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dysregulation of the monoamines. The priority concern for people with mood disorders is which of the following? a) Occupational functioning Safety Explanation: A nurse taking an admission history from a patient suspects that they physician will diagnose major depression. For the physician to make this diagnosis, the patient will have to demonstrate at least four of seven symptoms. The nurse knows that some of these symptoms include which of the following? (Select all that apply.) a) Obsessive desire to exercise • Disruption in concentration Explanation: The genetic theory, when applied to the occurrence of depression, supports that the psychiatric nurse should a) Assess for depression in the client's family history Assess for depression in the client's family history Explanation: According to the Learned Helplessness behavioral theory, the psychiatric nurse shows an understanding of therapeutic supportive care of a client depressed over the loss of employment when a) Providing a list of community services to reassure the client that resources are available to help until employment is found Providing positive reinforcement concerning the client's ability to find another job by helping him identify his employable skills Explanation: Carrie, age 20, was admitted to your unit following a suicide attempt. She is disheveled, disorganized, and dehydrated. The priority for her care during the first 24 hours of her admission is a) assisting
Carrie with her activities of daily living, including a shower and clean clothing. assessing Carrie's current suicidal ideation and putting her on suicide precautions. Explanation: The nurse working on a mental health unit is precepting a nursing student learning about depression. The student asks the preceptor about what constitutes a diagnosis for major depressive disorder. What is the nurse's best response? a) "The primary diagnostic criterion is one or more major depressive episodes for at least 2 weeks with other symptoms present." "The primary diagnostic criterion is one or more major depressive episodes for at least 2 weeks with other symptoms present." Explanation: A client is prescribed phenelzine (Nardil) to treat her depression. She is at a local café for lunch with a friend. Which of the following items on the menu would be least appropriate for the client to order? a) A
Cobb salad with blue cheese and Roquefort salad dressing A Cobb salad with blue cheese and Roquefort salad dressing Which disorder is characterized by at least 2 years of depressed mood for more days than not with some additional, less severe symptoms that do not meet the criteria for a major depressive episode? a) Dysthymic disorder Dysthymic disorder Explanation: Which of the following antidepressant medications is classified as a selective serotonin reuptake inhibitor (SSRI)? a) Tranylcypromine (Parnate) Fluoxetine (Prozac) Explanation: The nurse is caring for a patient receiving a tricyclic antidepressant and is monitoring for anticholinergic side effects. Anticholinergic effects include which of the following? a) Blurred vision Blurred vision Which of the following would not be associated with learned helplessness? a) Negative expectations Impulsivity A nurse is preparing a presentation for family members of clients who have been diagnosed with depression. When describing the family response to depression, which of the following would the nurse include? a) Family members typically can understand how disabling depression can be. Depression in one family member affects the entire family. Explanation: A client who just went through an upsetting divorce is threatening to commit suicide with a handgun. The client is involuntarily admitted to the psychiatric unit. Which of the following nursing diagnoses has the highest priority? a) Hopelessness related to recent divorce Risk for suicide related to highly lethal plan Explanation: A client's physician has prescribed paroxetine (Paxil) for the treatment of her depression. Which of the following teaching points should the nurse include in the client education related to this treatment? a) "Make sure that you don't change the quantity or timing of your medication without first consulting your doctor." Make sure that you don't change the quantity or timing of your medication without first consulting your doctor." Explanation: A client has been recently diagnosed with depression and has just begun medication management. Which of the client's following statements indicates an accurate understanding of this aspect of treatment? a) "I know that few people actually see an improvement in their mood with antidepressants, but I suppose I'll try anyhow." "I understand that I probably won't feel much better for a couple of weeks after I start the drugs." A client diagnosed with depression is being treated with Phenelzine (Nardil). The nurse should teach the client to avoid which of the following foods? a) Aged cheese Aged cheese Explanation: The nurse is teaching a 70-year-old man about his depression. Which of the following statements by the client would indicate that teaching has been effective? a) "I never knew depression could just happen for no specific reason." "I never knew depression could just happen for no specific reason."
