Question 1

An older adult client with cardiac disease describes a decline in the amount of sleep and difficulty falling asleep at night.What should the nurse consider is occurring with this client?

Accepted Answer

A) Drastic changes in sleep patterns may be early signs of underlying anxiety and depression and should be investigated and not written off as normal changes of aging. Pain, respiratory disease, and cardiac disease can also interfere with sleep, but sleep pattern disturbances need to be assessed further to determine if there is an underlying psychiatric problem.
B) Drastic changes in sleep patterns may be early signs of underlying anxiety and depression and should be investigated and not written off as normal changes of aging. Pain, respiratory disease, and cardiac disease can also interfere with sleep, but sleep pattern disturbances need to be assessed further to determine if there is an underlying psychiatric problem.
C) Drastic changes in sleep patterns may be early signs of underlying anxiety and depression and should be investigated and not written off as normal changes of aging. Pain, respiratory disease, and cardiac disease can also interfere with sleep, but sleep pattern disturbances need to be assessed further to determine if there is an underlying psychiatric problem.
D) Drastic changes in sleep patterns may be early signs of underlying anxiety and depression and should be investigated and not written off as normal changes of aging. Pain, respiratory disease, and cardiac disease can also interfere with sleep, but sleep pattern disturbances need to be assessed further to determine if there is an underlying psychiatric problem.

Question 2

The nurse observes a client being treated for depression sitting with the head down and avoiding conversation with peers.Which nursing intervention is appropriate for this client?

Accepted Answer

A) An open-ended question encourages more than a one-word response. Depressed clients should be comfortable with a one-to-one interaction prior to other client involvement. A closed-ended question is unlikely to encourage continued communication. Telling the client that if he does not get involved he will become more depressed is not encouraging communication.
B) An open-ended question encourages more than a one-word response. Depressed clients should be comfortable with a one-to-one interaction prior to other client involvement. A closed-ended question is unlikely to encourage continued communication. Telling the client that if he does not get involved he will become more depressed is not encouraging communication.
C) An open-ended question encourages more than a one-word response. Depressed clients should be comfortable with a one-to-one interaction prior to other client involvement. A closed-ended question is unlikely to encourage continued communication. Telling the client that if he does not get involved he will become more depressed is not encouraging communication.
D) An open-ended question encourages more than a one-word response. Depressed clients should be comfortable with a one-to-one interaction prior to other client involvement. A closed-ended question is unlikely to encourage continued communication. Telling the client that if he does not get involved he will become more depressed is not encouraging communication.

Question 3

The nurse overhears a client apologize to the spouse about being ill and leaving tasks at home uncompleted.In addition to this client's reason for hospitalization,the nurse realizes this client is at risk for developing which disease process?

Accepted Answer

A) People who are unusually sensitive to failure to achieve their goals are said to have self-critical traits. These cognitive-personality features increase the likelihood that stressors will lead to depression. There is not enough information to determine if the client will develop osteoporosis, congestive heart failure, or diabetes.
B) People who are unusually sensitive to failure to achieve their goals are said to have self-critical traits. These cognitive-personality features increase the likelihood that stressors will lead to depression. There is not enough information to determine if the client will develop osteoporosis, congestive heart failure, or diabetes.
C) People who are unusually sensitive to failure to achieve their goals are said to have self-critical traits. These cognitive-personality features increase the likelihood that stressors will lead to depression. There is not enough information to determine if the client will develop osteoporosis, congestive heart failure, or diabetes.
D) People who are unusually sensitive to failure to achieve their goals are said to have self-critical traits. These cognitive-personality features increase the likelihood that stressors will lead to depression. There is not enough information to determine if the client will develop osteoporosis, congestive heart failure, or diabetes.

Question 4

The nurse is planning care for a client demonstrating symptoms of depression.When assessing this client,which should the nurse use?

