Deck 28: Mood and Affect

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?

A) Normal signs of cardiac disease
B) Signs of anxiety and depression
C) Normal signs of aging
D) Normal signs of respiratory disease

Answer 1

Signs of anxiety and depression

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?

A) Ask open-ended questions about the client's feelings.
B) Ask the client close-ended questions.
C) Encourage a peer to sit with the client and the nurse.
D) Tell the client that lack of involvement leads to more depression.

Answer 2

Ask open-ended questions about the client's feelings.

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?

A) Osteoporosis
B) Congestive heart failure
C) Diabetes
D) Depression

Answer 3

Depression

Question 4

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

A) More time talking with the client
B) The client's family members, for answering the assessment questions
C) Beck Depression Inventory
D) Glasgow Coma Scale

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.

A) Intrapersonal theory focuses on the theme of loss, either real or symbolic.
B) The sociocultural factor theory states that those who are depressed focus on negative messages in the environment and ignore positive experiences.
C) 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.
D) The sociocultural factor theory suggests that gender socialization differences may be a factor in the higher rate of depression in women.
E) The learning theory states that individuals with depression typically experience little success in achieving gratification and little positive reinforcement in coping with negative incidents.

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?

A) Assessing the client for depression
B) Obtaining an order for different pain medication
C) Contacting the family to talk to the client
D) Reviewing of the client's lab values

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.

A) Promotes alertness and enthusiasm
B) Raises levels of endorphins
C) Stimulates the production of serotonin
D) Increases blood flow to the brain
E) Improves physical energy

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?

A) Serotonin-norepinephrine reuptake inhibitor
B) Monoamine oxidase inhibitor
C) Selective serotonin reuptake inhibitor
D) Tricyclic antidepressant

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.

A) Electroconvulsive therapy
B) Psychosocial interventions
C) Antidepressants
D) Time management and exercise therapy
E) Cognitive-behavioral therapy

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?

A) Risk factors for self-harm
B) Improvement in depression
C) Denial of the diagnosis of depression
D) 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?

A) Seasonal affective disorder
B) Side effect of medication
C) Situational depression
D) Anxiety

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.

A) Maintain nothing-by-mouth status until fully awake.
B) Administer intravenous fluids for 8 hours post procedure.
C) Place in the lateral recumbent position.
D) Provide oral fluids immediately after the procedure.
E) Place in the supine position with the head flat.

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.

A) Participation in psychotherapy with some medication therapy often needs to be continued after the treatments.
B) These treatments will cure the depression.
C) Long term memory loss often occurs after receiving ECT.
D) The treatments are known to help some but not all people with depression.
E) You will need to stop eating and drinking four hours prior to the therapy session.

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?

A) Social Isolation
B) Hopelessness
C) Situational Low Self-Esteem
D) Risk for Self-Directed Violence

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?

A) Depressed mood or loss of interest occasionally for at least 1 week
B) A depressed mood sporadically for at least 2 years
C) Restlessness, fatigue, suicidal ideation, feelings of guilt
D) Anxiety, change in appetite, grief, altered nutrition

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?

A) Bipolar disorder
B) Depression
C) Sadness
D) Extended grief

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?

A) Electrocardiogram
B) MRI of the brain
C) Thyroid function tests
D) Cerebral angiogram

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.

A) "Stop the medication immediately."
B) "A trial-and-error period is the best way to determine which medication is the most effective."
C) "A trial of 4 to 6 weeks is usually done to see how people respond to the medication."
D) "Stay on the medication for 6 months to see if there is a response."
E) "Learn to live with the depression."

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?

A) Cognitive-behavioral therapy
B) Light therapy
C) Bupropion extended-release
D) Selective serotonin reuptake inhibitor (SSRI)

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.

A) Assess all clients for suicide risk by using indirect questioning.
B) Ask if the client has any thought of suicide.
C) Asking about suicide will "plant the idea" in the client's mind.
D) Assess the lethality of the suicide plan, if one exists.
E) If the client has suicidal thoughts, assess whether or not the client would act on them.

