Question 1
Regular
The nurse makes a home visit to a client who has dysthymic disorder. Which of the following would the nurse expect to assess?
Correct!
Incorrect
The correct answer is: A
Rationale
Low energy.
Individuals with dysthymic disorder often experience chronic low mood, which significantly contributes to feelings of fatigue and diminished energy levels. This persistent state can hinder daily functioning and affect overall quality of life.
B: Intense concentration. Dysthymic disorder typically leads to difficulties in concentration, not enhancing it. Individuals often struggle with focus due to their pervasive low mood.
C: Agitation. While some may experience restlessness, dysthymic disorder is predominantly characterized by low energy and a lack of motivation rather than heightened agitation.
D: Normal appetite. Many individuals with dysthymic disorder experience changes in appetite, often resulting in decreased interest in food, which contrasts with the notion of a normal appetite.
Correct Answer: A
Rationale: Low energy.
Individuals with dysthymic disorder often experience chronic low mood, which significantly contributes to feelings of fatigue and diminished energy levels. This persistent state can hinder daily functioning and affect overall quality of life.
B: Intense concentration. Dysthymic disorder typically leads to difficulties in concentration, not enhancing it. Individuals often struggle with focus due to their pervasive low mood.
C: Agitation. While some may experience restlessness, dysthymic disorder is predominantly characterized by low energy and a lack of motivation rather than heightened agitation.
D: Normal appetite. Many individuals with dysthymic disorder experience changes in appetite, often resulting in decreased interest in food, which contrasts with the notion of a normal appetite.
Question 2
Regular
A client has been diagnosed with major depression. The client reports that he often wakes up during the night and has trouble returning to sleep. The nurse interprets this finding as suggesting which of the following?
Correct!
Incorrect
The correct answer is: D
Rationale
D: Middle insomnia indicates difficulty in maintaining sleep after initially falling asleep, which aligns with the client's experience of waking during the night and having trouble returning to sleep. This suggests a disruption in the sleep cycle characteristic of this condition.
A: Initial insomnia signifies trouble falling asleep at the beginning of the night, which does not align with the client's specific difficulty of waking up during the night.
B: Terminal insomnia refers to waking too early in the morning and being unable to go back to sleep, which is not the client's reported issue of waking during the night.
C: Hypersomnia involves excessive sleepiness or prolonged sleep duration, which contradicts the client's problem of being unable to stay asleep throughout the night effectively.
Correct Answer: D
Rationale: D: Middle insomnia indicates difficulty in maintaining sleep after initially falling asleep, which aligns with the client's experience of waking during the night and having trouble returning to sleep. This suggests a disruption in the sleep cycle characteristic of this condition.
A: Initial insomnia signifies trouble falling asleep at the beginning of the night, which does not align with the client's specific difficulty of waking up during the night.
B: Terminal insomnia refers to waking too early in the morning and being unable to go back to sleep, which is not the client's reported issue of waking during the night.
C: Hypersomnia involves excessive sleepiness or prolonged sleep duration, which contradicts the client's problem of being unable to stay asleep throughout the night effectively.
Question 3
Regular
The nurse is caring for a client in the outpatient setting who has been diagnosed with a depressive disorder. Before the client is given a prescription for a tricyclic antidepressant, assessment for which of the following would be most important?
Correct!
Incorrect
The correct answer is: C
Rationale
Assessment for cardiac arrhythmia is most important before prescribing a tricyclic antidepressant. These medications can affect heart rhythm, so evaluating the client’s cardiac health is crucial to prevent serious complications.
A: Suicide Potential risk of suicide is vital to consider, but cardiac arrhythmia poses an immediate risk associated with tricyclic antidepressants that can lead to severe consequences if unaddressed.
B: Hypersomnia While hypersomnia may be a symptom of depression, it does not present the same immediate health risks associated with the cardiac side effects of tricyclic antidepressants, making it less critical to assess first.
D: Erectile Dysfunction Although erectile dysfunction can be a side effect of antidepressants, it does not carry the same level of urgency as assessing for potential cardiac arrhythmia, which can be life-threatening.
Correct Answer: C
Rationale: Assessment for cardiac arrhythmia is most important before prescribing a tricyclic antidepressant. These medications can affect heart rhythm, so evaluating the client’s cardiac health is crucial to prevent serious complications.
A: Suicide Potential risk of suicide is vital to consider, but cardiac arrhythmia poses an immediate risk associated with tricyclic antidepressants that can lead to severe consequences if unaddressed.
B: Hypersomnia While hypersomnia may be a symptom of depression, it does not present the same immediate health risks associated with the cardiac side effects of tricyclic antidepressants, making it less critical to assess first.