Accepted Answer

A) The Beck Depression Inventory is a series of 21 questions that the client answers in order to self-rate the level of depression. It takes approximately 10 minutes for the client to complete. The nurse can use it to help with the assessment of this client. The Glasgow Coma Scale is not used to assess depression but rather level of responsiveness for neurological conditions. The nurse should not ask family members to answer assessment questions for the client. Assessment of clients with depression is often done in 15- to 20-minute increments because the client usually does not have the energy to talk much longer. For that reason, the nurse should not plan more time with the client to complete the assessment.
B) The Beck Depression Inventory is a series of 21 questions that the client answers in order to self-rate the level of depression. It takes approximately 10 minutes for the client to complete. The nurse can use it to help with the assessment of this client. The Glasgow Coma Scale is not used to assess depression but rather level of responsiveness for neurological conditions. The nurse should not ask family members to answer assessment questions for the client. Assessment of clients with depression is often done in 15- to 20-minute increments because the client usually does not have the energy to talk much longer. For that reason, the nurse should not plan more time with the client to complete the assessment.
C) The Beck Depression Inventory is a series of 21 questions that the client answers in order to self-rate the level of depression. It takes approximately 10 minutes for the client to complete. The nurse can use it to help with the assessment of this client. The Glasgow Coma Scale is not used to assess depression but rather level of responsiveness for neurological conditions. The nurse should not ask family members to answer assessment questions for the client. Assessment of clients with depression is often done in 15- to 20-minute increments because the client usually does not have the energy to talk much longer. For that reason, the nurse should not plan more time with the client to complete the assessment.
D) The Beck Depression Inventory is a series of 21 questions that the client answers in order to self-rate the level of depression. It takes approximately 10 minutes for the client to complete. The nurse can use it to help with the assessment of this client. The Glasgow Coma Scale is not used to assess depression but rather level of responsiveness for neurological conditions. The nurse should not ask family members to answer assessment questions for the client. Assessment of clients with depression is often done in 15- to 20-minute increments because the client usually does not have the energy to talk much longer. For that reason, the nurse should not plan more time with the client to complete the assessment.

Question 5

A nurse educator is teaching a group of student nurses regarding depression,its pathophysiology,and the theories related to the disorder.What statements will the nurse instructor include about the theories of depression? Select all that apply.

Accepted Answer

A) Among the theories of depression, the intrapersonal theory focuses on the theme of loss, either real or symbolic. Also, the learning theory states that individuals learn to be depressed in response to a self-perception of a lack of control over their life experiences. The learning theory also states that individuals with depression typically experience little success in achieving gratification and little positive reinforcement in coping with negative incidents. The cognitive theory states that those who are depressed focus on negative messages in the environment and ignore positive experiences. The gender bias theory suggests that gender socialization differences may be a factor in the higher rate of depression in women.
B) Among the theories of depression, the intrapersonal theory focuses on the theme of loss, either real or symbolic. Also, the learning theory states that individuals learn to be depressed in response to a self-perception of a lack of control over their life experiences. The learning theory also states that individuals with depression typically experience little success in achieving gratification and little positive reinforcement in coping with negative incidents. The cognitive theory states that those who are depressed focus on negative messages in the environment and ignore positive experiences. The gender bias theory suggests that gender socialization differences may be a factor in the higher rate of depression in women.
C) Among the theories of depression, the intrapersonal theory focuses on the theme of loss, either real or symbolic. Also, the learning theory states that individuals learn to be depressed in response to a self-perception of a lack of control over their life experiences. The learning theory also states that individuals with depression typically experience little success in achieving gratification and little positive reinforcement in coping with negative incidents. The cognitive theory states that those who are depressed focus on negative messages in the environment and ignore positive experiences. The gender bias theory suggests that gender socialization differences may be a factor in the higher rate of depression in women.
D) Among the theories of depression, the intrapersonal theory focuses on the theme of loss, either real or symbolic. Also, the learning theory states that individuals learn to be depressed in response to a self-perception of a lack of control over their life experiences. The learning theory also states that individuals with depression typically experience little success in achieving gratification and little positive reinforcement in coping with negative incidents. The cognitive theory states that those who are depressed focus on negative messages in the environment and ignore positive experiences. The gender bias theory suggests that gender socialization differences may be a factor in the higher rate of depression in women.
E) Among the theories of depression, the intrapersonal theory focuses on the theme of loss, either real or symbolic. Also, the learning theory states that individuals learn to be depressed in response to a self-perception of a lack of control over their life experiences. The learning theory also states that individuals with depression typically experience little success in achieving gratification and little positive reinforcement in coping with negative incidents. The cognitive theory states that those who are depressed focus on negative messages in the environment and ignore positive experiences. The gender bias theory suggests that gender socialization differences may be a factor in the higher rate of depression in women.

Question 6

An older adult client receiving pain medication for abdominal discomfort reports no relief of pain and continues to describe multiple somatic complaints.Which action by the nurse is appropriate?

Accepted Answer

A) Major clues to depression in the older adult include multiple somatic complaints and reports of persistent chronic pain and some vague pain. Many older people have more physical than emotional complaints. Therefore, further assessment for depression is warranted. The lab values are not indicated in this case, and obtaining different pain medication would not treat potential psychological problems. The family may also be ineffective in determining the client's psychological need.
B) Major clues to depression in the older adult include multiple somatic complaints and reports of persistent chronic pain and some vague pain. Many older people have more physical than emotional complaints. Therefore, further assessment for depression is warranted. The lab values are not indicated in this case, and obtaining different pain medication would not treat potential psychological problems. The family may also be ineffective in determining the client's psychological need.
C) Major clues to depression in the older adult include multiple somatic complaints and reports of persistent chronic pain and some vague pain. Many older people have more physical than emotional complaints. Therefore, further assessment for depression is warranted. The lab values are not indicated in this case, and obtaining different pain medication would not treat potential psychological problems. The family may also be ineffective in determining the client's psychological need.
D) Major clues to depression in the older adult include multiple somatic complaints and reports of persistent chronic pain and some vague pain. Many older people have more physical than emotional complaints. Therefore, further assessment for depression is warranted. The lab values are not indicated in this case, and obtaining different pain medication would not treat potential psychological problems. The family may also be ineffective in determining the client's psychological need.

Question 7

The nurse is providing care for a client with a history of depression.The client's psychiatrist recommended yoga to the client as a means of treating the depression.The client wants to know how this will help.Which will the nurse include in the response to the client regarding the benefits of yoga in treating depression? Select all that apply.

Accepted Answer

A) Yoga has been found to improve wellness and prevent disorders such as depression. The gentle nature of the exercises allows its use by people in almost any condition. Those who practice yoga on a regular basis report improved life satisfaction, alertness, enthusiasm, and mental and physical energy, all of which are the opposite of the symptoms of depression. Yoga does not specifically increase blood flow to the brain. Yoga does not stimulate the production of serotonin. Short periods of aerobic exercise or longer periods of anaerobic exercise over a period of weeks will raise the level of endorphins, which enhance the feeling of well-being.
B) Yoga has been found to improve wellness and prevent disorders such as depression. The gentle nature of the exercises allows its use by people in almost any condition. Those who practice yoga on a regular basis report improved life satisfaction, alertness, enthusiasm, and mental and physical energy, all of which are the opposite of the symptoms of depression. Yoga does not specifically increase blood flow to the brain. Yoga does not stimulate the production of serotonin. Short periods of aerobic exercise or longer periods of anaerobic exercise over a period of weeks will raise the level of endorphins, which enhance the feeling of well-being.
C) Yoga has been found to improve wellness and prevent disorders such as depression. The gentle nature of the exercises allows its use by people in almost any condition. Those who practice yoga on a regular basis report improved life satisfaction, alertness, enthusiasm, and mental and physical energy, all of which are the opposite of the symptoms of depression. Yoga does not specifically increase blood flow to the brain. Yoga does not stimulate the production of serotonin. Short periods of aerobic exercise or longer periods of anaerobic exercise over a period of weeks will raise the level of endorphins, which enhance the feeling of well-being.
D) Yoga has been found to improve wellness and prevent disorders such as depression. The gentle nature of the exercises allows its use by people in almost any condition. Those who practice yoga on a regular basis report improved life satisfaction, alertness, enthusiasm, and mental and physical energy, all of which are the opposite of the symptoms of depression. Yoga does not specifically increase blood flow to the brain. Yoga does not stimulate the production of serotonin. Short periods of aerobic exercise or longer periods of anaerobic exercise over a period of weeks will raise the level of endorphins, which enhance the feeling of well-being.
E) Yoga has been found to improve wellness and prevent disorders such as depression. The gentle nature of the exercises allows its use by people in almost any condition. Those who practice yoga on a regular basis report improved life satisfaction, alertness, enthusiasm, and mental and physical energy, all of which are the opposite of the symptoms of depression. Yoga does not specifically increase blood flow to the brain. Yoga does not stimulate the production of serotonin. Short periods of aerobic exercise or longer periods of anaerobic exercise over a period of weeks will raise the level of endorphins, which enhance the feeling of well-being.

Question 8

A client prescribed an antidepressant tells the nurse that the pill causes dizziness upon standing or changing position too quickly.Which medication does the nurse suspect the client is taking for the treatment of depression?

Accepted Answer

A) The most common side effect of tricyclic antidepressants is orthostatic hypotension, due to alpha1 blockade on blood vessels. Orthostatic hypotension is not associated with the other medications.
B) The most common side effect of tricyclic antidepressants is orthostatic hypotension, due to alpha1 blockade on blood vessels. Orthostatic hypotension is not associated with the other medications.
C) The most common side effect of tricyclic antidepressants is orthostatic hypotension, due to alpha1 blockade on blood vessels. Orthostatic hypotension is not associated with the other medications.
D) The most common side effect of tricyclic antidepressants is orthostatic hypotension, due to alpha1 blockade on blood vessels. Orthostatic hypotension is not associated with the other medications.

Question 9

A client with a 2-month-old child is experiencing insomnia,mood swings,and crying.Based on this data,which would the nurse anticipate the client would benefit from receiving? Select all that apply.

Accepted Answer

A) The client is demonstrating signs of postpartum depression as evidenced by the mood swings, insomnia, and crying. Treatment for this disorder includes antidepressants and psychosocial interventions. Electroconvulsive therapy would be indicated for some cases of depression but not for postpartum depression. Cognitive-behavioral therapy would be indicated for depression but not postpartum depression. Time management and exercise therapy would not be beneficial for a client experiencing postpartum depression.
B) The client is demonstrating signs of postpartum depression as evidenced by the mood swings, insomnia, and crying. Treatment for this disorder includes antidepressants and psychosocial interventions. Electroconvulsive therapy would be indicated for some cases of depression but not for postpartum depression. Cognitive-behavioral therapy would be indicated for depression but not postpartum depression. Time management and exercise therapy would not be beneficial for a client experiencing postpartum depression.
C) The client is demonstrating signs of postpartum depression as evidenced by the mood swings, insomnia, and crying. Treatment for this disorder includes antidepressants and psychosocial interventions. Electroconvulsive therapy would be indicated for some cases of depression but not for postpartum depression. Cognitive-behavioral therapy would be indicated for depression but not postpartum depression. Time management and exercise therapy would not be beneficial for a client experiencing postpartum depression.
D) The client is demonstrating signs of postpartum depression as evidenced by the mood swings, insomnia, and crying. Treatment for this disorder includes antidepressants and psychosocial interventions. Electroconvulsive therapy would be indicated for some cases of depression but not for postpartum depression. Cognitive-behavioral therapy would be indicated for depression but not postpartum depression. Time management and exercise therapy would not be beneficial for a client experiencing postpartum depression.
E) The client is demonstrating signs of postpartum depression as evidenced by the mood swings, insomnia, and crying. Treatment for this disorder includes antidepressants and psychosocial interventions. Electroconvulsive therapy would be indicated for some cases of depression but not for postpartum depression. Cognitive-behavioral therapy would be indicated for depression but not postpartum depression. Time management and exercise therapy would not be beneficial for a client experiencing postpartum depression.

Question 10

A client being treated for depression reports the desire to get out of bed,shower,eat,and contact friends and family for socialization.Which conclusion regarding the client's behavior is appropriate by the nurse?

Accepted Answer

A) The client reports the desire to get out of bed and is showering, eating, and contacting friends and family members. These are all indications that the client's depression is improving. This is not an indication of risk for harm, denial of the diagnosis, or the need for assistance with activities of daily living.
B) The client reports the desire to get out of bed and is showering, eating, and contacting friends and family members. These are all indications that the client's depression is improving. This is not an indication of risk for harm, denial of the diagnosis, or the need for assistance with activities of daily living.
C) The client reports the desire to get out of bed and is showering, eating, and contacting friends and family members. These are all indications that the client's depression is improving. This is not an indication of risk for harm, denial of the diagnosis, or the need for assistance with activities of daily living.
D) The client reports the desire to get out of bed and is showering, eating, and contacting friends and family members. These are all indications that the client's depression is improving. This is not an indication of risk for harm, denial of the diagnosis, or the need for assistance with activities of daily living.

Question 11

An older adult client tells the nurse about rarely going outdoors in the winter because of a lack of energy or desire.Based on this data,which does the nurse suspect the client is experiencing?

Accepted Answer

A) A decreased exposure to sunlight will reduce the production of serotonin in the brain, and that can cause a type of depression termed seasonal affective disorder. Older individuals are prone to isolation during the winter, so this is a likely explanation for the client's feelings. The nurse does not have enough information to determine if the client is experiencing a side effect of medication or anxiety. Situational depression is a depressive episode that occurs after an identifiable life event.
B) A decreased exposure to sunlight will reduce the production of serotonin in the brain, and that can cause a type of depression termed seasonal affective disorder. Older individuals are prone to isolation during the winter, so this is a likely explanation for the client's feelings. The nurse does not have enough information to determine if the client is experiencing a side effect of medication or anxiety. Situational depression is a depressive episode that occurs after an identifiable life event.
C) A decreased exposure to sunlight will reduce the production of serotonin in the brain, and that can cause a type of depression termed seasonal affective disorder. Older individuals are prone to isolation during the winter, so this is a likely explanation for the client's feelings. The nurse does not have enough information to determine if the client is experiencing a side effect of medication or anxiety. Situational depression is a depressive episode that occurs after an identifiable life event.
D) A decreased exposure to sunlight will reduce the production of serotonin in the brain, and that can cause a type of depression termed seasonal affective disorder. Older individuals are prone to isolation during the winter, so this is a likely explanation for the client's feelings. The nurse does not have enough information to determine if the client is experiencing a side effect of medication or anxiety. Situational depression is a depressive episode that occurs after an identifiable life event.

Question 12

A client with depression is receiving electroconvulsive therapy (ECT).Which interventions should the nurse plan when caring for this client? Select all that apply.

Accepted Answer

A) Care of the client recovering from electroconvulsive therapy includes placing in the lateral recumbent position to facilitate drainage and to prevent aspiration and to maintain nothing by mouth until fully awake. The supine with head flat position can lead to aspiration. The client does not need intravenous fluids for 8 hours after the procedure. Providing oral fluids when not fully awake can lead to aspiration.
B) Care of the client recovering from electroconvulsive therapy includes placing in the lateral recumbent position to facilitate drainage and to prevent aspiration and to maintain nothing by mouth until fully awake. The supine with head flat position can lead to aspiration. The client does not need intravenous fluids for 8 hours after the procedure. Providing oral fluids when not fully awake can lead to aspiration.
C) Care of the client recovering from electroconvulsive therapy includes placing in the lateral recumbent position to facilitate drainage and to prevent aspiration and to maintain nothing by mouth until fully awake. The supine with head flat position can lead to aspiration. The client does not need intravenous fluids for 8 hours after the procedure. Providing oral fluids when not fully awake can lead to aspiration.
D) Care of the client recovering from electroconvulsive therapy includes placing in the lateral recumbent position to facilitate drainage and to prevent aspiration and to maintain nothing by mouth until fully awake. The supine with head flat position can lead to aspiration. The client does not need intravenous fluids for 8 hours after the procedure. Providing oral fluids when not fully awake can lead to aspiration.
E) Care of the client recovering from electroconvulsive therapy includes placing in the lateral recumbent position to facilitate drainage and to prevent aspiration and to maintain nothing by mouth until fully awake. The supine with head flat position can lead to aspiration. The client does not need intravenous fluids for 8 hours after the procedure. Providing oral fluids when not fully awake can lead to aspiration.

