NURSING 5 NCLEX Depressive Disorders B Quiz
A client has been diagnosed with major depressive disorder. A common symptom would include which of the following?
a) Assertiveness
b) Increased energy
c) Ability to sleep without interruption
d) Self-blame
Self-blame
Explanation:
Symptoms of major depressive disorder include self-blame, feelings of worthlessness, decreased energy, insomnia, and difficulty making decisions.
Electroconvulsive therapy (ECT) has been shown to be an effective treatment for people with severe depression. However, ECT is contraindicated in which of the following disease processes?
b) Diabetes mellitus
c) Hypertension
d) Increased intracranial pressure
Research has shown that risk of suicide increases within which timeframe for initiation of antidepressant therapy?
a) 35 days
b) 42 days
c) 28 days
d) 14 days
Which of the following clients is most likely to benefit from electroconvulsive therapy (ECT)?
a) A client with bipolar disorder who is not compliant with the blood testing necessary for lithium therapy
b) A woman whose major depression has not responded appreciably to antidepressants
c) A client whose recent strange behavior has been attributed to cyclothymic disorder
d) A man with a diagnosis of bipolar II disorder who has recently begun experiencing a manic episode
A father of four small children lost his wife in an automobile accident 3 months ago and is admitted to the hospital with severe depression. Since his wife’s death, his mood has been somber; until now, he has refused treatment. For what is this patient at high risk? a) Schizophrenia
b) Dysthymic disorder
c) Bipolar disorder
d) Suicide
The monoamine hypothesis of depression
a) holds that depression is caused by sociocultural and psychological factors.
b) holds that depression is caused by only one of the biogenic amines.
c) relates to bipolar disorders, not to depression.
d) holds that depression results from a deficiency in the concentrations or in metabolic dysregulation of the monoamines.
The priority concern for people with mood disorders is which of the following?
a) Occupational functioning
b) Basic care
c) Safety
d) Social functioning
A nurse taking an admission history from a patient suspects that they physician will diagnose major depression. For the physician to make this diagnosis, the patient will have to demonstrate at least four of seven symptoms. The nurse knows that some of these symptoms include which of the following? (Select all that apply.)
a) Obsessive desire to exercise
b) Disruption in concentration
c) Disruption in sleep
d) Excessive guilt
e) Disruption in appetite
The genetic theory, when applied to the occurrence of depression, supports that the psychiatric nurse should
a) Assess for depression in the client’s family history
b) Prepare the client for diagnostic genetic testing to confirm the diagnosis
c) Encourage the client to seek genetic counseling before considering a pregnancy
d) Educate the client regarding the symptoms of related physical disorders
According to the Learned Helplessness behavioral theory, the psychiatric nurse shows an understanding of therapeutic supportive care of a client depressed over the loss of employment when
a) Providing a list of community services to reassure the client that resources are available to help until employment is found
b) Determining how the client reacted to stressors like this before in order to evaluate the effectiveness of his coping skills
c) Providing positive reinforcement concerning the client’s ability to find another job by helping him identify his employable skills
d) Helping the client realize he was not responsible for the loss of his job but rather it is a result of circumstances outside of his control
Carrie, age 20, was admitted to your unit following a suicide attempt. She is disheveled, disorganized, and dehydrated. The priority for her care during the first 24 hours of her admission is
a) assisting Carrie with her activities of daily living, including a shower and clean clothing.
b) assessing Carrie’s current suicidal ideation and putting her on suicide precautions.
c) rehydrating Carrie by forcing fluids.
d) assessing Carrie’s recent suicide attempt and identifying factors that may have contributed to it.
The nurse working on a mental health unit is precepting a nursing student learning about depression. The student asks the preceptor about what constitutes a diagnosis for major depressive disorder. What is the nurse’s best response?
a) “The primary diagnostic criterion is one or more major depressive episodes for at least 2 weeks with other symptoms present.”
b) “Depression is a mood variation to life events.”
c) “The physician diagnoses depression when a patient has feelings of sadness several times a year.”
d) “Feelings of anxiety and sadness as a response to a life event are the most important qualifiers for depression.”
