Question 1

A patient diagnosed with major depressive disorder shows vegetative signs of depression. Which nursing actions should be implemented? (Select all that apply.)

Accepted Answer

A)  Offer laxatives, if needed. 
B)  Monitor food and fluid intake. 
C)  Provide a quiet sleep environment. 
D)  Eliminate all daily caffeine intake. 
E)  Restrict the intake of processed foods.

Question 2

A nurse instructs a patient taking a drug that inhibits the action of monoamine oxidase (MAO) to avoid certain foods and drugs because of the risk of:

Accepted Answer

A)  hypotensive shock. 
B)  hypertensive crisis. 
C)  cardiac dysrhythmia. 
D)  cardiogenic shock.

Question 3

A nurse wants to reinforce positive self-esteem for a patient diagnosed with major depressive disorder. Today, the patient is wearing a new shirt and has neat, clean hair. Which remark is most appropriate?

Accepted Answer

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

Question 4

A patient being treated for major depressive disorder has taken 300 mg amitriptyline (Elavil) daily for a year. The patient calls the case manager at the clinic and says, "I stopped taking my antidepressant 2 days ago. Now I am having cold sweats, nausea, a rapid heartbeat, and nightmares." The nurse should advise the patient:

Accepted Answer

A)  "Go to the nearest emergency department immediately." 
B)  "Do not to be alarmed. Take two aspirin and drink plenty of fluids." 
C)  "Take one dose of the antidepressant. Come to the clinic to see the health care provider." 
D)  "Resume taking the antidepressant for 2 more weeks, and then discontinue it again."

Question 5

A nurse provided medication education for a patient who takes phenelzine (Nardil) for depression. Which behavior indicates effective learning? The patient:

Accepted Answer

A)  monitors sodium intake and weight daily. 
B)  wears support stockings and elevates the legs when sitting. 
C)  consults the pharmacist when selecting over-the-counter medications. 
D)  can identify foods with high selenium content, which should be avoided.

Question 6

A patient says to the nurse, "My life does not have any happiness in it anymore. I once enjoyed holidays, but now they're just another day." How would the nurse document the complaint?

Accepted Answer

A)  Vegetative 
B)  Anhedonia 
C)  Euphoria 
D)  Anergia

Question 7

Which beverage should the nurse offer to a patient diagnosed with major depressive disorder who refuses solid food?

Accepted Answer

A)  Tomato juice 
B)  Orange juice 
C)  Hot tea 
D)  Milk

Question 8

A nurse worked with a patient diagnosed with major depressive disorder who was severely withdrawn and dependent on others. After 3 weeks, the patient did not improve. The nurse is at risk for feelings of:

Accepted Answer

A)  overinvolvement. 
B)  guilt and despair. 
C)  interest and pleasure. 
D)  ineffectiveness and frustration.

Question 9

A student nurse caring for a patient diagnosed with major depressive disorder reads in the patient's medical record, "This patient shows vegetative signs of depression." Which nursing diagnoses most clearly relate to the vegetative signs? (Select all that apply.)

Accepted Answer

A)  Imbalanced nutrition: less than body requirements 
B)  Chronic low self-esteem 
C)  Sexual dysfunction 
D)  Self-care deficit 
E)  Powerlessness
F) Insomnia

Question 10

An adult diagnosed with major depressive disorder was treated with medication and cognitive behavioral 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)  Use of complementary therapy 
D)  Learning desensitization techniques

Question 11

A patient diagnosed with major depressive disorder tells the nurse, "Bad things that happen are always my fault." To assist the patient in reframing this overgeneralization, the nurse should respond:

Accepted Answer

A)  "I really doubt that one person can be blamed for all the bad things that happen." 
B)  "Let's look at one bad thing that happened to see if another explanation exists." 
C)  "You are being exceptionally hard on yourself when you say those things." 
D)  "How does your belief in fate relate to your cultural heritage?"

Question 12

A patient being treated with paroxetine (Paxil) 50 mg/day orally for major depressive disorder reports to the clinic nurse, "I took a few extra tablets earlier in the day and now I feel bad." Which aspects of the nursing assessment are most critical? (Select all that apply.)

Accepted Answer

A)  Vital signs 
B)  Urinary frequency 
C)  Increased suicidal ideation 
D)  Presence of abdominal pain and diarrhea 
E)  Hyperactivity or feelings of restlessness

Question 13

A nurse is caring for a patient with low self-esteem. Which nonverbal communication should the nurse anticipate?

Accepted Answer

A)  Arms crossed 
B)  Staring at the nurse 
C)  Smiling inappropriately 
D)  Eyes pointed downward

Exam 15: Mood Disorders: Depression