Question 21

The nurse is providing care for a client who is experiencing situational depression after the death of a parent.During the assessment,the nurse learns that the client has returned to work,is caring for her family,and spends quiet time reflecting on her life and future.Which conclusion by the nurse is most appropriate?

A) The client is working through the grief process.
B) The client is experiencing denial regarding the death of a parent.
C) The client is exhibiting ineffective coping.
D) The client is experiencing anxiety.

Question 22

A student nurse is assisting in the care of a client with bipolar disorder.The student nurse researches the disorder further,focusing on the pathophysiology and etiology of the disorder.Which are true regarding the pathophysiology and etiology of bipolar disorder? Select all that apply.

A) No definitive cause or specific pathophysiology has been identified for bipolar spectrum disorders.
B) Bipolar disorders, anxiety disorders, and personality disorders share biological susceptibility and inheritance patterns.
C) Immunological abnormalities may contribute to the pathophysiology of mania and bipolar disorder.
D) Children of parents with bipolar disorder have an increased risk of developing the disorder.
E) Stressful life events and an emotionally overinvolved, hostile, and critical communication pattern are factors associated with heritability of the disorder.

Question 23

A client experiencing situational depression after losing a good job tells the nurse,"I am tired of always having to start over." Which actions by the nurse are appropriate based on this data? Select all that apply.

A) Ask what the client has done in the past to make "starting over" so successful.
B) Suggest the client talk with the physician about medications to help his mood.
C) Remind the client that an alcoholic beverage with the evening meal could help with stress.
D) Encourage the client to take the time to rest and relax.
E) Encourage the client to maintain a consistent exercise plan.

Question 24

The nurse is caring for an adolescent with bipolar disorder who has expressed the desire to harm self.What is the priority nursing diagnosis for this client?

A) Powerlessness related to mood instability
B) Impaired Social Interaction
C) Risk for Suicide
D) Social Isolation related to disorder

Question 25

The nurse is providing care to a client diagnosed with bipolar disorder.The client's family asks the nurse what this is.Which response by the nurse is appropriate?

A) "Bipolar disorder is a type of depression that includes attention deficit disorder symptoms."
B) "Bipolar disorder means there are cycles of depression as well as hyperactivity, or mania."
C) "Bipolar disorder just means that the mood alternates with the seasons, and it becomes worse in the winter."
D) "Bipolar disorder is just another type of depression, except depression occurs in cycles."

Question 26

The home care nurse hears the spouse of an older client say "You have been so sick but you insist on living in this huge home that you cannot maintain but expect me to." The client engages in an argument with the spouse.Which does the home care nurse identify as occurring with this couple?

A) Evidence of low blood glucose levels
B) Financial struggles within the family
C) Possible situational depression for both client and spouse
D) Spousal abuse

Question 27

The nurse is providing care to a client who is exhibiting clinical manifestations of biplar disorder.Which assessment findings support that the client is at an increased risk for this disorder? Select all that apply.

A) Blood pressure 120/80 mmHg
B) Recent major life-altering event
C) Works out at the gym every week
D) Currently employed
E) Mother diagnosed with bipolar disorder

Question 28

The nurse sees a client crying after being dropped off for a clinic appointment.The client states,"I am a burden to my entire family now that I cannot drive." Based on this data,which does the nurse include in the client's plan of care?

A) Risk for depression
B) Risk for cardiac disease
C) Risk for situational depression
D) Risk for bipolar disorder

Question 29

A client informs the nurse,"My mother keeps telling me to get over the death of my spouse,but I'm having a hard time doing that." Which action by the nurse is appropriate to assist the client and family?

A) Refusing to get involved with a family conflict
B) Telling the client that arguing with a parent never ends in a good way
C) Reminding the client and family that the grief process is different for everyone, and that no time limit can be set
D) Agreeing with the client's mother

Question 30

During a routine physical examination,a client tells the nurse,"I don't know what to do anymore since my husband died and left me alone." Which is the priority nursing diagnosis for this client?

