Deck 25: Depressive Disorders

Question 1

After breakfast a depressed patient pleads with the nurse, "Please let me go to my room to lie down for a while." What response should the nurse provide to maintain a therapeutic environment?

A) "You need to attend scheduled unit activities so you won't isolate yourself."
B) "If you agree to attend the next activity, then you can rest."
C) "Just this once, I'll rearrange the activity schedule so you can rest."
D) "Your health care team will be displeased if you go to sleep."

Answer 1

"You need to attend scheduled unit activities so you won't isolate yourself."

Question 2

During an interview of a depressed client, why is it important for the nurse to assess social interactions?

A) To determine any disruptions in relationships with others
B) To identify the client's need for diversional activities therapy
C) To determine the presence of an available support system
D) To assess the patient's ability to make effective decisions

Answer 2

To determine any disruptions in relationships with others

Question 3

A depressed patient has just responded to the nurse in an overtly angry manner. What is the nurse's best response?

A) "I seem to have hit a raw nerve. I'm sorry."
B) "You are angry. Let's talk about the issue."
C) "Please watch your tone of voice when you speak to me."
D) "I don't think I deserved to be shouted at. What's really the matter?"

Answer 3

"You are angry. Let's talk about the issue."

Question 4

What excessive behaviors support the nurse's suspections that the client is demonstrating psychomotor agitation? (Select all that apply.)

A) Pacing
B) Singing loudly
C) Handwringing
D) Fidgeting
E) Refusing to eat

Question 5

Which intervention has the highest priority for inclusion in the care plan of a client diagnosed with anhedonia?

A) Assess history of seasonal variations of mood.
B) Observe for increased sensitivity to rejection.
C) Monitor and document sleep patterns.
D) Assess for echolalia and posturing.

Question 6

A patient who was prescribed a selective serotonin reuptake inhibitor (SSRI) 3 days ago says, "I'm so disappointed, this medicine isn't working." What intervention best addresses the client's expressed concern?

A) Explaining that it's normal for a time lag between starting the antidepressants and symptom relief
B) Reassuring the patient that the medication is an excellent therapy and it will be effective soon
C) Critically assessing the patient for indications that there is a lessening of symptoms
D) Assessing the patient's understanding of depression

Question 7

Which adolescent would the nurse consider to have the highest priority for health promotion interventions aimed at reducing risk for depression, based on the person's history?

A) Parents killed in an auto accident
B) Lived with adoptive parents since birth
C) Allergies to dust, pollen, and mold
D) Frequent conflicts with siblings

Question 8

A patient diagnosed with seasonal affective disorder asks, "Will I ever feel better?" Based on an understanding of this psychopathology, what is the nurse's best response?

A) "Your depressed mood will probably spontaneously improve in 6 months to a year."
B) "People with seasonal affective disorder usually feel better in spring and summer, when there are longer periods of light."
C) "It's important to engage in community activities to improve your depressed mood. Activity stimulates important brain chemicals."
D) "Most people with seasonal affective disorder feel better during the fall and winter seasons as they experience the pleasure of the holidays."

Question 9

What assessment data would best support a client's diagnosis of dysthymic?

A) Changes in appetite and weight
B) Presence of suicidal ideation
C) How long symptoms have persisted
D) Presence of delusions or hallucinations

Question 10

The sibling of a depressed patient says, "When we were children my sister always gave up easily. Now as an adult, everyone in the family takes advantage of her." What is the most appropriate nursing intervention to support the client's self-esteem?

A) Begin cognitive therapy to reduce negative thinking.
B) Plan measures to reduce inappropriate feelings of guilt.
C) Discuss the value of assertiveness training with the patient.
D) Invite the sibling to join the patient's group therapy sessions.

Question 11

Which statement made by a newly admitted depressed patient best demonstrates a depression-related delusion?

A) "I am a presidential advisor."
B) "Cancer is rotting my body."
C) "There are aliens chasing me."
D) "I discovered a cure for cancer."

Question 12

A clinic nurse assesses a Latino patient who reports having frequent headaches beginning about 6 months ago when immigrating to the United States. When no organic pathology is found, what intervention should the nurse implement first?

A) Providing information regarding stress reduction techniques
B) Encouraging the patient to maintain good health habits
C) Assessing the client for possible sources of stress
D) Screening for signs and symptoms of depression

Question 13

The plan for a depressed patient includes use of cognitive therapy. Which nursing intervention best supports this therapy?

A) Uncovering unconscious conflicts by encouraging description of childhood traumas
B) Challenging pessimistic beliefs and recognizing the patient's accomplishments
C) Determining areas of mutual understanding between the nurse and patient
D) Using role-playing to rehearse new behaviors

Question 14

A patient diagnosed with depression paces, pulls at clothing constantly, and cannot sit for longer than 5 minutes. What nursing intervention should the nurse implement to help manage the client's behavior?

A) Reassure the patient that depression is treatable.
B) Direct the patient to lie down every 2 hours.
C) Ask the patient to assist in a simple, repetitive activity.
D) Seek a prescription for a PRN antipsychotic medication.

Question 15

Which topics should be included by the nurse preparing psychoeducational groups for patients diagnosed with major depressive disorder (MDD) and their families? (Select all that apply.)

A) Flight of ideas
B) Changes in weight and sleep
C) Feelings of importance or elation
D) Psychomotor retardation or agitation
E) Inability to concentrate or make decisions

Question 16

Which statement should the nurse include when preparing a patient for a scheduled dexamethasone suppression test?

A) "This test will determine whether or not you are clinically depressed."
B) "This test is like a computed tomography scan. It will take about 20 minutes and will be painless."
C) "You will be given an injection; then, blood and urine samples will be collected."
D) "You will not be allowed to eat or drink after midnight, and a fasting blood sample will be collected in the morning."

Question 17

Which account of history and symptoms is most consistent with the diagnosis of dysthymia?

A) Depressed mood for 2 weeks; anhedonia; feelings of worthlessness
B) Delusions of guilt and poverty; weight loss; agitation beginning 3 weeks ago
C) Depressed mood for 3 months; suicidal ruminations; hypersomnia; sullen affect
D) Depressed for 3 years; poor concentration; anhedonia; low self-esteem; indecision

Question 18

Which nursing diagnosis is almost universally applicable to persons with depression?

A) Ineffective denial
B) Disturbed body image
C) Chronic low self-esteem
D) Risk for other-directed violence

Question 19

Which entry in the medical record best indicates that the treatment plan for a depressed patient was successful?

A) Gained 2 lb; sleeping 8 hours nightly; states, "I'm feeling better about my life situation"
B) Weight stable; sleeping 6 hours nightly; reports of abdominal pain and headache decreasing
C) Gained 6 lb; sleeping 10 hours nightly; sensitive to interpersonal conflicts
D) Lost 2 lb; sleeping 5 hours nightly; shows moderate interest in activities

Question 20

The nurse observes a severely depressed patient leaving the dining room with a shirt that is soiled from spilled food. What intervention should the nurse implement to assist the client deal with the primary issue?

A) Fostering independence by suggesting changing shirts
B) Ignoring the spill to avoid embarrassing the patient
C) Assisting the patient to change shirts to help with motivation
D) Asking the client if they have a clean shirt to help with self-esteem