Question 1

A nurse admits an older client with memory loss, confused thinking, and apathy. A psychiatrist suspects a depressive disorder. What is the rationale for performing a mini-mental status exam?

Accepted Answer

A)   To rule out bipolar disorder
B)   To rule out schizophrenia
C)   To rule out neurocognitive disorder
D)   To rule out personality disorder C

Question 2

A nurse assesses a client suspected of having the diagnosis of major depressive episode. Which client symptom would rule out this diagnosis?

Accepted Answer

A)   The client is disheveled and malodorous.
B)   The client refuses to interact with others and isolates self in room.
C)   The client is unable to feel any pleasure.
D)   The client has maxed-out charge cards and exhibits promiscuous behaviors. D

Question 3

A nurse is working with a client who has just been prescribed buproprion (Wellbutrin). Which statement by the client indicates that further education is necessary?

Accepted Answer

A)   "I will begin using sunblock when outdoors."
B)   "If I miss a dose, I will just take two pills the next day to catch up."
C)   "I will only discontinue the medication under the guidance of my physician."
D)   "I will use caution when driving and using dangerous machinery." B

Question 4

What is the rationale for a nurse to perform a full physical health assessment on a client admitted with a diagnosis of major depressive episode?

Accepted Answer

A)   The attention during the assessment is beneficial in decreasing social isolation.
B)   Depression can generate somatic symptoms that can mask actual physical disorders.
C)   Physical health complications are likely to arise from antidepressant therapy.
D)   Depressed clients avoid addressing physical health and ignore medical problems.

Question 5

A client diagnosed with major depressive episode hears voices commanding self-harm. Which should be the nurse's priority intervention at this time?

Accepted Answer

A)   Obtaining an order for locked seclusion until client is no longer suicidal
B)   Conducting 15-minute checks to ensure safety
C)   Placing the client on one-to-one observation while continuing to monitor suicidal ideations
D)   Encouraging client to express feelings related to suicide

Question 6

___________________________ is a pervasive and sustained emotion that may have a major influence on a person's perception of the world.

Accepted Answer

The answer of ___________________________ is a pervasive and sustained emotion...

Question 7

The nurse educator is lecturing a group of nursing students on depression in adolescents. Which statement indicates that teaching has been effective?

Accepted Answer

A)   "Adolescents are not likely to suffer from depression."
B)   "Depressed adolescents always seek immediate treatment."
C)   "Many symptoms are attributed to normal adjustments of adolescents."
D)   "Suicide is not common among depressed adolescents."

Question 8

An individual experiences sadness and melancholia in September continuing through November. Which of the following factors should a nurse identify as most likely to contribute to the etiology of these symptoms?

Accepted Answer

A)   Gender differences in social opportunities that occur with age
B)   Drastic temperature and barometric pressure changes
C)   A seasonal increase in social interactions
D)   Variations in serotonergic functioning
E)   Inaccessibility of resources for dealing with life stressors

Question 9

A nursing instructor is teaching about the new DSM-5 diagnostic category of disruptive mood dysregulation disorder (DMDD). Which of the following information should the instructor include?

Accepted Answer

A)   Symptoms include verbal rages or physical aggression toward people or property.
B)   Temper outbursts must be present in at least two settings (at home, at school, or with peers) .
C)   DMDD is characterized by severe recurrent temper outbursts.
D)   The temper outbursts are manifested only behaviorally.
E)   Symptoms of DMDD must be present for 18 or more months to meet diagnostic criteria.Other

Question 10

A nurse reviews the laboratory data of a client suspected of having the diagnosis of major depressive episode. Which lab value would potentially rule out this diagnosis?

Accepted Answer

A)   Thyroid-stimulating hormone (TSH)  level of 25 U/mL
B)   Potassium (K+)  level of 4.2 mEq/L
C)   Sodium (Na+)  level of 140 mEq/L
D)   Calcium (Ca2+)  level of 9.5 mg/dL

Question 11

A client who has been newly diagnosed with depression is beginning tricyclic antidepressant therapy. The nurse has just completed teaching with this client. Which statement by the client indicates the need for further education?

