Question 1

A student nurse caring for a patient diagnosed with depression reads in the patient's medical record,"This patient shows vegetative signs of depression." Which nursing diagnoses most clearly relate to the vegetative signs? Select all that apply.

Accepted Answer

Vegetative signs of depression are alterations in body processes necessary to support life and growth,such as eating,sleeping,elimination,and sexual activity.These diagnoses are more closely related to vegetative signs than diagnoses associated with feelings about self.See relationship to audience response question.

Question 2

The admission note indicates a patient diagnosed with major depression has anergia and anhedonia.For which measures should the nurse plan? Select all that apply.

Accepted Answer

Anergia refers to a lack of energy.Anhedonia refers to the inability to find pleasure or meaning in life; thus,planning should include measures to accommodate psychomotor retardation,assist with activities of daily living,and instill hopefulness.Anergia is lack of energy,not excessive energy.Anhedonia does not necessarily imply the presence of guilty ruminations.

Question 3

A disheveled patient with severe depression and psychomotor retardation has not showered for several days.The nurse will:

Accepted Answer

When patients are unable to perform self-care activities,staff must assist them rather than ignore the issue.Better grooming increases self-esteem.Calmly telling the patient to bathe daily and bringing up the issue at a community meeting are punitive.

Question 4

A patient being treated with paroxetine (Paxil)50 mg po daily for depression reports to the clinic nurse,"I took a few extra tablets earlier today and now I feel bad." Which assessments are most critical? Select all that apply.

Accepted Answer

The patient is taking the maximum dose of this SSRI and has ingested an additional unknown amount of the drug.Central serotonin syndrome must be considered.Symptoms include abdominal pain,diarrhea,tachycardia,elevated blood pressure,hyperpyrexia,increased motor activity,and muscle spasms.Central serotonin syndrome may progress to a full medical emergency if not treated early.The patient may have urinary retention,but frequency would not be expected.

Question 5

Transcranial Magnetic Stimulation (TCM)is scheduled for a patient diagnosed with major depression.Which comment by the patient indicates teaching about the procedure was effective?

Accepted Answer

Transcranial Magnetic Stimulation (TCM)treatments take about 30 minutes.Treatments are usually 5 days a week.Patients are awake and alert during the procedure.After the procedure,patients may experience a headache and lightheadedness.No neurological deficits or memory problems have been noted.The patient will be able to care for children.

Question 6

A nurse instructs a patient taking a medication that inhibits the action of monoamine oxidase (MAO)to avoid certain foods and drugs because of the risk of:

Accepted Answer

Patients taking MAO-inhibiting drugs must be on a tyramine-free diet to prevent hypertensive crisis.In the presence of MAOIs,tyramine is not destroyed by the liver and in high levels produces intense vasoconstriction,resulting in elevated blood pressure.

Question 7

A patient diagnosed with major depression began taking escitalopram (Lexapro)5 days ago.The patient now says,"This medicine isn't working." The nurse's best intervention would be to:

Accepted Answer

Escitalopram is an SSRI antidepressant.One to three weeks of treatment is usually necessary before symptom relief occurs.This information is important to share with patients.

Question 8

A nurse is caring for a patient with low self-esteem.Which nonverbal communication should the nurse anticipate from this patient?

Accepted Answer

Nonverbal communication is usually considered more powerful than verbal communication.Downward casted eyes suggest feelings of worthlessness or hopelessness.

Question 9

During a psychiatric assessment,the nurse observes a patient's facial expression is without emotion.The patient says,"Life feels so hopeless to me.I've been feeling sad for several months." How will the nurse document the patient's affect and mood?

Accepted Answer

Mood refers to a person's self-reported emotional feeling state.Affect is the emotional feeling state that is outwardly observable by others.When there is no evidence of emotion in a person's expression,the affect is flat.

Question 10

A patient diagnosed with major depression refuses solid foods.In order to meet nutritional needs,which beverage will the nurse offer to this patient?

Accepted Answer

Milk is the only beverage listed that provides protein,fat,and carbohydrates.In addition,milk is fortified with vitamins.

Question 11

A patient diagnosed with depression repeatedly tells staff,"I have cancer.It's my punishment for being a bad person." Diagnostic tests reveal no cancer.Select the priority nursing diagnosis.

Accepted Answer

A patient diagnosed with depression who feels so worthless as to believe cancer is deserved is at risk for suicide.Safety concerns take priority over the other diagnoses listed.

Question 12

A patient diagnosed with major depression shows vegetative signs of depression.Which nursing actions should be implemented? Select all that apply.

Accepted Answer

The correct options promote a normal elimination pattern.Although excessive intake of stimulants such as caffeine may make the patient feel jittery and anxious,small amounts may provide useful stimulation.No indication exists that processed foods should be restricted.See relationship to audience response question.

Question 13

A patient diagnosed with major depression received six electroconvulsive therapy sessions and aggressive doses of antidepressant medication.The patient owns a small business and was counseled not to make major decisions for a month.Select the correct rationale for this counseling.

Accepted Answer

Recent memory impairment and/or confusion is often present during and for a short time after electroconvulsive therapy.An inappropriate business decision might be made because of forgotten important details.The rationales are untrue statements in the incorrect responses.The patient needing time to reorient to a pressured work schedule is less relevant than the correct rationale.

Quiz 14: Depressive Disorders

A student nurse caring for a patient diagnosed with depression reads in the patient's medical record,"This patient shows vegetative signs of depression." Which nursing diagnoses most clearly relate to the vegetative signs? Select all that apply.

The admission note indicates a patient diagnosed with major depression has anergia and anhedonia.For which measures should the nurse plan? Select all that apply.

A disheveled patient with severe depression and psychomotor retardation has not showered for several days.The nurse will:

A patient being treated with paroxetine (Paxil) 50 mg po daily for depression reports to the clinic nurse,"I took a few extra tablets earlier today and now I feel bad." Which assessments are most critical? Select all that apply.

Transcranial Magnetic Stimulation (TCM) is scheduled for a patient diagnosed with major depression.Which comment by the patient indicates teaching about the procedure was effective?

A nurse instructs a patient taking a medication that inhibits the action of monoamine oxidase (MAO) to avoid certain foods and drugs because of the risk of:

A patient diagnosed with major depression began taking escitalopram (Lexapro) 5 days ago.The patient now says,"This medicine isn't working." The nurse's best intervention would be to: