Question 1

Which documentation for a patient diagnosed with major depression indicates the treatment plan was effective?

Accepted Answer

A)  Slept 6 hours uninterrupted. Sang with activity group. Anticipates seeing grandchild. 
B)  Slept 10 hours uninterrupted. Attended craft group; stated "project was a failure, just like me." 
C)  Slept 5 hours with brief interruptions. Personal hygiene adequate with assistance. Weight loss of 1 pound. 
D)  Slept 7 hours uninterrupted. Preoccupied with perceived inadequacies. States, "I feel tired all the time." 
A)  Slept 6 hours uninterrupted. Sang with activity group. Anticipates seeing grandchild. 
B)  Slept 10 hours uninterrupted. Attended craft group; stated "project was a failure, just like me." 
C)  Slept 5 hours with brief interruptions. Personal hygiene adequate with assistance. Weight loss of 1 pound. 
D)  Slept 7 hours uninterrupted. Preoccupied with perceived inadequacies. States, "I feel tired all the time."

Question 2

An adult diagnosed with major depression was treated with medication and cognitive-behavioural therapy. The patient now recognizes how passivity contributed to the depression. Which intervention should the nurse suggest?

Accepted Answer

A)  Social skills training 
B)  Relaxation training classes 
C)  Desensitization techniques 
D)  Use of complementary therapy 
A)  Social skills training 
B)  Relaxation training classes 
C)  Desensitization techniques 
D)  Use of complementary therapy

Question 3

How long after a patient stops a monoamine oxidase inhibitor does he or she need to maintain the dietary restrictions followed when taking this medication?

Accepted Answer

A)  Can resume normal diet immediately 
B)  48 hours after the last dose 
C)  1 week after the last dose 
D)  2 weeks after the last dose 
A)  Can resume normal diet immediately 
B)  48 hours after the last dose 
C)  1 week after the last dose 
D)  2 weeks after the last dose

Question 4

A nurse instructs a patient taking a medication that inhibits the action of monoamine oxidase (MAO) to avoid certain foods and drugs because of the risk for which of the following?

Accepted Answer

A)  Hypotensive shock 
B)  Hypertensive crisis 
C)  Cardiac dysrhythmia 
D)  Cardiogenic shock 
A)  Hypotensive shock 
B)  Hypertensive crisis 
C)  Cardiac dysrhythmia 
D)  Cardiogenic shock

Question 5

A patient diagnosed with depression begins selective serotonin reuptake inhibitor (SSRI) antidepressant therapy. The nurse should provide information to the patient and family about which of the following?

Accepted Answer

A)  Restricting sodium intake to 1 gram daily 
B)  Minimizing exposure to bright sunlight 
C)  Reporting increased suicidal thoughts 
D)  Maintaining a tyramine-free diet 
A)  Restricting sodium intake to 1 gram daily 
B)  Minimizing exposure to bright sunlight 
C)  Reporting increased suicidal thoughts 
D)  Maintaining a tyramine-free diet

Question 6

A patient diagnosed with major depression says, "No one cares about me anymore. I'm not worth anything." Today the patient is wearing a new shirt and has neat, clean hair. Which remark by the nurse supports building a positive self-esteem for this patient?

Accepted Answer

A)  "You look nice this morning." 
B)  "You're wearing a new shirt." 
C)  "I like the shirt you are wearing." 
D)  "You must be feeling better today." 
A)  "You look nice this morning." 
B)  "You're wearing a new shirt." 
C)  "I like the shirt you are wearing." 
D)  "You must be feeling better today."

Question 7

A patient diagnosed with depression is receiving amitriptyline (Elavil) 50 mg qhs. Which assessment finding would prompt the nurse to collaborate with the health care provider regarding potentially hazardous side effects of this drug?

Accepted Answer

A)  Dry mouth 
B)  Blurred vision 
C)  Nasal congestion 
D)  Urinary retention 
A)  Dry mouth 
B)  Blurred vision 
C)  Nasal congestion 
D)  Urinary retention

Question 8

A nurse worked with a patient diagnosed with major depression, severe withdrawal, and psychomotor retardation. After 3 weeks, the patient did not improve. The nurse is most at risk for which of the following?

Accepted Answer

A)  Feelings of guilt and despair 
B)  Feelings of over-involvement 
C)  Feelings of interest and pleasure 
D)  Feelings of ineffectiveness and frustration 
A)  Feelings of guilt and despair 
B)  Feelings of over-involvement 
C)  Feelings of interest and pleasure 
D)  Feelings of ineffectiveness and frustration

Question 9

A patient diagnosed with major depression began taking escitalopram (Cipralex) 5 days ago. The patient now says, "This medicine isn't working." The nurse's best intervention would be which of the following?

Accepted Answer

A)  Discuss with the health care provider the need to increase the dose 
B)  Reassure the patient that the medication will be effective soon 
C)  Explain the time lag before antidepressants relieve symptoms 
D)  Critically assess the patient for symptoms of improvement 
A)  Discuss with the health care provider the need to increase the dose 
B)  Reassure the patient that the medication will be effective soon 
C)  Explain the time lag before antidepressants relieve symptoms 
D)  Critically assess the patient for symptoms of improvement

Question 10

A patient diagnosed with major depression began taking a tricyclic antidepressant 1 week ago. Today the patient says, "I don't think I can keep taking these pills. They make me so dizzy, especially when I stand up." The nurse will do which of the following?

