Question 1

An adult diagnosed with major depression was treated with medication and cognitive-behavioural therapy. The patient now recognizes how passivity contributed to the depression. Which intervention should the nurse suggest?

Accepted Answer

Social skills training can help the patient develop more active and assertive behaviors, which can counteract passivity and improve social interactions, thereby reducing depressive symptoms.

Question 2

What is the focus of priority nursing interventions for the period immediately after electroconvulsive therapy treatment?

Accepted Answer

The period immediately after electroconvulsive therapy treatment is focused on supporting physiological stability, including monitoring vital signs and oxygen saturation, assessing for any adverse effects from anesthesia or muscle relaxants, and ensuring adequate recovery from the procedure. While nutrition and hydration are important, they are not the immediate focus after the treatment. Reducing disorientation and confusion and assisting the patient to identify and test negative thoughts may be relevant interventions for the patient's overall psychiatric care, but they are not the immediate focus after the treatment.

Question 3

A patient diagnosed with major depression does not interact with others except when addressed, and then only in monosyllables. The nurse wants to show nonjudgemental acceptance and support for the patient. Which communication technique will be effective?

Accepted Answer

Making observations is an effective communication technique as it allows the nurse to acknowledge the patient's presence and behavior without requiring a response, demonstrating nonjudgmental acceptance and support.

Question 4

A nurse provided medication education for a patient diagnosed with major depression who began a new prescription for phenelzine (Nardil). Which behaviour indicates effective learning?

Accepted Answer

Phenelzine (Nardil) is a monoamine oxidase inhibitor (MAOI), and patients must avoid certain over-the-counter medications that can interact with MAOIs and cause serious side effects. Consulting with a pharmacist ensures safe medication practices.

Question 5

Which documentation for a patient diagnosed with major depression indicates the treatment plan was effective?

Accepted Answer

The patient slept for 6 hours uninterrupted, engaged in an activity group and expressed anticipation to see a grandchild. These indications show that the treatment plan was effective.

Question 6

A patient became depressed after the last of the family's six children moved out of the home 4 months ago. Select the best initial outcome for the nursing diagnosis Situational low self-esteem related to feelings of abandonment.

Accepted Answer

The best initial outcome for situational low self-esteem is for the patient to recognize and verbalize positive characteristics about themselves, which can help build self-esteem and counter feelings of abandonment.

Question 7

A patient diagnosed with major depression says, "No one cares about me anymore. I'm not worth anything." Today the patient is wearing a new shirt and has neat, clean hair. Which remark by the nurse supports building a positive self-esteem for this patient?

Accepted Answer

Patients with depression usually see the negative side of things.The meaning of compliments may be altered to "I didn't look nice yesterday" or "They didn't like my other shirt." Neutral comments such as making an observation avoid negative interpretations.Saying,"You look nice" or "I like your shirt" gives approval (non-therapeutic techniques).Saying "You must be feeling better today" is an assumption,which is non-therapeutic.

Question 8

A patient being treated for depression has taken 300 mg amitriptyline (Elavil) daily for a year. The patient calls the case manager at the clinic and says, "I stopped taking my antidepressant 2 days ago. Now I am having cold sweats, nausea, a rapid heartbeat, and nightmares." What will the nurse advise the patient to do?

Accepted Answer

The patient is experiencing withdrawal symptoms from abruptly stopping amitriptyline. The nurse should advise the patient to take a dose of the medication and see the healthcare provider for proper guidance on tapering off the medication safely.

Question 9

A patient was diagnosed with seasonal affective disorder (SAD). During which month would this patient's symptoms be most acute?

Accepted Answer

Seasonal affective disorder (SAD) is a type of depression that is related to changes in seasons. It typically occurs during the winter months when there is less sunlight and days are shorter. January is typically the peak month for SAD symptoms because it is the middle of winter and has the least amount of sunlight.

Question 10

A patient diagnosed with major depression began taking a tricyclic antidepressant 1 week ago. Today the patient says, "I don't think I can keep taking these pills. They make me so dizzy, especially when I stand up." The nurse will do which of the following?

Accepted Answer

Tricyclic antidepressants can cause postural hypotension, especially when starting the medication. Teaching the patient strategies to manage this side effect, such as rising slowly from sitting or lying positions, is appropriate.