D: Erectile Dysfunction Although erectile dysfunction can be a side effect of antidepressants, it does not carry the same level of urgency as assessing for potential cardiac arrhythmia, which can be life-threatening.
Question 4
Regular
A client diagnosed with major depression was prescribed imipramine (Tofranil) and has been taking this medication for 1 week. The client took his last dose of imipramine (Tofranil) at 9:00 PM. The client is scheduled to have blood drawn to monitor the medication level the next morning. The nurse should instruct the client to have his blood drawn as close as possible to which time?
Correct!
Incorrect
The correct answer is: A
Rationale
A: 6:00 AM. Blood levels of imipramine should be monitored shortly after the last dose to accurately reflect the drug's peak concentration in the bloodstream, which occurs within several hours after administration.
B: 7:00 AM. This timing may be too late to capture the peak concentration, potentially skewing the results and leading to an inaccurate assessment of the medication's effectiveness.
C: 8:00 AM. Drawing blood at this hour would likely miss the optimal time frame for measuring the imipramine levels, thus not providing the most precise reflection of the medication's presence.
D: 9:00 AM. This time would be well after the peak levels, making it unsuitable for an accurate evaluation of the imipramine concentration in the client's bloodstream.
Correct Answer: A
Rationale: A: 6:00 AM. Blood levels of imipramine should be monitored shortly after the last dose to accurately reflect the drug's peak concentration in the bloodstream, which occurs within several hours after administration.
B: 7:00 AM. This timing may be too late to capture the peak concentration, potentially skewing the results and leading to an inaccurate assessment of the medication's effectiveness.
C: 8:00 AM. Drawing blood at this hour would likely miss the optimal time frame for measuring the imipramine levels, thus not providing the most precise reflection of the medication's presence.
D: 9:00 AM. This time would be well after the peak levels, making it unsuitable for an accurate evaluation of the imipramine concentration in the client's bloodstream.
Question 5
Regular
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?
Correct!
Incorrect
The correct answer is: B
Rationale
B: Hopelessness related to symptoms of depression. This diagnosis reflects the client’s expressed uncertainty about life’s worth, indicating a profound sense of despair typical in major depression, requiring immediate attention to prevent further deterioration.
A: Self-esteem, Low, related to depressive episode. While low self-esteem may be present, it doesn’t directly address the immediate expression of hopelessness, which is crucial for prioritizing nursing interventions.
C: Anxiety related to lack of energy for self-care activities. Anxiety may exist, but the client’s primary concern revolves around feelings of hopelessness rather than anxiety or energy issues, making this diagnosis less urgent.
D: Thought Processes, Disturbed, related to memory loss and depression. Although cognitive disturbances can occur, the client's immediate concern is hopelessness, making this diagnosis secondary to the critical emotional state presented.
Correct Answer: B
Rationale: B: Hopelessness related to symptoms of depression. This diagnosis reflects the client’s expressed uncertainty about life’s worth, indicating a profound sense of despair typical in major depression, requiring immediate attention to prevent further deterioration.
A: Self-esteem, Low, related to depressive episode. While low self-esteem may be present, it doesn’t directly address the immediate expression of hopelessness, which is crucial for prioritizing nursing interventions.
C: Anxiety related to lack of energy for self-care activities. Anxiety may exist, but the client’s primary concern revolves around feelings of hopelessness rather than anxiety or energy issues, making this diagnosis less urgent.
D: Thought Processes, Disturbed, related to memory loss and depression. Although cognitive disturbances can occur, the client's immediate concern is hopelessness, making this diagnosis secondary to the critical emotional state presented.
Question 6
Regular
A client is prescribed phenelzine (Nardil) to treat her depression. She is at a local caf├® for lunch with a friend. Which of the following items on the menu would be least appropriate for the client to order?
Correct!
Incorrect
The correct answer is: B
Rationale
B: A Cobb salad with blue cheese and Roquefort salad dressing. This option contains aged cheeses, which are high in tyramine. Tyramine can cause dangerous interactions with phenelzine, potentially leading to hypertensive crises in patients taking MAO inhibitors.
A: Roast beef, mashed potatoes, and gravy. This meal does not contain high-tyramine foods, making it safer for clients on phenelzine without triggering adverse effects.
C: Scrambled eggs, toast, and grape jelly. This dish is free from tyramine-rich ingredients, thus posing minimal risk to clients taking phenelzine, allowing for safe consumption.
D: Medium-well steak, French fries, and broccoli. While steak is generally safe, the cooking process may increase tyramine levels; however, this option is still less risky than aged cheeses in choice B.
Correct Answer: B
Rationale: B: A Cobb salad with blue cheese and Roquefort salad dressing. This option contains aged cheeses, which are high in tyramine. Tyramine can cause dangerous interactions with phenelzine, potentially leading to hypertensive crises in patients taking MAO inhibitors.
A: Roast beef, mashed potatoes, and gravy. This meal does not contain high-tyramine foods, making it safer for clients on phenelzine without triggering adverse effects.
C: Scrambled eggs, toast, and grape jelly. This dish is free from tyramine-rich ingredients, thus posing minimal risk to clients taking phenelzine, allowing for safe consumption.
D: Medium-well steak, French fries, and broccoli. While steak is generally safe, the cooking process may increase tyramine levels; however, this option is still less risky than aged cheeses in choice B.
Question 7
Regular
A 34-year-old client with depression is admitted to an inpatient psychiatric unit. The nurse enters her room and initiates interaction with the client. When talking with the client, which approach would be least appropriate?
Correct!
Incorrect
The correct answer is: B
Rationale
A: Animated and cheerful manner. This approach may overwhelm the client, who is experiencing depression, and could be perceived as insincere or dismissive of her feelings, hindering effective communication.
A: Quiet and empathetic manner. This strategy fosters a safe environment, allowing the client to express her emotions and concerns without feeling pressured or judged, promoting therapeutic engagement.
C: Matter-of-fact manner. This demeanor may come off as overly blunt or insensitive, potentially alienating the client and discouraging her from opening up about her struggles.
D: Respectful, direct manner. This approach encourages honesty and clarity in communication, helping the client feel valued and understood while promoting a constructive dialogue about her mental health.
Correct Answer: B
Rationale: A: Animated and cheerful manner. This approach may overwhelm the client, who is experiencing depression, and could be perceived as insincere or dismissive of her feelings, hindering effective communication.
A: Quiet and empathetic manner. This strategy fosters a safe environment, allowing the client to express her emotions and concerns without feeling pressured or judged, promoting therapeutic engagement.
C: Matter-of-fact manner. This demeanor may come off as overly blunt or insensitive, potentially alienating the client and discouraging her from opening up about her struggles.
D: Respectful, direct manner. This approach encourages honesty and clarity in communication, helping the client feel valued and understood while promoting a constructive dialogue about her mental health.
Question 8
Regular
A client is hospitalized on a psychiatric unit secondary to a suicide attempt. He has been diagnosed with depression. He has been consistently depressed. When assessing the client, which of the following would alert the nurse that the client?s suicidal risk has worsened?
Correct!
Incorrect
The correct answer is: A
Rationale
He tells the nurse that he feels more depressed than ever. This statement indicates a significant worsening of the client's mental state, suggesting an increase in despair and hopelessness, which are critical factors that heighten suicidal risk. The acknowledgment of feeling worse can signal an urgency for intervention and a potential escalation in suicidal ideation.
B: He is lethargic, remaining isolated from other clients. While lethargy and isolation are concerning, they do not necessarily indicate an immediate increase in suicidal thoughts compared to expressing worsening feelings.
C: He says he feels better as he interacts more with other clients. Feeling better may actually suggest an improvement in mood; thus, it does not signal a heightened risk of suicide.
D: His energy level and degree of depression remain the same. Stability in energy and depression levels does not indicate an increase in suicidal risk; it suggests a lack of significant change in his mental state.
Correct Answer: A
Rationale: He tells the nurse that he feels more depressed than ever. This statement indicates a significant worsening of the client's mental state, suggesting an increase in despair and hopelessness, which are critical factors that heighten suicidal risk. The acknowledgment of feeling worse can signal an urgency for intervention and a potential escalation in suicidal ideation.
B: He is lethargic, remaining isolated from other clients. While lethargy and isolation are concerning, they do not necessarily indicate an immediate increase in suicidal thoughts compared to expressing worsening feelings.
C: He says he feels better as he interacts more with other clients. Feeling better may actually suggest an improvement in mood; thus, it does not signal a heightened risk of suicide.
D: His energy level and degree of depression remain the same. Stability in energy and depression levels does not indicate an increase in suicidal risk; it suggests a lack of significant change in his mental state.
Question 9
Multiple Choice
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.
Correct!
Incorrect
The correct answer is: A,B,C,D,E
Rationale
A, B, C, D, E. All listed options are recognized risk factors for depressive disorders. They encompass a range of biological, psychological, and social elements that contribute to the development of these disorders, highlighting the multifaceted nature of mental health challenges.