A client is prescribed phenelzine (Nardil) to treat her depression. She is at a local café for lunch with a friend. Which of the following items on the menu would be least appropriate for the client to order?
a) A Cobb salad with blue cheese and Roquefort salad dressing
b) Medium-well steak, French fries, and broccoli
c) Scrambled eggs, toast, and grape jelly
d) Roast beef, mashed potatoes, and gravy
Which disorder is characterized by at least 2 years of depressed mood for more days than not with some additional, less severe symptoms that do not meet the criteria for a major depressive episode?
a) Dysthymic disorder
b) Seasonal affective disorder
c) Cyclothymic disorder
d) Hypomania
Which of the following antidepressant medications is classified as a selective serotonin reuptake inhibitor (SSRI)?
a) Tranylcypromine (Parnate)
b) Phenelzine (Nardil)
c) Isocarboxazid (Marplan)
d) Fluoxetine (Prozac)
The nurse is caring for a patient receiving a tricyclic antidepressant and is monitoring for anticholinergic side effects. Anticholinergic effects include which of the following? a) Blurred vision
b) Hyperactive bowel sounds
c) Urinary incontinence
d) Moist skin
Which of the following would not be associated with learned helplessness?
a) Negative expectations
b) Hopelessness
c) Passivity
d) Impulsivity
A nurse is preparing a presentation for family members of clients who have been diagnosed with depression. When describing the family response to depression, which of the following would the nurse include?
a) Family members typically can understand how disabling depression can be.
b) Abuse of the depressed person is a rare occurrence in families.
c) Depression in one family member affects the entire family.
d) Families of women older than 55 years of age with depression experience the majority of problems.
A client who just went through an upsetting divorce is threatening to commit suicide with a handgun. The client is involuntarily admitted to the psychiatric unit. Which of the following nursing diagnoses has the highest priority?
a) Hopelessness related to recent divorce
b) Ineffective coping related to inadequate stress management
c) Spiritual distress related to conflicting thoughts about suicide and sin
d) Risk for suicide related to highly lethal plan
A client’s physician has prescribed paroxetine (Paxil) for the treatment of her depression. Which of the following teaching points should the nurse include in the client education related to this treatment?
a) “Make sure that you don’t change the quantity or timing of your medication without first consulting your doctor.”
b) “The advantage of Paxil is that it will normally relieve depression in a few weeks and it has no side effects.”
c) “If you don’t feel noticeably better within three weeks, increase your dose by 50 %.”
d) “If you forget to take a dose one day, take a double dose the next day and be sure to let your doctor know.”
A client has been recently diagnosed with depression and has just begun medication management. Which of the client’s following statements indicates an accurate understanding of this aspect of treatment?
a) “I know that few people actually see an improvement in their mood with antidepressants, but I suppose I’ll try anyhow.”
b) “I understand that I probably won’t feel much better for a couple of weeks after I start the drugs.”
c) “I can tell that I get a lift each morning after I take my antidepressant.”
d) “I’m still trying to decide whether antidepressants will be helpful in my treatment.”
A client diagnosed with depression is being treated with Phenelzine (Nardil). The nurse should teach the client to avoid which of the following foods?
a) Aged cheese
b) Chicken
c) Oranges
d) Rice
The nurse is teaching a 70-year-old man about his depression. Which of the following statements by the client would indicate that teaching has been effective?
a) “I never knew depression could just happen for no specific reason.”
b) “All old people get depressed at times.”
c) “I’m glad I’ll feel better in 2 or 3 days.”
d) “When I reduce the stress in my life, the depression will go away.” Which type of antidepressants is rarely fatal in overdose?
a) SSRIs
b) MAOIs
c) Tricyclics
d) Atypical
A client has been diagnosed with major depressive disorder. The clinical symptoms that would be included when the clinician makes this diagnosis are what?
a) A significant decrease in appetite
b) Demonstrated examples of unwise decisions
c) A significant failure in an occupational or relational setting
d) Claims by family, friends, or coworkers that the client is depressed The mental health nurse appropriately provides education on phototherapy to a
a) 45-year-old lawyer whose medication therapy needs an additional treatment
b) 50-year-old farmer whose major depression has not responded to any treatment modality
c) 58-year-old showing signs of early Alzheimer’s disease
d) 20-year-old college student who reports being “too tired, sad and unfocused” to enroll for classes in the winter term
The nurse is caring for a client with major depression. The client tells the nurse that she “just isn’t sure that life is worth living.” The nurse documents which nursing diagnosis as the priority?
a) Hopelessness related to symptoms of depression
b) Thought Processes, Disturbed, related to memory loss and depression
c) Self-esteem, Low, related to depressive episode
d) Anxiety related to lack of energy for self-care activities
After teaching a group of nursing students about the neurobiologic theories of depression, the instructor determines the need for additional teaching when the students identify which neurotransmitter is playing a role?
