Deck 19: Pharmacotherapy of Mood Disorders

Question 1

A client with depression is to begin treatment with an antidepressant medication.In performing the initial assessment,what is the most important the nurse to ask?

A)"Are you allergic to any medications?"
B)"How long have you been depressed?"
C)"Have you had any thoughts about killing yourself?"
D)"How much alcohol do you consume during the week?"

Answer 1

"Have you had any thoughts about killing yourself?"

Question 2

A client with bipolar disorder in the manic phase is started on lithium (Eskalith).The client's current lithium level is 0.4 mEq/L.What will the nurse expect to assess in this client?

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

Answer 2

Hyperactivity and pressured speech

Question 3

The client asks the nurse why she needs to continue using table salt,because her prescribed lithium (Eskalith)is a salt.What is the best response by the nurse?

A)"You must continue to use salt to avoid lithium (Eskalith)toxicity.If you use sea salt,you don't need as much."
B)"You must use table salt or your kidneys will retain lithium (Eskalith),and you will become toxic."
C)"Salt is very important to avoid lithium (Eskalith)toxicity,but not as important as drinking 1 to 1.5 L of water per day."
D)"The amount is not important; just increase your table salt if you notice signs of lithium (Eskalith)toxicity."

Answer 3

"You must use table salt or your kidneys will retain lithium (Eskalith),and you will become toxic."

Question 4

A client taking amitriptyline (Elavil)for two weeks tells the nurse that the medication "isn't working" because feelings of depression continue.Which response by the nurse is the most appropriate?

A)"This might not be the best medicine for you; I'll call your doctor."
B)"You might still feel depressed,but you are looking much better."
C)"It is working,but it can take several months to have an effect."
D)"It is working,but it can take several weeks to have an effect."

Question 5

A client with depression does not want to take prescribed medication because of the side effects.What can the nurse suggest to help with medication adherence? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Use ice chips to help alleviate dry mouth.
B)Chew gum or use hard candy to help alleviate dry mouth.
C)Avoid alcohol-based mouthwash to help alleviate dry mouth.
D)Use "dry eye" drops to help with eye dryness.
E)Take alcoholic beverages several times a week to help with unpleasant side effects.

Question 6

The nurse is conducting a group education session for clients who have been diagnosed with depression.The nurse evaluates the education as effective when a client makes which comments about the cause of depression? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"Depression results from parents who are cold and distant and don't really care about their children."
B)"Depression results from unresolved conflicts in your childhood."
C)"We really don't know what causes depression; it has not been studied very much."
D)"Depression can be an inherited illness."
E)"Depression has many causes; they could include environmental as well as brain-based disorders."

Question 7

Mood disorders are closely associated with which part of the brain?

A)Limbic
B)Hippocampus
C)Hypothalamus
D)Brainstem

Question 8

The nurse has completed medication education for a client about to begin therapy with phenelzine (Nardil).The nurse evaluates the education as effective when the client makes which statements? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"I can't eat fried chicken and gravy."
B)"I'll have to give up my beer at the football games."
C)"I really shouldn't eat at a restaurant; too many foods are on my restricted list."
D)"I am not supposed to have processed meats or cheese."
E)"I am really going to miss my morning coffee and sweet roll."

Question 9

The nurse is concerned that a client is moving into the manic phase of bipolar disorder when what is assessed? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Not sleeping
B)Losing weight
C)Sluggish activity
D)Complaints of muscle pain
E)Constant talking

Question 10

Mood disorders are emotional disorders characterized by changes in mood,and they range from mania to depression.Which symptoms characterize major depressive disorder?

A)Fatigue and decreased appetite
B)Anxiety and elevated mood
C)Low mood and increased activity
D)Psychosis and euphoria

Question 11

A client who has been taking antidepressant medication for several months and is demonstrating an improvement in symptoms tells the nurse that counseling sessions might be helpful.Which types of therapies will the nurse review with the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Behavioral therapy
B)Interpersonal therapy
C)Cognitive-behavioral therapy
D)Psychodynamic therapy
E)Crisis therapy

Question 12

Which medication,when administered with lithium,increases the risk of toxicity?

A)Lomefloxacin
B)Sodium bicarbonate
C)Calcium iodine
D)Furosemide

Question 13

A client diagnosed with depression has been placed on imipramine (Tofranil).What would the nurse most likely assess if the client experiences adverse effects of this medication?

A)Various anemias accompanied by bradycardia
B)Hypertension with severe emesis
C)Dizziness accompanied by possible photosensitivity
D)Polyuria with gross proteinuria

Question 14

The nurse is instructing a client on the cause of bipolar disorder.Which neurotransmitters will the nurse describe as contributing to the manic phase of this disorder? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Excessive glutamate
B)Excessive norepinephrine
C)Deficiency of gamma-aminobutyric acid
D)Deficiency of dopamine
E)Excessive serotonin

Question 15

A client,prescribed sertraline (Zoloft)for anxiety and depression,reports experiencing delayed ejaculation since being on this medication.Which response by the nurse is the most appropriate?

A)"I am concerned that you will become suicidal if you stop the medication."
B)"Keep taking the medicine,as this usually goes away after a few months."
C)"I will let your doctor know."
D)"This does happen,but treating your depression is a bigger priority."

Question 16

The client tells the nurse,"I thought I was just depressed,but my doctor says I have bipolar disorder.What is that?" Which response by the nurse is the most appropriate?

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

Question 17

The nurse is caring for a client receiving electroconvulsive therapy (ECT).What is the priority assessment for this client?

A)Orientation
B)Level of consciousness
C)Airway
D)Vital signs

Question 18

During a health history,the nurse is concerned that a client with depression is at risk for suicide.Which assessment findings support this concern? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)States that "suicide is always an option"
B)Describes a previous unsuccessful attempt at suicide by aspirin overdose
C)States that the prescribed medication is not working and that feelings of depression are worse
D)Requests prescriptions for pain medication and a sleeping aid
E)Expresses interest in meeting with friends more often

Question 19

During a health history,the nurse wants to include an assessment of depression for an older adult client.Which statements will the nurse use to conduct this assessment? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"How often do you go out to socialize with friends?"
B)"Explain your self-care activities."
C)"How much alcohol do you consume every day?"
D)"How is living with your oldest daughter and her family working out for you?"
E)"Are you feeling depressed?"