Question 13

An older adult client is scheduled for electroconvulsive therapy (ECT)for the treatment of depression.Which instructions will the nurse include regarding this therapy? Select all that apply.

Accepted Answer

A) The nurse should provide information to the client regarding ECT treatment for depression. ECT will not cure depression. It is often used in conjunction with psychotherapy and medication therapy. Short term memory loss is expected but long term memory loss is not. The treatment is known to help some people who experiencing depression, but not all. The client must be NPO for 4 hour prior to receiving ECT treatment.
B) The nurse should provide information to the client regarding ECT treatment for depression. ECT will not cure depression. It is often used in conjunction with psychotherapy and medication therapy. Short term memory loss is expected but long term memory loss is not. The treatment is known to help some people who experiencing depression, but not all. The client must be NPO for 4 hour prior to receiving ECT treatment.
C) The nurse should provide information to the client regarding ECT treatment for depression. ECT will not cure depression. It is often used in conjunction with psychotherapy and medication therapy. Short term memory loss is expected but long term memory loss is not. The treatment is known to help some people who experiencing depression, but not all. The client must be NPO for 4 hour prior to receiving ECT treatment.
D) The nurse should provide information to the client regarding ECT treatment for depression. ECT will not cure depression. It is often used in conjunction with psychotherapy and medication therapy. Short term memory loss is expected but long term memory loss is not. The treatment is known to help some people who experiencing depression, but not all. The client must be NPO for 4 hour prior to receiving ECT treatment.
E) The nurse should provide information to the client regarding ECT treatment for depression. ECT will not cure depression. It is often used in conjunction with psychotherapy and medication therapy. Short term memory loss is expected but long term memory loss is not. The treatment is known to help some people who experiencing depression, but not all. The client must be NPO for 4 hour prior to receiving ECT treatment.

Question 14

A client being treated for depression reports feeling better and having more energy.Which is a priority nursing diagnosis for the client at this time?

Accepted Answer

A) The one risk that occurs with successful treatment of a client with depression is that once the depression begins to resolve, the underlying thought of suicide could prevail. With treatment, the client may begin to have more energy to make a plan regarding suicide. The nurse should further assess this client's statement about making plans. The client is not demonstrating low self-esteem, hopelessness, or social isolation.
B) The one risk that occurs with successful treatment of a client with depression is that once the depression begins to resolve, the underlying thought of suicide could prevail. With treatment, the client may begin to have more energy to make a plan regarding suicide. The nurse should further assess this client's statement about making plans. The client is not demonstrating low self-esteem, hopelessness, or social isolation.
C) The one risk that occurs with successful treatment of a client with depression is that once the depression begins to resolve, the underlying thought of suicide could prevail. With treatment, the client may begin to have more energy to make a plan regarding suicide. The nurse should further assess this client's statement about making plans. The client is not demonstrating low self-esteem, hopelessness, or social isolation.
D) The one risk that occurs with successful treatment of a client with depression is that once the depression begins to resolve, the underlying thought of suicide could prevail. With treatment, the client may begin to have more energy to make a plan regarding suicide. The nurse should further assess this client's statement about making plans. The client is not demonstrating low self-esteem, hopelessness, or social isolation.

Question 15

A nurse working on a psychiatric unit is caring for a client who has been diagnosed with major depressive disorder (MDD).Upon assessment of the client,which clinical manifestations does the nurse anticipate?

