Exam 13: Depressive Disorders

A depressed patient does not converse except when addressed,and then only in monosyllables.Which response by the nurse is likely to be most helpful?

A middle-aged patient who has been treated for depression with SSRIs and cognitive-behavioral therapy has identified that passivity probably contributed to her depression.Which treatment modality would be best for the nurse to suggest?

A recently divorced man with severe depression exhibits poor sleep and impaired concentration,leading him to function poorly at work.Inattention to hygiene and irritability with others aggravate problems at work.Co-workers do not recognize that he is depressed and instead assume his behavioral changes are due to drug abuse.One day he is fired.Work had been his one remaining source of self-worth.The man presents at the emergency room seeking medication to help him sleep.Which of the following responses would be most important for the triage nurse to take at this time?

A woman became severely depressed when the last of her six children moved out of the home 4 months ago.Since then she has neglected to care for herself,sleeps poorly,lost weight,and repeatedly states,"No one cares about me anymore.I'm worthless." After hospitalization,the nursing diagnosis of situational low self-esteem related to feelings of abandonment was identified.The nurse wishes to reinforce the patient's self-esteem by acknowledging the improvement in her personal appearance.She's wearing a new dress and has combed her hair.The most appropriate remark would be:

A patient being treated for depression has been taking 300 mg amitriptyline (Elavil)daily for nearly a year.She calls her case manager at the mental health clinic,stating she stopped taking her antidepressant 2 days ago and has developed something like the "flu," with cold sweats,nausea,a rapid heartbeat,terrible nightmares when she sleeps,but no other symptoms.How should the nurse respond?

During assessment,the nurse is most likely to find the attitude of the depressed patient toward his illness to be:

A depressed patient who is taking a tricyclic antidepressant tells the nurse,"I don't think I can keep taking these pills.They make me very dizzy,especially when I stand up." The best nursing response is:

A student nurse working with a depressed patient finds herself becoming angry with the patient when he responds slowly or not at all to her efforts to improve his mood.Which explanation most likely explains her emotional response?

A patient being treated for major depression is the CEO of her own business.She has shown significant improvement and is about to be discharged after completing a course of 15 electroconvulsive therapy sessions.She will continue on SSRI medications.The patient has been counseled not to make a major business decision for a month.The rationale for this is that:

A severely depressed patient with psychomotor retardation has begun activities therapy.His schedule is: 9 AM,ceramics;10 AM,exercise group;11 AM to noon,open;noon,lunch.The nurse creating the patient's schedule should opt to fill the hour block from 11 AM to noon with:

A man with severe depression is admitted to the partial hospitalization program for mood disorders after exhibiting unintentional weight loss and refusal to go to work.He does not bathe or shave,sleeps poorly,and repeatedly states: "I'm useless,I'm no good to anyone." Which intervention would be best to include in the patient's initial care plan?

An elderly patient complains bitterly and repetitively about numerous somatic concerns,but he has been examined thoroughly by several different health care providers,and physical examinations suggest that he is in good health.The nurse should suspect that the patient's somatic complaints most likely are:

A student in the Mood Disorders Clinic states that everything he does is wrong and that nothing he tries ever works.Although he has never failed an exam,he believes he will fail the next one.Based on evidence-based research,which of the following interventions would best address a presentation of this type?

A disheveled,severely depressed patient with psychomotor retardation has not showered for several days.The nurse should:

A patient taking a monoamine oxidase inhibitor reports that he forgot he wasn't supposed to take over-the-counter drugs without prior approval and took some medication for his cold 6 hours ago.His wife,a nurse's aide,checked and reports that his blood pressure is 128/84,slightly above his usual blood pressure.He has not noticed any other changes or symptoms.Which of the following responses by the nurse would be most appropriate? Select all that apply.

Planned interventions for a newly admitted severely depressed patient should include: