Question 1

A 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 this documentation? (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)   PowerlessnessF)  Insomnia A, C, D, F

Question 2

A patient was diagnosed with seasonal affective disorder (SAD). During which month would this patient's symptoms be most acute?

Accepted Answer

A)   January
B)   April
C)   June
D)   September A

Question 3

Priority interventions for a patient diagnosed with major depressive disorder and feelings of worthlessness should include

Accepted Answer

A)   distracting the patient from self-absorption.
B)   careful unobtrusive observation around the clock.
C)   allowing the patient to spend long periods alone in meditation.
D)   opportunities to assume a leadership role in the therapeutic milieu. B

Question 4

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

Accepted Answer

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

Question 5

Major depressive disorder resulted after a patient's employment was terminated. The patient now says to the nurse, "I'm not worth the time you spend with me. I am the most useless person in the world." Which nursing diagnosis applies?

Accepted Answer

A)   Powerlessness
B)   Defensive coping
C)   Situational low self-esteem
D)   Disturbed personal identity

Question 6

When counseling patients diagnosed with major depressive disorder, an advanced practice nurse will address the negative thought patterns by using

Accepted Answer

A)   psychoanalytic therapy.
B)   desensitization therapy.
C)   cognitive-behavioral therapy.
D)   alternative and complementary therapies.

Question 7

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 of

Accepted Answer

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

Question 8

Transcranial Magnetic Stimulation (TCM) is scheduled for a patient diagnosed with major depressive disorder. Which comment by the patient indicates teaching about the procedure was effective?

Accepted Answer

A)   "They will put me to sleep during the procedure so I won't know what is happening."
B)   "I might be a little dizzy or have a mild headache after each procedure."
C)   "I will be unable to care for my children for about 2 months."
D)   "I will avoid eating foods that contain tyramine."

Question 9

A patient diagnosed with major depressive disorder refuses solid foods. In order to meet nutritional needs, which beverage will the nurse offer to this patient?

Accepted Answer

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

Question 10

During a psychiatric assessment, the nurse observes a patient's facial expression is without emotion. The patient says, "Life feels so hopeless to me. I've been feeling sad for several months." How will the nurse document the patient's affect and mood?

Accepted Answer

A)   Affect depressed; mood flat
B)   Affect flat; mood depressed
C)   Affect labile; mood euphoric
D)   Affect and mood are incongruent.

Question 11

A patient became depressed after the last of the family's six children moved out of the home 4 months ago. Select the best initial outcome for the nursing diagnosis Situational low self-esteem related to feelings of abandonment. The patient will

Accepted Answer

A)   verbalize realistic positive characteristics about self by (date) .
B)   agree to take an antidepressant medication regularly by (date) .
C)   initiate social interaction with another person daily by (date) .
D)   identify two personal behaviors that alienate others by (date) .

Question 12

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)   Desensitization techniques
D)   Use of complementary therapy

Question 13

A patient being treated for depression has taken sertraline daily for a year. The patient calls the clinic nurse and says, "I stopped taking my antidepressant 2 days ago. Now I am having nausea, nervous feelings, and I can't sleep." The nurse will advise the patient to:

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 a dose of your antidepressant now and come to the clinic to see the health care provider."
D)   "Resume taking your antidepressants for 2 more weeks and then discontinue them again."

Question 14

A disheveled patient in the acute phase of major depressive disorder is withdrawn, has psychomotor retardation, and has not showered for several days. The nurse will

Accepted Answer

A)   bring up the issue at the community meeting.
B)   calmly tell the patient, "You must bathe daily."
C)   make observations about the patient's poor personal hygiene.
D)   firmly and neutrally assist the patient with showering.

Question 15

A patient diagnosed with major depressive disorder tells the nurse, "Bad things that happen are always my fault." Which response by the nurse will best assist the patient to reframe this overgeneralization?

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 extremely hard on yourself. Try to have a positive focus."
D)   "Are you saying that you don't have any good things happen?"

Question 16

A patient diagnosed with major depressive disorder began taking escitalopram 5 days ago. The patient now says, "This medicine isn't working." The nurse's best intervention would be to

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.

Question 17

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 intake of processed foods.

Question 18

A nurse taught a patient about a tyramine-restricted diet. Which menu selection would the nurse approve?

Accepted Answer

A)   Macaroni and cheese, hot dogs, banana bread, caffeinated coffee
B)   Mashed potatoes, ground beef patty, corn, green beans, apple pie
C)   Avocado salad, ham, creamed potatoes, asparagus, chocolate cake
D)   Noodles with cheddar cheese sauce, smoked sausage, lettuce salad, yeast rolls

Question 19

A patient is experiencing psychomotor agitation associated with major depressive disorder. Which observation would the nurse associate with this symptom? The patient

Accepted Answer

A)   paces aimlessly around the room.
B)   asks the nurse to repeat instructions.
C)   complains of prickly skin sensations.
D)   demonstrates slowed verbal responses.

Question 20

A patient diagnosed with depressive disorder begins selective serotonin reuptake inhibitor (SSRI) antidepressant therapy. The nurse should provide information to the patient and family about

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.

Exam 14: Depressive Disorders