a) Dopamine
b) Gamma-amino butyric acid (GABA)
c) Norepinephrine
d) Serotonin
A patient is admitted to the hospital. When the nurse takes a medication history, the patient reports use of St. John’s wort. The nurse knows that this herb is used for which of the following?
a) To fight high cholesterol
b) To prevent cancer
c) To fight depression
d) To prevent enlarged prostate
When completing discharge medication education for the client, he asks how long it will take before the effects of his prescribed SSRI could be felt. The nurse states that it will likely take?
a) 3 to 4 weeks
b) 5 to 7 days
c) 1 to 2 days
d) 2 to 3 weeks
The nurse makes a home visit to a client who has dysthymic disorder. Which of the following would the nurse expect to assess?
a) Agitation
b) Normal appetite
c) Intense concentration
d) Low energy
A client comes to the emergency department complaining of a severe pounding headache in the temples and a stiff neck. The client is flushed and diaphoretic, and his pulse is racing. The client states that he is being treated for depression with selegiline.
Which question by the nurse would be most important to ask at this time?
a) “Are you having any chest pain?”
b) “What have you had to eat or drink today?”
c) “Do you use any herbal remedies?”
d) “When did you last have blood drawn to check your drug level?”
Susan was abandoned by her parents at age 3, resulting in her perception of the world as a hostile place and the subsequent development of rage against men. This statement is an example of
a) a physiological explanation for Susan’s depressive disorder.
b) a psychodynamic interpretation of Susan’s major depressive disorder.
c) why Susan has become lesbian at the age of 23.
d) a feminist viewpoint of depression.
To best minimize the risk of a client’s noncompliance with new drug therapy for a mood disorder, the nurse discusses (Select all that apply.)
a) Social barriers against psychiatric treatments
b) Detailed description of possible side effects
c) Importance of staying in touch with mental health care provider
d) That the length of time treatment is anticipated
e) That there is a possibility that two or more drugs will be prescribed Which of the following is a true statement regarding depressive disorders?
a) They are more prevalent in men than women.
b) The monoamines norepinephrine, dopamine, and serotonin have been implicated.
c) Depression in older adults is easier to diagnose.
d) It is the leading cause of U.S. disability in clients older than 44 years of age.
Cognitive psychotherapy is most likely to be appropriate in the care of a client who has been diagnosed with which one of the following?
a) Moderate depression
b) Postpartum psychosis
c) A mood disorder due to a general medical condition
d) Anaclitic depression
Suicide is the intentional act of killing oneself. Which characteristic is most common among suicidal clients?
a) Anger
b) Remorse
c) Ambivalence
d) Psychosis
Ambivalence
Explanation:
Suicide involves ambivalence. Many fatal accidents may be impulsive suicides. It is impossible to know, for example, whether the person who drove into a telephone pole
did this intentionally.
The patient is taking an MAOI for depression. The nurse teaches the patient to avoid foods containing which of the following while taking this medication?
a) Sugar
b) Tyramine
c) Calcium
d) Potassium
A group of nursing students is reviewing information about the epidemiology of depressive disorders. The students demonstrate understanding of the information when they identify which of the following as possible risk factors? Select all that apply.
a) Inadequate coping skills
b) Prior episode of anxiety disorder
c) Concomitant medical illnesses
d) History of substance abuse as a teenager
e) Little social support
A client with depression is prescribed fluoxetine. On a return visit to the clinic, the client tells the nurse that he also just started taking St. John’s wort to feel better. The nurse assesses the client for which of the following?
a) Serotonin syndrome
b) Water intoxication
c) Hypertensive crisis
d) Increased depressive symptoms
A nurse taking an admission history from a patient suspects that they physician will diagnose major depression. For the physician to make this diagnosis, the patient will have to demonstrate at least four of seven symptoms. The nurse knows that some of these symptoms include which of the following? (Select all that apply.)
a) Disruption in concentration
b) Disruption in appetite
c) Excessive guilt
d) Obsessive desire to exercise
e) Disruption in sleep
A client with severe depression after immigrating to the United States and the loss of an infant expresses increasing suicidal ideation to the primary nurse. The priority nursing intervention should be:
a) Ensuring that the client is not permitted to use anything that would be potentially dangerous.
b) Encouraging the client to express feelings of isolation following the recent immigration.
c) Encouraging attendance at group cognitive-behavioral therapy on the unit.
d) Exploring the grief and loss issues concerning the baby’s death