Accepted Answer

A)  Limit the patient's activities to those that can be performed in a sitting position 
B)  Withhold the drug, force oral fluids, and notify the health care provider 
C)  Teach the patient strategies to manage postural hypotension 
D)  Update the patient's mental status examination 
A)  Limit the patient's activities to those that can be performed in a sitting position 
B)  Withhold the drug, force oral fluids, and notify the health care provider 
C)  Teach the patient strategies to manage postural hypotension 
D)  Update the patient's mental status examination

Question 11

Which falls within the parameters of the normal course of treatment of depression with ECT?

Accepted Answer

A)  Daily for 7 days 
B)  Three times per week for 10 weeks 
C)  Once a week for 8 weeks 
D)  Twice a week for 4 weeks 
A)  Daily for 7 days 
B)  Three times per week for 10 weeks 
C)  Once a week for 8 weeks 
D)  Twice a week for 4 weeks

Question 12

A patient diagnosed with major depression does not interact with others except when addressed, and then only in monosyllables. The nurse wants to show nonjudgemental acceptance and support for the patient. Which communication technique will be effective?

Accepted Answer

A)  Make observations. 
B)  Ask the patient direct questions. 
C)  Phrase questions to require yes or no answers. 
D)  Frequently reassure the patient to reduce guilt feelings. 
A)  Make observations. 
B)  Ask the patient direct questions. 
C)  Phrase questions to require yes or no answers. 
D)  Frequently reassure the patient to reduce guilt feelings.

Exam 13: Depressive Disorders

Which documentation for a patient diagnosed with major depression indicates the treatment plan was effective?

An adult diagnosed with major depression was treated with medication and cognitive-behavioural therapy. The patient now recognizes how passivity contributed to the depression. Which intervention should the nurse suggest?

How long after a patient stops a monoamine oxidase inhibitor does he or she need to maintain the dietary restrictions followed when taking this medication?

A nurse instructs a patient taking a medication that inhibits the action of monoamine oxidase (MAO) to avoid certain foods and drugs because of the risk for which of the following?

A patient diagnosed with depression begins selective serotonin reuptake inhibitor (SSRI) antidepressant therapy. The nurse should provide information to the patient and family about which of the following?

A patient diagnosed with major depression says, "No one cares about me anymore. I'm not worth anything." Today the patient is wearing a new shirt and has neat, clean hair. Which remark by the nurse supports building a positive self-esteem for this patient?

A patient diagnosed with depression is receiving amitriptyline (Elavil) 50 mg qhs. Which assessment finding would prompt the nurse to collaborate with the health care provider regarding potentially hazardous side effects of this drug?

A nurse worked with a patient diagnosed with major depression, severe withdrawal, and psychomotor retardation. After 3 weeks, the patient did not improve. The nurse is most at risk for which of the following?

A patient diagnosed with major depression began taking escitalopram (Cipralex) 5 days ago. The patient now says, "This medicine isn't working." The nurse's best intervention would be which of the following?

A patient diagnosed with major depression began taking a tricyclic antidepressant 1 week ago. Today the patient says, "I don't think I can keep taking these pills. They make me so dizzy, especially when I stand up." The nurse will do which of the following?

Which falls within the parameters of the normal course of treatment of depression with ECT?

A patient diagnosed with major depression does not interact with others except when addressed, and then only in monosyllables. The nurse wants to show nonjudgemental acceptance and support for the patient. Which communication technique will be effective?

Mental Health and Mental Illness

Historical Overview of Psychiatric Mental Health Nursing

Overview of Psychiatric Mental Health Nursing Care Within Various Settings

Relevant Theories and Therapies for Nursing Practice

Understanding Responses to Stress

The Nursing Process and Standards of Care for Psychiatric Mental Health Nursing

Ethical Responsibilities and Legal Obligations for Psychiatric Mental Health Nursing Practice

Cultural Considerations for Psychiatric Mental Health Nursing

Therapeutic Relationships

Communication and the Clinical Interview

Psychotropic Drugs

Anxiety and Related Disorders

Bipolar Disorders

Schizophrenia Spectrum and Other Psychotic Disorders

Eating and Feeding Disorders

Neurocognitive Disorders

Psychoactive Substance Use and Treatment

Personality Disorders

Sleepwake Disorders

Crisis and Disaster

Suicide and Nonsuicidal Self-Injury

Anger, Aggression, and Violence

Interpersonal Violence: Child, Older Adult, and Intimate Partner Abuse

Sexual Assault

Sexuality and Gender

Disorders of Children and Adolescents

Psychosocial Needs of the Older Adult

Living With Recurrent and Persistent Mental Illness

Psychological Needs of Patients With Medical Conditions

Care for the Dying and for Those Who Grieve

Forensic Psychiatric Nursing

Therapeutic Groups

Family Interventions

Integrative and Complimentary Therapies

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