Deck 16: Depressive and Bipolar Disorders

Question 1

The nurse is teaching a patient with bipolar disorder about lithium carbonate (Lithobid), which the provider has just prescribed for the patient. What information will the nurse provide the patient regarding the use of lithium?

A) Test serum levels regularly.
B) Decrease salt and fluid intake.
C) Increase the dose if fine hand tremors appear.
D) Discontinue the medication when feeling better.

Answer 1

Test serum levels regularly.

Question 2

The nurse knows that a patient with a mood disorder who is exhibiting slurred speech and muscle weakness has likely developed which condition?

A) Lithium toxicity
B) Steven-Johnson syndrome
C) Aplastic anemia
D) QT interval prolongation

Answer 2

Lithium toxicity

Question 3

The nurse knows that which factors can interact with individual biology to create recurrences of bipolar illness? Select all that apply.

A) Disruption in social rhythms
B) Adequate family functioning
C) Social support from peers and family
D) Availability of someone to speak with
E) Nonadherence with medication regimen

Answer 3

Disruption in social rhythms
Nonadherence with medication regimen

Question 4

The nurse is caring for a patient with major depressive disorder. Which therapy will the nurse recommend to help the patient gain a greater understanding of self and awareness of behaviors?

A) Social rhythm therapy
B) Dynamic psychotherapy
C) Neuromodulation therapy
D) Interpersonal psychotherapy

Question 5

An adolescent patient with a major depressive disorder tells the nurse, "I used to love swimming, but I don't enjoy it at all anymore." What condition is the patient displaying?

A) Aphasia
B) Atypical
C) Anhedonia
D) Antagonism

Question 6

A patient diagnosed with depression has been taking paroxetine (Paxil) 10mg PO daily for the past month. The patient presents to the clinic with complaints of restlessness and abdominal pain. Which factor does the nurse consider during the assessment?

A) The patient has been taking medication with grapefruit juice at breakfast.
B) The patient is experiencing severe side effects and will be taken off the medication.
C) The patient is taking too much of the drug and is experiencing unexpected side effects.
D) The patient expresses that she is nervous that the side effects will increase with continued use.

Question 7

A nurse is caring for patient with depression who is exhibiting vegetative signs. Which symptom is associated with vegetative signs of depression?

A) Insomnia
B) Helplessness
C) Hopelessness
D) Suicidal ideation

Question 8

The nurse knows that depression is the primary abnormal mood state for patients who are diagnosed with bipolar disorder. What other mood state might the nurse recognize in the patient with bipolar disorder?

A) Hypomania
B) Hypersexuality
C) Inappropriate intimacy
D) Exaggerated sense of importance

Question 9

The nurse is conducting a patient education session on major depression. Which factor will the nurse explain has a strong association with major depression?

A) Being male
B) Schizophrenia
C) First-degree relatives
D) Environmental influences

Question 10

The nurse caring for a patient with severe mania anticipates that which neuromodulation therapy will likely be ordered for maintenance treatment?

A) Light therapy
B) Deep brain stimulation (DBS)
C) Electroconvulsive therapy (ECT)
D) Repetitive transcranial magnetic stimulation (rTMS)

Question 11

The nurse is providing education for a patient with a mood disorder. The patient asks about using complementary therapies. Which will the nurse discuss as a reasonable augmentation to the care plan for patients with mood disorders?

A) Kava
B) Ginger root
C) B-12 supplements
D) Omega-3 fatty acids

Question 12

The nurse is explaining the differences between bipolar disorder and major depressive disorder. Which factor will she discuss as being a defining feature of bipolar disorder that is not present in major depressive disorder?

A) Suicidal ideation
B) Mania
C) Short duration of symptoms
D) No history of depressive symptoms

Question 13

The nurse is providing information to the spouse of a patient who has been diagnosed with bipolar disorder. What treatment will the nurse share as being most effective for a patient with acute mania?

A) Group therapy
B) Fluoxetine (Prozac)
C) Seclusion and restraint
D) Electroconvulsive therapy (ECT)

Question 14

The nurse understands that the Hispanic patient in the clinic complaining of abdominal pain and fatigue needs to be further assessed, but may be expressing which type of mood?

A) Tired
B) Euthymic
C) Dysphoric
D) Anhedonic

Question 15

The nurse knows that the clinical feature of anxious distress in depression includes which characteristics? Select all that apply.

A) Overeating
B) Feeling tense
C) Being unusually restless
D) Waking up early in the morning
E) Having hallucinations and disruption in thought

Question 16

Which model would most support the development of depression in a male patient whose mother was sentenced to jail for 15 years when the patient was 3 months old?

A) Genetic
B) Environmental
C) Neuroendocrine
D) Diathesis-stress

Question 17

The nurse knows that, according to recent research, which areas of the brain are involved in the regulation of both mood and emotion? Select all that apply.

A) Septum
B) Amygdala
C) Basal ganglia
D) Hippocampus
E) Pre-frontal

Question 18

The nurse is working with a patient who was diagnosed two days ago with severe depression. Reflecting on the diathesis-stress model, the nurse recognizes that which event is most likely to be a factor in the development of depression?

A) Losing his job last week
B) His mother's suicide when he was ten years old
C) Breaking up with his girlfriend the week before his diagnosis
D) The death of his 12-year-old dog three years ago

Question 19

Which information related to the physiology of circadian rhythms would be most significant in the assessment of a patient suspected of having bipolar disorder?

A) Personality patterns
B) Psychiatric diagnosis
C) Negative thought patterns
D) Sleep and appetite patterns

Question 20

The nurse is caring for patient with depression. What information will the nurse include in the patient teaching regarding phenelzine (Nardil)?

A) May use with opioids.
B) Maintain a low glycemic diet.
C) Maintain a low tyramine diet.
D) May use with a selective serotonin reuptake inhibitor (SSRI).

Question 21

The novice psychiatric-mental health nurse understands the importance of professional and personal qualities when working with patients who have psychiatric conditions. What is the most important personal quality the nurse should have when working with patients with mood disorders?

A) Good recall
B) Self-awareness
C) The ability to sympathize
D) An extroverted personality

Question 22

When planning care for an older patient diagnosed with depression which is the priority nursing action?

A) Screening the patient for suicide risk
B) Assessing the patient for low-grade depressive symptoms
C) Assessing to distinguish depressive symptoms from a grief response
D) Promoting physical activity and maintain meaningful social connections for wellness

Question 23

The nurse caring is discussing different options for therapy with a patient who has been diagnosed with bipolar disorder. The nurse will explain that which is characteristic of interpersonal psychotherapy?

A) Improving communication
B) Motivating through planning
C) Gaining an understanding of self
D) Providing support and feedback to peers

Question 24

A patient with a major depressive disorder states, "I don't care about anything anymore." What is the nurse's best response?

A) "You have such a good life!"
B) "Are you feeling suicidal?"
C) "Don't worry. You'll feel better tomorrow."
D) "What about your children? They are so cute and wonderful!"

Question 25

The nurse caring for a patient with bipolar disorder understands that which is a priority consideration when planning patient care goals?

A) Establishing a therapeutic alliance
B) Improving mood symptoms through psychotherapy
C) Educating patients about the trajectory of improvement
D) Determining the therapeutic efficacy of the patient's lithium therapy

Question 26

The nurse is caring for a patient with a mood disorder who has been admitted to the medical-surgical unit for postoperative care. Which actions are appropriate therapeutic strategies for use with a patient with a mood disorder? Select all that apply.

A) Offering a variety of choices in order to keep communication open
B) Keeping communication simple by offering limited choices
C) Reminding patients of delusional material when symptoms have resolved
D) Questioning the patient's belief system when it conflicts with the nurse's
E) Not reminding patients of inappropriate behaviors when in an altered state of mental health

Question 27

The nurse knows that treatment of patients diagnosed with depressive disorder includes which long-term goals? Select all that apply.

A) Achieving complete remission
B) Maintaining adherence with therapy
C) Promoting regular patterns of activity
D) Restoring to appropriate weight
E) Minimizing functional impairment

Question 28

The nurse is caring for a patient with bipolar disorder who is agitated and telling everyone he is the king of England. The nurse will select which nursing diagnosis as appropriate for this patient?

A) Self-care deficit
B) Ineffective coping
C) Disturbed sleep pattern
D) Alteration in thought processes