Accepted Answer

A) MDD is diagnosed when the client experiences either depressed mood or loss of interest most of the day, almost every day, for at least 2 weeks. The depression must be accompanied by at least four symptoms, including: sleep disturbance, fatigue, feelings of guilt or worthlessness, restlessness or psychomotor agitation, and suicidal ideation or attempt.
B) MDD is diagnosed when the client experiences either depressed mood or loss of interest most of the day, almost every day, for at least 2 weeks. The depression must be accompanied by at least four symptoms, including: sleep disturbance, fatigue, feelings of guilt or worthlessness, restlessness or psychomotor agitation, and suicidal ideation or attempt.
C) MDD is diagnosed when the client experiences either depressed mood or loss of interest most of the day, almost every day, for at least 2 weeks. The depression must be accompanied by at least four symptoms, including: sleep disturbance, fatigue, feelings of guilt or worthlessness, restlessness or psychomotor agitation, and suicidal ideation or attempt.
D) MDD is diagnosed when the client experiences either depressed mood or loss of interest most of the day, almost every day, for at least 2 weeks. The depression must be accompanied by at least four symptoms, including: sleep disturbance, fatigue, feelings of guilt or worthlessness, restlessness or psychomotor agitation, and suicidal ideation or attempt.

Question 16

A client who was widowed 3 years ago states,"I don't have many friends.The only people I visit with are some acquaintances at the local bar." Which health problem does the nurse suspect the client is experiencing based on this data?

Accepted Answer

A) Risk factors for the development of depression include a history of the loss of a close family member and substance abuse. Bipolar disorder is characterized by periods of mania with periods of depression. The client is not describing or demonstrating these periods. The client may or may not be experiencing extended grief. There is not enough information to determine if the client is demonstrating sadness.
B) Risk factors for the development of depression include a history of the loss of a close family member and substance abuse. Bipolar disorder is characterized by periods of mania with periods of depression. The client is not describing or demonstrating these periods. The client may or may not be experiencing extended grief. There is not enough information to determine if the client is demonstrating sadness.
C) Risk factors for the development of depression include a history of the loss of a close family member and substance abuse. Bipolar disorder is characterized by periods of mania with periods of depression. The client is not describing or demonstrating these periods. The client may or may not be experiencing extended grief. There is not enough information to determine if the client is demonstrating sadness.
D) Risk factors for the development of depression include a history of the loss of a close family member and substance abuse. Bipolar disorder is characterized by periods of mania with periods of depression. The client is not describing or demonstrating these periods. The client may or may not be experiencing extended grief. There is not enough information to determine if the client is demonstrating sadness.

Question 17

A client is experiencing symptoms of depression.Which laboratory or diagnostic test would be used to determine if depression is being caused by another health problem?

Accepted Answer

A) Heart disorders are not associated with the diagnosis of mood disorders. Cerebral MRI is not used to differentiate mood disorders from physical disorders. Thyroid function tests would be prescribed because thyroid disorders may mimic depression or hypomania. A cerebral angiogram is not used to differentiate mood disorders from physical disorders.
B) Heart disorders are not associated with the diagnosis of mood disorders. Cerebral MRI is not used to differentiate mood disorders from physical disorders. Thyroid function tests would be prescribed because thyroid disorders may mimic depression or hypomania. A cerebral angiogram is not used to differentiate mood disorders from physical disorders.
C) Heart disorders are not associated with the diagnosis of mood disorders. Cerebral MRI is not used to differentiate mood disorders from physical disorders. Thyroid function tests would be prescribed because thyroid disorders may mimic depression or hypomania. A cerebral angiogram is not used to differentiate mood disorders from physical disorders.
D) Heart disorders are not associated with the diagnosis of mood disorders. Cerebral MRI is not used to differentiate mood disorders from physical disorders. Thyroid function tests would be prescribed because thyroid disorders may mimic depression or hypomania. A cerebral angiogram is not used to differentiate mood disorders from physical disorders.

Question 18

The spouse of a client being treated for depression believes the client is not responding to prescribed medication.Which statements by the nurse are appropriate when responding to the client's spouse? Select all that apply.

Accepted Answer

A) A trial-and-error period may be needed to determine what medication is best for the individual. About 30% of clients do not respond to their antidepressant in a trial of 4 to 6 weeks. Do not stop medications without notification of the prescriber. Antidepressant medication is often prescribed for clients with depression symptoms. Stating that the spouse will have to learn to live with the depression is inappropriate.
B) A trial-and-error period may be needed to determine what medication is best for the individual. About 30% of clients do not respond to their antidepressant in a trial of 4 to 6 weeks. Do not stop medications without notification of the prescriber. Antidepressant medication is often prescribed for clients with depression symptoms. Stating that the spouse will have to learn to live with the depression is inappropriate.
C) A trial-and-error period may be needed to determine what medication is best for the individual. About 30% of clients do not respond to their antidepressant in a trial of 4 to 6 weeks. Do not stop medications without notification of the prescriber. Antidepressant medication is often prescribed for clients with depression symptoms. Stating that the spouse will have to learn to live with the depression is inappropriate.
D) A trial-and-error period may be needed to determine what medication is best for the individual. About 30% of clients do not respond to their antidepressant in a trial of 4 to 6 weeks. Do not stop medications without notification of the prescriber. Antidepressant medication is often prescribed for clients with depression symptoms. Stating that the spouse will have to learn to live with the depression is inappropriate.
E) A trial-and-error period may be needed to determine what medication is best for the individual. About 30% of clients do not respond to their antidepressant in a trial of 4 to 6 weeks. Do not stop medications without notification of the prescriber. Antidepressant medication is often prescribed for clients with depression symptoms. Stating that the spouse will have to learn to live with the depression is inappropriate.

Question 19

A nurse is caring for a client who displays symptoms associated with seasonal affective disorder (SAD).Which prescription would the nurse question as inappropriate for this client?

Accepted Answer

A) The nurse would question the order for a selective serotonin reuptake inhibitor (SSRI). This medication is used in the treatment of major depressive disorder (MDD) and dysthymic disorder, not seasonal affective disorder (SAD). All the other orders are appropriate for a client with SAD.
B) The nurse would question the order for a selective serotonin reuptake inhibitor (SSRI). This medication is used in the treatment of major depressive disorder (MDD) and dysthymic disorder, not seasonal affective disorder (SAD). All the other orders are appropriate for a client with SAD.
C) The nurse would question the order for a selective serotonin reuptake inhibitor (SSRI). This medication is used in the treatment of major depressive disorder (MDD) and dysthymic disorder, not seasonal affective disorder (SAD). All the other orders are appropriate for a client with SAD.
D) The nurse would question the order for a selective serotonin reuptake inhibitor (SSRI). This medication is used in the treatment of major depressive disorder (MDD) and dysthymic disorder, not seasonal affective disorder (SAD). All the other orders are appropriate for a client with SAD.

Question 20

A nurse working in a psychiatric hospital is performing a suicide assessment on a client diagnosed with major depressive disorder (MDD).Which actions by the nurse are appropriate when conducting a suicide assessment? Select all that apply.

Accepted Answer

A) When performing a suicide assessment, the nurse should always use direct, not indirect, questioning. The nurse should ask if the client has any thought of suicide and assess the lethality of the suicide plan, if one exists, and whether or not the client will act on these thoughts. Asking about suicide will not "plant the idea" in the client's mind.
B) When performing a suicide assessment, the nurse should always use direct, not indirect, questioning. The nurse should ask if the client has any thought of suicide and assess the lethality of the suicide plan, if one exists, and whether or not the client will act on these thoughts. Asking about suicide will not "plant the idea" in the client's mind.
C) When performing a suicide assessment, the nurse should always use direct, not indirect, questioning. The nurse should ask if the client has any thought of suicide and assess the lethality of the suicide plan, if one exists, and whether or not the client will act on these thoughts. Asking about suicide will not "plant the idea" in the client's mind.
D) When performing a suicide assessment, the nurse should always use direct, not indirect, questioning. The nurse should ask if the client has any thought of suicide and assess the lethality of the suicide plan, if one exists, and whether or not the client will act on these thoughts. Asking about suicide will not "plant the idea" in the client's mind.
E) When performing a suicide assessment, the nurse should always use direct, not indirect, questioning. The nurse should ask if the client has any thought of suicide and assess the lethality of the suicide plan, if one exists, and whether or not the client will act on these thoughts. Asking about suicide will not "plant the idea" in the client's mind.

Quiz 28: Mood and Affect