A) Helplessness
B) Anxiety
C) Imbalanced Nutrition
D) Overload Stress

Question 31

A client experiencing situational depression after the traumatic death of the spouse tells the nurse,"Since I started taking a walk every day,I've been feeling better." Which conclusion regarding the impact of exercise for this client is appropriate? Select all that apply.

A) The client is experiencing an elevated mood due to exercise.
B) The client's stress is relieved as a result of the exercise.
C) Exercise is providing a short-term diversion to the pain of losing the spouse.
D) Exercise has given the client something to do.
E) The client is experiencing increased brain stimulation as a result of the increased oxygenation that occurs with exercise.

Question 32

A client in the manic phase of bipolar disorder is unable to sleep during the night.Which interventions could be helpful to this client? Select all that apply.

A) Engage in conversation.
B) Extend daytime naps.
C) Encourage the client to watch television.
D) Assist the client with a warm bath and provide a light snack.
E) Encourage the client to listen to soothing music.

Question 33

The nurse is planning care for an adolescent client experiencing the manic phase of bipolar disorder.Which intervention would address hallucinations?

A) Encourage spending time with others.
B) Discuss a homework assignment.
C) Keep isolated in a quiet room.
D) Explain that hallucinations are not real.

Question 34

Which client observation indicates that interventions provided to a client in the manic phase of bipolar disorder has improved self-care activities?

A) Completed morning bath and changed clothes
B) Washes hands after using the toilet
C) Cleaned liquid spilled on floor but did not change clothes
D) Brushes own teeth every time when reminded

Question 35

A client experiencing situational depression over the loss of a spouse is overwhelmed with having to close the spouse's business,settle finances,and figure out a way to survive financially.Which actions by the nurse are appropriate when assisting this client? Select all that apply.

A) Ask if the client can move in with parents.
B) Suggest that the client attend group therapy with a grief counselor.
C) Investigate whether the spouse had life insurance and what income the client can expect.
D) Help the client focus on strengths.
E) Help the client prioritize things that need to be accomplished.

Question 36

A client in the manic phase of bipolar disorder is prescribed lithium and has a current level of 0.4.Which clinical manifestation does the nurse anticipate when assessing this client?

A) A decrease in manic behavior.
B) Hyperactivity and pressured speech.
C) A return to baseline behavior, calm and rational.
D) Signs and symptoms of depression.

Question 37

A novice nurse is working in a behavioral health hospital and desires to learn more about bipolar disorder.The nurse understands that bipolar disorders affect clients differently across the lifespan.Which is true regarding bipolar disorder and lifespan considerations?

A) Children with bipolar disorders present with mood changes only.
B) Children with bipolar disorders are usually diagnosed quickly, preventing years of undiagnosed mental illness.
C) Suicide risk does not increase in adolescents and teenagers who are diagnosed with bipolar disorders.
D) Lifetime prevalence of bipolar disorders in adolescents is 0%-3%.

Question 38

A client in the manic phase of bipolar disorder will not sit down to eat.Which can the nurse do to ensure adequate nutrition and improved self-care of this client? Select all that apply.

A) Provide a sedative before meals.
B) Discuss finger-food options with the dietitian.
C) Use a jacket restraint at meal times.
D) Ask the healthcare provider if intravenous feedings would be applicable.
E) Provide frequent nutritious snacks.

Question 39

A nurse is caring for a client with an adjustment disorder with depressed mood.The nurse wants to perform interventions that will promote hope for the client.Which intervention best promotes hope in this client?

A) Help caregivers acknowledge clients' dependency and assume appropriate responsibility.
B) Help clients to identify ways in which they have control of their lives.
C) Provide families with a list of community resources and encourage them to participate in support groups.
D) Provide the families with information about clients' condition in accordance with client preferences.

Question 40

A nurse is performing research on the etiology,pathophysiology,and treatment of adjustment disorder with depressed mood.Which findings does the nurse anticipate regarding the effects of exercise on depression?

A) Many studies specifically investigate the role of exercise in adjustment disorder with depressed mood or situational depression.
B) Evidence indicates that exercise is effective in reducing symptoms of depression; however, exercise must be aerobic and for 60 minutes or more per day.
C) Resistance exercise is less effective in reducing symptoms of depression than aerobic exercise alone.
D) Evidence suggests that physical exercise is as effective as cognitive-behavioral therapy (CBT) or medication in reducing depression.