Accepted Answer

A)   "I will continue to take this medication even if the symptoms have not subsided."
B)   "I may experience drowsiness or dizziness while taking this medication."
C)   "I do not need to quit smoking."
D)   "I will stop drinking alcohol now that I am taking this medication."

Question 12

A client is diagnosed with major depressive episode. Which nursing diagnosis should a nurse assign to this client, to address a behavioral symptom of this disorder?

Accepted Answer

A)   Altered communication R/T feelings of worthlessness AEB anhedonia
B)   Social isolation R/T poor self-esteem AEB secluding self in room
C)   Altered thought processes R/T hopelessness AEB persecutory delusions
D)   Altered nutrition: less than body requirements R/T high anxiety AEB anorexia

Question 13

Order the depressive disorders and their predominant affective symptoms according to level of severity.
________ Dysthymic disorder (pessimistic outlook, low self-esteem)
________ Grief (feelings of anger, anxiety, guilt, helplessness)
________ Major depressive episode (despair, worthlessness, flat affect, apathy, anhedonia)
________ Transient depression (sadness, dejection, feeling downhearted, having "the blues")

Accepted Answer

The answer of Order the depressive disorders and their predominant...

Question 14

After 6 months of taking imipramine (Tofranil) for depressive symptoms, a client complains that the medication doesn't seem as effective as before. Which question should the nurse ask to determine the cause of this problem?

Accepted Answer

A)   "Are you consuming foods high in tyramine?"
B)   "How many packs of cigarettes do you smoke daily?"
C)   "Do you drink any alcohol?"
D)   "Are you taking St. John's wort?"

Question 15

A nurse is planning care for a 13-year-old client who is experiencing depression. Which medication is approved by the Food and Drug Administration (FDA) for the treatment of depression in adolescents?

Accepted Answer

A)   Paroxetine (Paxil) 
B)   Sertraline (Zoloft) 
C)   Citalopram (Celexa) 
D)   Escitalopram (Lexapro)

Question 16

A nurse administers 100 percent oxygen to a client during and after electroconvulsive therapy treatment (ECT). What is the rationale for this procedure?

Accepted Answer

A)   To prevent increased intracranial pressure resulting from anoxia
B)   To prevent decreased blood pressure, pulse, and respiration owing to electrical stimulation
C)   To prevent anoxia resulting from medication-induced paralysis of respiratory muscles
D)   To prevent blocked airway, resulting from seizure activity

Question 17

A nursing home resident has a diagnosis of dysthymic disorder. When planning care for this client, which of the following symptoms should a nurse expect the client to exhibit?

Accepted Answer

A)   Sad mood on most days
B)   Mood rating of 2 out of 10 for the past 6 months
C)   Labile mood
D)   Sad mood for the past 3 years after spouse's death
E)   Pressured speech when communicating

Question 18

An older client has recently been prescribed sertraline (Zoloft). The client's spouse is taking paroxetine (Paxil). A nurse assesses that the client is experiencing restlessness, tachycardia, diaphoresis, and tremors. Which complication should a nurse suspect, and why?

Accepted Answer

A)   Neuroleptic malignant syndrome; caused by ingestion of two different serotonin reuptake inhibitors (SSRIs) 
B)   Neuroleptic malignant syndrome; caused by ingestion of an SSRI and a monoamine oxidase inhibitor (MAOI) 
C)   Serotonin syndrome; possibly caused by ingestion of an SSRI and an MAOI
D)   Serotonin syndrome; possibly caused by ingestion of two different SSRIs

Question 19

Immediately after electroconvulsive therapy (ECT), in which position should a nurse place the client?

Accepted Answer

A)   On his or her side, to prevent aspiration
B)   In high Fowler's position, to prevent increased intracranial pressure
C)   In Trendelenburg's position, to promote blood flow to vital organs
D)   In prone position, to prevent airway blockage

Question 20

A staff nurse is counseling a depressed client. The nurse determines that the client is using the cognitive distortion of "automatic thoughts." Which client statement is evidence of the "automatic thought" of discounting positives?

Accepted Answer

A)   "It's all my fault for trusting him."
B)   "I don't play games. I never win."
C)   "She never visits, because she thinks I don't care."
D)   "I don't have a green thumb. Any old fool can grow a rose."

Exam 16: Depressive Disorders