Question 11

A patient became severely depressed when the last of the family's six children moved out of the home 4 months ago. The patient repeatedly says, "No one cares about me. I'm not worth anything." Which response by the nurse would be the most helpful?

Accepted Answer

This response shows empathy and offers concrete actions to demonstrate care for the patient. It also acknowledges the patient's feelings and offers support rather than dismissing them or making assumptions about them. Option A is dismissive and minimizes the patient's feelings, while option B may come across as insincere. Option C is confrontational and unhelpful.

Question 12

A patient says to the nurse, "My life doesn't have any happiness in it anymore. I once enjoyed holidays, but now they're just another day." The nurse documents this report as an example of which of the following?

Accepted Answer

Anhedonia is the inability to feel pleasure in normally pleasurable activities, such as holidays, which is what the patient is describing.

Question 13

Priority interventions for a patient diagnosed with major depression and feelings of worthlessness should include which of the following?

Accepted Answer

Careful, unobtrusive observation is crucial to ensure the patient's safety, as feelings of worthlessness can increase the risk of self-harm or suicide.

Question 14

When counselling patients diagnosed with major depression, an advanced practice nurse will address the negative thought patterns by using which of the following?

Accepted Answer

Cognitive-behavioural therapy (CBT) is specifically designed to address negative thought patterns and is commonly used in treating major depression.

Question 15

Major depression resulted after a patient's employment was terminated. The patient now says to the nurse, "I'm not worth the time you spend with me. I am the most useless person in the world." Which nursing diagnosis applies?

Accepted Answer

The patient's statement indicates feelings of worthlessness and low self-esteem, which aligns with the nursing diagnosis of Situational low self-esteem. A diagnosis of Powerlessness would indicate a lack of control over a situation, which is not conveyed in the patient's statement. Defensive coping and Disturbed personal identity do not fit with the patient's statement either.

Question 16

A nurse worked with a patient diagnosed with major depression, severe withdrawal, and psychomotor retardation. After 3 weeks, the patient did not improve. The nurse is most at risk for which of the following?

Accepted Answer

The nurse is likely to feel ineffective and frustrated due to the lack of improvement in the patient's condition despite efforts over 3 weeks.

Question 17

A patient diagnosed with major depression tells the nurse, "Bad things that happen are always my fault." Which response by the nurse will best assist the patient to reframe this overgeneralization?

Accepted Answer

By suggesting to look at one specific bad thing that happened, the nurse is encouraging the patient to examine other possible explanations for the event, which can help to reframe the overgeneralization. Option A dismisses the patient's feelings and does not provide any practical ways to address the issue. Option C minimizes the patient's experience and may not effectively challenge the overgeneralization. Option D changes the subject and does not address the patient's statement.

Question 18

A nurse taught a patient about a tyramine-restricted diet. Which menu selection would the nurse approve?

Accepted Answer

The menu selection in B includes foods that are low in tyramine, such as mashed potatoes, ground beef patty, corn, green beans, and apple pie. On the other hand, options A, C, and D include foods that are high in tyramine, such as hot dogs, ham, and smoked sausage, which can cause a dangerous elevation in blood pressure in patients on MAOI therapy. Caffeinated coffee and chocolate cake are also high in tyramine. Thus, option B is the best choice for a tyramine-restricted diet.

Question 19

A patient diagnosed with depression is receiving amitriptyline (Elavil) 50 mg qhs. Which assessment finding would prompt the nurse to collaborate with the health care provider regarding potentially hazardous side effects of this drug?

Accepted Answer

Urinary retention is a potentially hazardous side effect of amitriptyline, a tricyclic antidepressant, and requires prompt medical attention.

Question 20

A patient diagnosed with depression begins selective serotonin reuptake inhibitor (SSRI) antidepressant therapy. The nurse should provide information to the patient and family about which of the following?

Accepted Answer

SSRIs can increase the risk of suicidal thoughts, especially in young adults and adolescents, so it is crucial for patients and their families to be aware of this potential side effect and report any increase in suicidal thoughts to their healthcare provider.

Quiz 13: Depressive Disorders