A: History of substance abuse as a teenager. Substance abuse during adolescence significantly increases vulnerability to developing depressive disorders due to its impact on brain development and emotional regulation.
B: Little social support. A lack of social connections can lead to feelings of isolation and helplessness, which are known contributors to the onset of depressive symptoms.
C: Inadequate coping skills. Poor coping mechanisms hinder an individual’s ability to manage stress effectively, increasing the risk of developing depression when faced with life challenges.
D: Prior episode of anxiety disorder. A history of anxiety disorders often correlates with later depressive episodes, as the two conditions can share underlying psychological vulnerabilities and trigger similar stress responses.
E: Concomitant medical illnesses. Chronic health conditions can exacerbate feelings of helplessness and despair, creating a direct link to the development of depressive disorders in affected individuals.
Correct Answer: A,B,C,D,E
Rationale: A, B, C, D, E. All listed options are recognized risk factors for depressive disorders. They encompass a range of biological, psychological, and social elements that contribute to the development of these disorders, highlighting the multifaceted nature of mental health challenges.
A: History of substance abuse as a teenager. Substance abuse during adolescence significantly increases vulnerability to developing depressive disorders due to its impact on brain development and emotional regulation.
B: Little social support. A lack of social connections can lead to feelings of isolation and helplessness, which are known contributors to the onset of depressive symptoms.
C: Inadequate coping skills. Poor coping mechanisms hinder an individual’s ability to manage stress effectively, increasing the risk of developing depression when faced with life challenges.
D: Prior episode of anxiety disorder. A history of anxiety disorders often correlates with later depressive episodes, as the two conditions can share underlying psychological vulnerabilities and trigger similar stress responses.
E: Concomitant medical illnesses. Chronic health conditions can exacerbate feelings of helplessness and despair, creating a direct link to the development of depressive disorders in affected individuals.
Question 10
Multiple Choice
A nursing instructor is preparing a class discussion about major depression. Which of the following would the instructor expect to include?
Correct!
Incorrect
The correct answer is: C,E,F
Rationale
Episodes of depression tend to occur more frequently over time. This reflects the chronic nature of major depression, where individuals often experience recurrent episodes, leading to a cumulative impact on mental health and increased complexity in treatment approaches. Understanding this progression is crucial for effective management and support in nursing practice.
A: Depression in children is manifested in the same manner as in adults. Symptoms and expressions of depression can significantly differ between children and adults, requiring distinct diagnostic approaches.
B: The risk for suicide is especially high during the mid-adolescent years. While adolescents do face risks, the statement does not encompass the broader age-related factors influencing suicide rates across various demographics.
D: People older than age 65 years have the lowest suicide rates of any age group. Contrary to this claim, older adults often experience higher rates of suicide, driven by various psychosocial factors.
F: Depressive disorders are most often treated in the primary care setting. While primary care plays a role, specialized mental health services are frequently essential for comprehensive treatment of depressive disorders.
Correct Answer: C,E,F
Rationale: Episodes of depression tend to occur more frequently over time. This reflects the chronic nature of major depression, where individuals often experience recurrent episodes, leading to a cumulative impact on mental health and increased complexity in treatment approaches. Understanding this progression is crucial for effective management and support in nursing practice.
A: Depression in children is manifested in the same manner as in adults. Symptoms and expressions of depression can significantly differ between children and adults, requiring distinct diagnostic approaches.
B: The risk for suicide is especially high during the mid-adolescent years. While adolescents do face risks, the statement does not encompass the broader age-related factors influencing suicide rates across various demographics.
D: People older than age 65 years have the lowest suicide rates of any age group. Contrary to this claim, older adults often experience higher rates of suicide, driven by various psychosocial factors.
F: Depressive disorders are most often treated in the primary care setting. While primary care plays a role, specialized mental health services are frequently essential for comprehensive treatment of depressive disorders.
Question 11
Regular
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?
Correct!
Incorrect
The correct answer is: A
Rationale
Gamma-amino butyric acid (GABA) does not primarily influence depression in the same manner as other neurotransmitters discussed in neurobiologic theories. Its role is more associated with inhibitory functions rather than mood regulation.
B: Norepinephrine plays a significant role in mood regulation and is often linked to depressive symptoms, making it a key neurotransmitter in understanding depression.
C: Serotonin is widely recognized for its impact on mood and is a major focus in neurobiologic theories of depression, highlighting its relevance in this context.
D: Dopamine is also implicated in mood disorders, particularly in relation to reward and pleasure, thus being a critical neurotransmitter in the study of depression.