Question 41

The nurse,who has been calling postpartum clients,learns that one client reports having no appetite and wants to sleep all day.What does this information suggest to the nurse?

A) The client is feeling blue, which is normal.
B) The client's sleep-wake cycle is disrupted.
C) The client may be experiencing postpartum depression.
D) The client is developing postpartum psychosis.

Question 42

A nurse manager working in labor and delivery is providing educational material to staff nurses regarding postpartum depression and the maternal role attainment (MRA)process.Which information is true regarding the MRA process?

A) Maternal role attainment occurs in five stages.
B) During the formal stage of the MRA process, the woman is still influenced by the guidance of others and tries to act as she believes others expect her to act.
C) During the formal stage of the MRA process, the woman looks to role models, especially her own mother, for examples of how to mother.
D) The personal stage of the MRA process begins when the mother starts making her own choices about mothering.

Question 43

A nurse working in labor and delivery is assessing a client's risk for developing postpartum depression.Which is a risk factor for this disorder?

A) Multiparity (multiple pregnancies)
B) Overwhelming family support
C) History of bipolar disorder
D) History of anxiety disorder

Question 44

The postpartum client states that she cannot understand why she does not enjoy being with her baby.Based on this data,which does the nurse suspect the client is experiencing?

A) Postpartum infection
B) Postpartum depression
C) Postpartum psychosis
D) Postpartum blues

Question 45

A client of Eastern European descent who gave birth to her third child on the previous shift tells the nurse that she wants to get cleaned up and have something to eat so that she can be ready to go home in the morning.Which action by the nurse is appropriate?

A) Suggest that the client take advantage of the rest since she has other children at home who will also need her care.
B) Instruct the client to pace herself and that there is no hurry rush to go home.
C) Assist the client with self-care requests and check on when the meals will be delivered.
D) Suggest that her plans to go home depend upon her physician.

Question 46

The nurse is instructing a new mother on the strategies to prevent the development of postpartum depression.Which instructions will the nurse include in the teaching session with the client? Select all that apply.

A) Restrict fluids and eat a low-fat diet help to avoid the onset of postpartum depression.
B) Realize that feeling depressed after delivering a baby is normal and can last for months.
C) The only way to avoid postpartum depression is to not have children.
D) Encourage the client to plan how to manage the baby's care needs at home to help adjust to motherhood.
E) Instruct the client to recognize the signs and symptoms of postpartum depression and phone the health care provider if these occur.

Question 47

The home care nurse determines that a client being treated for postpartum depression is improving.Which assessment data supports the nurse's conclusion?

A) Client in casual wear, holding baby while rocking in a chair
B) Spouse making dinner, client in bed asleep, baby in rocker in the kitchen
C) Dirty dishes in the sink, beds unmade, and client wearing clothing for sleep
D) Client watching television in the living room while the baby is in the crib crying

Question 48

A client who is breastfeeding has been diagnosed with postpartum depression after delivering her first child.Which medications might be prescribed for this client? Select all that apply.

A) Diazepam
B) Phenytoin
C) Paroxetine
D) Fluoxetine
E) Sertraline

Question 49

The nurse caring for a postpartum client would consider the nursing diagnosis of ineffective individual coping when the client demonstrates which behavior?

A) Reading material on care of a newborn
B) Lying in bed, lights dim, and refusing to spend time with the baby
C) Cuddling the new infant
D) Talking with friends and family on the phone

Question 50

The home care nurse is planning care for a client with a history of postpartum depression after the births of all her children.Based on this data,which will the nurse include in the client's plan of care? Select all that apply.

A) Encouraging the client to take advantage of those who want to help and maintain outside interests
B) Contacting the healthcare provider to ensure the client is prescribed medication for postpartum depression
C) Encouraging as much sleep as possible
D) Focusing on the care the other children need
E) Instructing the client to eat a healthful diet with limited alcohol intake