Question 1

A nurse is caring for four clients taking various medications,including imipramine (Tofranil),doxepine (Sinequan),ziprasidone (Geodon),and tranylcypromine (Parnate).The nurse orders a special diet for the client receiving which medication?

Accepted Answer

Hypertensive crisis occurs in clients receiving a monoamine oxidase inhibitor (MAOI)who consume foods or drugs with a high tyramine content.

Question 2

A client admitted to the psychiatric unit following a suicide attempt is diagnosed with major depressive disorder.Which behavioral symptoms should the nurse expect to assess?

Accepted Answer

Lack of attention to grooming and hygiene is the only behavioral symptom presented.Lack of energy,low self-esteem,and feelings of helplessness and hopelessness (all common symptoms of depression)contribute to lack of attention to activities of daily living,including grooming and hygiene.

Question 3

An individual experiences sadness and melancholia in September continuing through November.Which of the following factors should a nurse identify as most likely to contribute to the etiology of these symptoms? Select all that apply.

Accepted Answer

The nurse should identify drastic temperature and barometric pressure changes,increased levels of melatonin,and/or variations in serotonergic functioning as contributing to the etiology of the client's symptoms.A number of studies have examined seasonal patterns associated with mood disorders and have revealed two prevalent periods of seasonal involvement: spring (March,April,May)and fall (September,October,November).

Question 4

A 20-year-old female has a diagnosis of premenstrual dysphoric disorder.Which of the following should a nurse identify as consistent with this diagnosis? Select all that apply.

Accepted Answer

Diagnostic criteria for a premenstrual dysphoric disorder include that symptoms must be associated with significant distress,occur in the week before onset of menses,and improve or disappear in the week post-menses

Question 5

A client diagnosed with major depressive disorder was raised in a strongly religious family where bad behavior was equated with sins against God.Which nursing intervention would be most appropriate to help the client address spirituality as it relates to his illness?

Accepted Answer

A client raised in an environment that reinforces one's inadequacy may be at risk for experiencing guilt,shame,low self-esteem,and hopelessness,which can contribute to depression.Assisting the client to bring these feelings into awareness allows the client to realistically appraise distorted responsibility and dysfunctional guilt.

Question 6

A 75-year-old client with a long history of depression is currently on doxepin (Sinequan),100 mg daily.The client takes a daily diuretic for hypertension and is recovering from the flu.Which nursing diagnosis should the nurse assign highest priority?

Accepted Answer

A side effect of Sinequan is orthostatic hypotension.Dehydration due to fluid loss from a combination of diuretic medication and flu symptoms can also contribute to this problem,putting this client at risk for injury R/T orthostatic hypotension.

Question 7

A client is prescribed phenelzine (Nardil).Which of the following client statements should indicate to a nurse that discharge teaching about this medication has been successful? Select all that apply.

Accepted Answer

The nurse should evaluate that teaching has been successful when the client states that phenelzine (Nardil)should not be taken in conjunction with the use of alcohol or foods high in tyramine and should not be stopped abruptly.Phenelzine is a monoamine oxidase inhibitor (MAOI)that can have negative interactions with other medications.The client needs to tell other physicians about taking MAOIs because of the risk of drug interactions.

Question 8

A newly admitted client diagnosed with major depressive disorder states,"I have never considered suicide." Later the client confides to the nurse about plans to end it all by medication overdose.What is the most helpful nursing reply?

Accepted Answer

By admitting to the staff a suicide plan,this client has taken responsibility for possible personal actions and expresses trust in the nurse.Therefore,the client may be receptive to continuing a safety plan.Recognition of this achievement reinforces this adaptive behavior.

Question 9

Which client statement expresses a typical underlying feeling of clients diagnosed with major depressive disorder?

Accepted Answer

Hopelessness and helplessness are typical symptoms of clients diagnosed with major depressive disorder.

Question 10

A client is admitted with a diagnosis of persistent depressive disorder.Which client statement would describe a symptom consistent with this diagnosis?

Accepted Answer

Persistent depressive disorder is characterized by depressed mood for most of day,for more days than not,for at least 2 years.Thoughts of death would be more consistent with major depressive disorder; hearing voices is more consistent with a psychotic disorder; and fear of leaving the house is more consistent with a phobia.

Quiz 25: Depressive Disorders

A nurse is caring for four clients taking various medications,including imipramine (Tofranil) ,doxepine (Sinequan) ,ziprasidone (Geodon) ,and tranylcypromine (Parnate) .The nurse orders a special diet for the client receiving which medication?