

Severity and duration of symptoms differentiate major depression from dysthymic disorder. Major depression involves severe symptoms that typically last at least two weeks, while dysthymic disorder involves less severe symptoms that last for at least two years in adults or one year in children and adolescents.

Question 5

Light therapy has been shown to be effective in treating patients with:

Accepted Answer

Light therapy is primarily known for its effectiveness in treating Major Depression with Seasonal Pattern, formerly known as Seasonal Affective Disorder (SAD), where individuals experience depressive episodes during certain seasons of the year, typically in the winter months when there is less natural sunlight.

Question 6

You are caring for an older adult who is recently widowed. She says, "No one cares if I die. Everyone I ever loved is dead." What is the best response?

Accepted Answer

Acknowledging the patient's feelings and reflecting them back is a therapeutic communication technique. It shows empathy and understanding without dismissing or challenging the patient's current emotional state.

Question 7

Your patient with major depression sits in her room for hours staring out the window. Which of the following would be the most appropriate intervention?

Accepted Answer

Sitting with the patient and gently offering availability to help is a supportive and non-intrusive approach that acknowledges the patient's current state while providing a sense of safety and availability for interaction, which is crucial in the care of individuals with major depression.

Question 8

Annie has been diagnosed as having dysthymic disorder. The nurse knows that symptoms of this disorder include (select all that apply):

Accepted Answer

Dysthymic disorder, also known as persistent depressive disorder, is characterized by a long-term (two years or more) depressed mood. Symptoms include low self-esteem, difficulty making decisions, and disturbances in sleep patterns. Hallucinations and periods of euphoria are not typical symptoms of dysthymic disorder.

Question 9

When your patient says, "I am depressed," what is the best response?

Accepted Answer

Asking the patient to elaborate on their feelings and experiences shows empathy and encourages open communication, which is crucial for understanding and addressing their concerns effectively.

Question 10

Your patient has been taking a selective serotonin reuptake inhibitor (SSRI) antidepressant for 6 weeks. On arrival at the clinic, which observation would indicate a positive outcome from the medication?

Accepted Answer

Selective serotonin reuptake inhibitors (SSRIs) are a class of drugs typically used to treat depression and anxiety. A positive outcome from taking an SSRI would be an improvement in overall functioning and well-being. If a patient arrives neatly dressed, it may indicate an improvement in self-care and mood, suggesting that the medication is having a positive effect. The other options (A, B, C) are more indicative of side effects or lack of improvement.

Question 11

Some medications such as tricyclics cause blurred vision. What is the cause of this effect?

Accepted Answer

Tricyclic antidepressants have anticholinergic effects, which can lead to various side effects including blurred vision. This is because anticholinergic drugs block the action of acetylcholine, which can interfere with the normal operation of the muscles and functions in the eye, leading to difficulties in focusing or blurred vision.

Question 12

Which of the following meal choices indicates the patient understands the diet restrictions when taking a monoamine oxidase inhibitor (MAOI)?

Accepted Answer

Patients taking MAOIs must avoid foods high in tyramine to prevent hypertensive crises. Choice C (Fried fish, rice, and cola) is safe as it does not contain high-tyramine foods or alcohol, unlike the other options.

Question 13

Your patient takes tranylcypromine for depression. Which of the following is most likely to indicate dietary restrictions have not been followed?

Accepted Answer

Tranylcypromine is a monoamine oxidase inhibitor (MAOI) used in the treatment of depression. Patients taking MAOIs must follow dietary restrictions to avoid foods high in tyramine, as this can lead to a hypertensive crisis. Failure to follow these restrictions is most likely indicated by a hypertensive crisis.

Question 14

Patients with major depression commonly display signs of:

Accepted Answer

Patients with major depression often experience feelings of worthlessness, which is a common symptom of the disorder. This can include persistent feelings of guilt, shame, and a strong sense of inadequacy.

Quiz 11: Depressive Disorders