Explanation: Which type of antidepressants is rarely fatal in overdose? a) SSRIs SSRIs Explanation: A client has been diagnosed with major depressive disorder. The clinical symptoms that would be included when the clinician makes this diagnosis are what? a) A significant decrease in
appetite A significant decrease in appetite Explanation: The mental health nurse appropriately provides education on phototherapy to a a) 45-year-old lawyer whose medication therapy needs an additional treatment 20-year-old college student who reports being "too tired, sad and unfocused" to enroll for classes in the winter term Explanation: The nurse is caring for a client with major depression. The client tells the nurse that she "just isn't sure that life is worth living." The nurse documents which nursing diagnosis as the priority? a) Hopelessness related to symptoms of depression Hopelessness related to symptoms of depression Explanation: After teaching a group of nursing students about the neurobiologic theories of depression, the instructor determines the need for additional teaching when the students identify which neurotransmitter as playing a role? a) Dopamine Gamma-amino butyric acid (GABA) Explanation: A patient is admitted to the hospital. When the nurse takes a medication history, the patient reports use of St. John's wort. The nurse knows that this herb is used for which of the following? a) To fight high cholesterol To fight depression Explanation: When completing discharge medication education for the client, he asks how long it will take before the effects of his prescribed SSRI could be felt. The nurse states that it will likely take? a) 3 to 4 weeks 2 to 3 weeks Explanation: The nurse makes a home visit to a client who has dysthymic disorder. Which of the following would the nurse expect to assess? a) Agitation Low energy Explanation: A client comes to the emergency department complaining of a severe pounding headache in the temples and a stiff neck. The client is flushed and diaphoretic, and his pulse is racing. The client states that he is being treated for depression with selegiline. Which question by the nurse would be most important to ask at this time? a) "Are you having any chest pain?" "What have you had to eat or drink today?" Susan was abandoned by her parents at age 3, resulting in her perception of the world as a hostile place and the subsequent development of rage against men. This statement is an example of a) a biophysiological explanation for Susan's depressive disorder. a psychodynamic interpretation of Susan's major depressive disorder. Explanation: To best minimize the risk of a client's noncompliance with new drug therapy for a mood disorder, the nurse discusses (Select all that apply.) a) Social barriers against psychiatric
treatments • That the length of time treatment is anticipated Which of the following is a true statement regarding depressive disorders? a) They are more prevalent in men than women. The monoamines norepinephrine, dopamine, and serotonin have been implicated. Cognitive psychotherapy is most likely to be appropriate in the care of a client who has been diagnosed with which one of the following? a) Moderate depression Moderate depression Suicide is the intentional act of killing oneself. Which characteristic is most common among suicidal clients? a) Anger Ambivalence The patient is taking an MAOI for depression. The nurse teaches the patient to avoid foods containing which of the following while taking this medication? a) Sugar Tyramine
Explanation: A group of nursing students is reviewing information about the epidemiology of depressive disorders. The students demonstrate understanding of the information when they identify which of the following as possible risk factors? Select all that apply. a) Inadequate coping skills • Little social support A client with depression is prescribed fluoxetine. On a return visit to the clinic, the client tells the nurse that he also just started taking St. John's wort to feel better. The nurse assesses the client for which of the following? a) Serotonin syndrome Serotonin syndrome A nurse taking an admission history from a patient suspects that they physician will diagnose major depression. For the physician to make this diagnosis, the patient will have to demonstrate at least four of seven symptoms. The nurse knows that some of these symptoms include which of the following? (Select all that apply.) a) Disruption in concentration • Disruption in sleep A client with severe depression after immigrating to the United States and the loss of an infant expresses increasing suicidal ideation to the primary nurse. The priority nursing intervention should be: a) Ensuring that the client is not permitted to use anything that would be potentially dangerous. Ensuring that the client is not permitted to use anything that would be potentially dangerous. What qualifies as a major depressive episode?A major depressive episode is a period of two weeks or longer in which a person experiences certain symptoms of major depression: feelings of sadness and hopelessness, fatigue, weight gain or weight loss, changes in sleeping habits, loss of interest in activities, or thoughts of suicide.
What is the required frequency for major depressive episode?A major depressive episode (MDE) is characterized by five or more of the following symptoms being present every day, or almost every day, for a minimum of two weeks: Depressed mood for most of the day. Loss of interest or enjoyment in all or most activities.
What must be present for someone diagnosed with major depressive disorder?Major Depressive Disorder
Diminished interest or loss of pleasure in almost all activities (anhedonia) Significant weight change or appetite disturbance: For children, this can be failure to achieve expected weight gain. Sleep disturbance (insomnia or hypersomnia) Psychomotor agitation or retardation.
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