Deck 28: Mood and Affect Updated for Dsm-5

Question 1

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)Avoid asking about suicide to avoid "planting 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.

Answer 1

Ask if the client has any thought of suicide.
Assess the lethality of the suicide plan,if one exists.
If the client has suicidal thoughts,assess whether or not the client would act on them.

Question 2

The nurse is caring for a client with a chronic health condition.Which condition should the nurse identify as a common complication associated with reduced role function?

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

Answer 2

Depression

Question 3

Which intervention is a primary prevention strategy for depression?

A)Regular screening for depression
B)Provide education about stress management
C)Counseling clients about their risk for mood disorders
D)Developing community-based mental health programs

Answer 3

Provide education about stress management

Question 4

A client with a 2-month-old child is experiencing insomnia,mood swings,and crying.Which interventions does the nurse anticipate being incorporated into a collaborative plan of care for the client experiencing postpartum depression? Select all that apply.

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

Question 5

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 recognize as consistent with this diagnosis?

A)Depressed mood or loss of interest occasionally for at least 1 week
B)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 6

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)Sociocultural theory emphasizes the role that social stressors play in the development of depression.
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 all people have an inborn need for interpersonal relationships.
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 7

A client is experiencing symptoms of depression.Which laboratory or diagnostic test would be the priority 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 8

A nurse is caring for a client who displays symptoms associated with seasonal affective disorder (SAD).Which treatment 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 9

Which condition is associated with the highest rate of comorbidity with depression?

A)Alcohol abuse
B)Obesity
C)Back problems
D)Hypertension

Question 10

The home care nurse hears the spouse of a client say "With you being so sick lately,I can't maintain this home by myself,so I never invite family over anymore.I can't stand to have them see our house in this rundown state." The client engages in an argument with the spouse,and the spouse begins to cry.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
D)Spousal abuse

Question 11

A nurse at a psychiatrist's office is reviewing the medication prescribed to several new clients for mood disorders.Which order would the nurse question?

A)A prescription for paroxetine for a 15-year-old boy with depression
B)A prescription for fluoxetine for a 14-year-old girl with depression
C)A prescription for sertraline for a 10-year-old boy with obsessive-compulsive disorder
D)A prescription for sertraline for an 11-year-old girl with depression

Question 12

A client receiving pain medication for abdominal discomfort reports no relief of pain and continues to describe multiple somatic complaints.The client also describes feelings of discouragement and hopelessness related to the pain,because the healthcare team has not yet found a cause for the pain.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 13

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 realize the client is at risk for based on this statement?

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

Question 14

The nurse is planning care for an adult client demonstrating symptoms of depression.Which assessment technique is most appropriate?

A)More time talking with the client
B)Ask family members about the client's demeanor
C)Beck Depression Inventory
D)Mood Disorder Questionnaire

Question 15

A client being treated for severe 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 16

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 postprocedure.
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 17

The nurse observes a client being treated for depression sitting with the head down and avoiding conversation with peers.Which nursing intervention is most appropriate for this client?

A)Ask open-ended questions about the client's feelings.
B)Ask the client closed-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.

Question 18

A client is scheduled for electroconvulsive therapy (ECT)for the treatment of depression.Which instructions should the nurse include regarding this therapy? Select all that apply.

A)You will need to remove all jewelry before beginning the therapy session.
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 4 hours prior to the therapy session.

Question 19

A 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 20

A client prescribed an antidepressant tells the nurse that the pill causes dizziness upon standing or changing position too quickly.This is a common side effect of which antidepressant medication?

A)Atypical antidepressant
B)Monoamine oxidase inhibitor (MAOI)
C)Selective serotonin reuptake inhibitor (SSRI)
D)Lithium

Question 21

The nurse is providing care for a client who is experiencing situational depression after the death of her mother.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 woman with bipolar disorder is taking lithium.She continues to take lithium until she realizes she is pregnant,which is 6 weeks into the pregnancy.Which potential adverse effect might the nurse tell the client about when she asks about lithium and pregnancy?

A)Craniofacial defects
B)Neural tube defects
C)Heart defects
D)Gastrointestinal defects

Question 23

Which individual has the most risk factors for depression?

A)A 43-year-old man who was fired from his job 8 months ago and has been unable to find employment
B)A 38-year-old woman who recently moved away from all her family to go to graduate school
C)A 68-year-old man who lost his wife in a car accident and lives close to two of their three children
D)A 19-year-old woman who was emotionally and physically abused as a child and dropped out of school at the age of 16 when she became pregnant

Question 24

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)Ensuring the client is getting adequate sleep
D)Focusing on the care the other children need
E)Instructing the client to eat a healthful diet with limited alcohol intake

Question 25

Which molecule has been implicated in the pathophysiology of depression?

A)Brain natriuretic peptide
B)Dopamine
C)Epinephrine
D)Calcitonin

Question 26

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 extreme elevations in mood,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 27

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 nutritious liquids.

Question 28

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 rarely exhibit violent tempers.
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 29

The nurse is performing an assessment on an 8-year-old child who the mother is concerned has depression.Which symptoms of depression are consistent with a child of this age?

A)Regression in toilet training
B)Self-destructive play themes
C)Decrease in academic performance
D)Poor self-care

Question 30

The nurse is providing care to a client who is exhibiting manifestations of a mood disorder.Which assessment findings indicate that the client may be at an increased risk for bipolar 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 31

The nurse caring for a postpartum client would consider the nursing diagnosis of ineffective 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 32

Which statement about bipolar disorder is true?

A)The client will exhibit functional impairment at work during remission periods.
B)Episodes associated with bipolar disorder tend to decrease in frequency with age.
C)Some clients with bipolar disorder do not experience remission periods.
D)Bipolar disorders typically appear between the ages of 25 and 50.

Question 33

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 34

A client in the manic phase of bipolar disorder is prescribed lithium and has a current lithium blood level of 0.4 mEq/L.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 35

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

A)Powerlessness
B)Impaired Social Interaction
C)Risk for Suicide
D)Social Isolation

Question 36

The nurse is assessing a client who is 4 weeks postpartum.The client reports having no appetite and wanting 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 37

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 38

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)Immunologic 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 39

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

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

Question 40

The nurse is providing teaching to a 71-year-old client who was prescribed escitalopram (Lexapro)for depression.The client is also taking medication for type II diabetes,hypertension,and heart disease.What should the nurse include in her teaching?

A)The client will need to come in for more frequent monitoring.
B)The client may experience an increase in memory problems.
C)The client will not be able to drive.
D)The client will no longer need to take medication for hypertension.

Question 41

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 healthcare provider if these occur.

Question 42

A client states that he often wonders if everyone would be better off if he were dead.What does the nurse identify this as?

A)A suicide attempt
B)Suicide planning
C)A suicide threat
D)Suicidal ideation

Question 43

Which neurotransmitter change is frequently associated with suicide?

A)Increase in serotonin
B)Decrease in serotonin
C)Increase in dopamine
D)Decrease in dopamine

Question 44

The nurse is caring for a client recovering from a suicide attempt.Which client statement indicates to the nurse that the risk of suicide has diminished?

A)"I am not looking forward to going home with my parents."
B)"I now know that threatening suicide will help me get what I want from my parents."
C)"Even though I failed this time,I lived to think about it again."
D)"I am looking forward to going to school and seeing my friends."

Question 45

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)Supportive relationship with spouse

Question 46

Which assessment findings indicate that a client is at increased risk for suicide? Select all that apply.

A)Substance abuse
B)Age 59
C)Plays golf twice a week
D)Widowed for 6 months
E)Recently started a new job

Question 47

A nursing instructor is evaluating a nursing student's knowledge regarding a client with suicidal thoughts.Which statement made by the student demonstrates an understanding regarding assessing a client with suicidal thoughts?

A)"I should attempt to make light of the circumstances."
B)"I should be indirect and respectful."
C)"I should not talk about suicide directly."
D)"I should directly acknowledge the situation."

Question 48

A 76-year-old man was recently diagnosed with Alzheimer disease.His wife passed away 6 months ago due to metastatic breast cancer.The client states that he doesn't sleep well,often forgets to eat because he doesn't feel hungry,and he just doesn't get involved in social functions anymore because his kids don't want him to drive.He states that he feels isolated and lonely.What diagnosis should the nurse include as the highest priority in this client's plan of care?

A)Ineffective Activity Planning
B)Grieving
C)Risk for Loneliness
D)Risk for Suicide

Question 49

What is the greatest risk for a woman diagnosed with postpartum psychosis?

A)Infanticide
B)Hallucinations
C)Insomnia
D)Poor judgment

Question 50

The nurse is caring for several clients who have plans to commit suicide.Which plan does the nurse identify as being most lethal?

A)The individual who plans to use a mild overdose of pharmaceuticals
B)The individual who plans to jump off a tall building
C)The individual who plans to jump off a bridge into a river
D)The individual who plans to slit across one wrist

Question 51

A client who has attempted to commit suicide in the past tells the nurse about feeling better since being prescribed an antidepressant medication.Which conclusion by the nurse is appropriate based on the assessment data?

A)Improved mood
B)Improved sleep
C)Improved feelings of guilt
D)Improved appetite

Question 52

Which data should suggest to the home health nurse that the client experiencing postpartum depression is improving?

A)Client wearing clean clothes,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 53

Which nursing intervention would the nurse anticipate carrying out to meet the needs of the family of a client experiencing postpartum depression?

A)Emotional support for the newborn
B)Emotional support for the father
C)Temporary placement of the newborn in foster care
D)Child care for the newborn

Question 54

An adolescent client hospitalized with asphyxiation following a suicide attempt tells the nurse,"I know other kids have the same problems I do,but I just wanted to make it stop." Which action by the nurse is the most appropriate?

A)Discuss the client's attendance at school and what activities are enjoyed.
B)Suggest the client listen to music and read a light novel to reduce stress.
C)Ask if the client would like to talk about stressors and problems.
D)Ask what is so devastating that the client needed to commit suicide.

Question 55

A client who is breastfeeding has been diagnosed with postpartum depression after delivering her first child.Which medications does the nurse anticipate being prescribed for this client? Select all that apply.

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

Question 56

A nurse is conducting an admission assessment on a client admitted for thoughts of suicide.Which assessment findings would indicate that the client is at a high level risk of suicide? Select all that apply.

A)Displays mild depression.
B)Shows curiosity about death.
C)Has access to a gun at home.
D)Admits planning to end his or her life.
E)Discusses a plan to end his or her life in detail.

Question 57

A nurse is interviewing a client who recently attempted suicide.Which question is appropriate for the nurse to ask the client?

A)"Do you currently have a plan for killing yourself?"
B)"Why would you think about harming yourself?"
C)"Did you feel unsafe?"
D)"Do you ever think about hurting yourself?"