Correct Answer: A
Rationale: Gamma-amino butyric acid (GABA) does not primarily influence depression in the same manner as other neurotransmitters discussed in neurobiologic theories. Its role is more associated with inhibitory functions rather than mood regulation.
B: Norepinephrine plays a significant role in mood regulation and is often linked to depressive symptoms, making it a key neurotransmitter in understanding depression.
C: Serotonin is widely recognized for its impact on mood and is a major focus in neurobiologic theories of depression, highlighting its relevance in this context.
D: Dopamine is also implicated in mood disorders, particularly in relation to reward and pleasure, thus being a critical neurotransmitter in the study of depression.
Question 12
Regular
A nurse is preparing to assess a middle-aged male client who was brought to the emergency department by his wife. She reports that the client has been extremely depressed lately. When assessing this client, which of the following would be a priority assessment?
Correct!
Incorrect
The correct answer is: B
Rationale
Thoughts of self-harm. Assessing for any suicidal ideation is crucial in cases of severe depression, as it directly relates to the safety and immediate well-being of the client.
A: Changes in sleeping patterns. While significant, sleep disturbances alone do not immediately indicate imminent danger to the client’s safety compared to potential self-harm considerations that require urgent attention.
C: Appetite changes. Although alterations in appetite can reflect emotional distress, they do not pose an immediate risk to life, making them a lower priority in urgent situations.
D: Level of fatigue. Fatigue may signal depression severity but does not directly connect to the risk of self-harm, thus making it a less critical assessment focus in this context.
Correct Answer: B
Rationale: Thoughts of self-harm. Assessing for any suicidal ideation is crucial in cases of severe depression, as it directly relates to the safety and immediate well-being of the client.
A: Changes in sleeping patterns. While significant, sleep disturbances alone do not immediately indicate imminent danger to the client’s safety compared to potential self-harm considerations that require urgent attention.
C: Appetite changes. Although alterations in appetite can reflect emotional distress, they do not pose an immediate risk to life, making them a lower priority in urgent situations.
D: Level of fatigue. Fatigue may signal depression severity but does not directly connect to the risk of self-harm, thus making it a less critical assessment focus in this context.
Question 13
Regular
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?
Correct!
Incorrect
The correct answer is: C
Rationale
C: Serotonin syndrome
Combining fluoxetine, a selective serotonin reuptake inhibitor, with St. John’s wort, a natural antidepressant that increases serotonin levels, heightens the risk of serotonin syndrome, a potentially life-threatening condition characterized by excessive serotonin accumulation.
A: Water intoxication
Water intoxication relates to excessive water intake affecting electrolyte balance, which does not pertain to the interaction between fluoxetine and St. John's wort or depressive symptoms.
B: Increased depressive symptoms
While St. John's wort is used for depression, it may not necessarily exacerbate depressive symptoms when taken with fluoxetine; it poses a different concern regarding serotonin levels.
D: Hypertensive crisis
Hypertensive crisis typically involves medications affecting norepinephrine or dopamine levels, which does not relate to the interaction between fluoxetine and St. John's wort affecting serotonin pathways.
Correct Answer: C
Rationale: C: Serotonin syndrome
Combining fluoxetine, a selective serotonin reuptake inhibitor, with St. John’s wort, a natural antidepressant that increases serotonin levels, heightens the risk of serotonin syndrome, a potentially life-threatening condition characterized by excessive serotonin accumulation.
A: Water intoxication
Water intoxication relates to excessive water intake affecting electrolyte balance, which does not pertain to the interaction between fluoxetine and St. John's wort or depressive symptoms.
B: Increased depressive symptoms
While St. John's wort is used for depression, it may not necessarily exacerbate depressive symptoms when taken with fluoxetine; it poses a different concern regarding serotonin levels.
D: Hypertensive crisis
Hypertensive crisis typically involves medications affecting norepinephrine or dopamine levels, which does not relate to the interaction between fluoxetine and St. John's wort affecting serotonin pathways.
Question 14
Regular
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?
Correct!
Incorrect
The correct answer is: B
Rationale
B: What have you had to eat or drink today? This question is crucial as the client is on selegiline, which can interact with tyramine-rich foods, potentially leading to hypertensive crises, worsening their symptoms. Assessing dietary intake helps determine if this is a contributing factor to the client's severe headache and other alarming symptoms.
A: When did you last have blood drawn to check your drug level? Monitoring drug levels is important, but it doesn't directly address the immediate symptoms and potential dietary interactions affecting the client’s condition.
C: Are you having any chest pain? While chest pain can indicate serious issues, the immediate context of a severe headache and neck stiffness suggests a more likely relationship with dietary intake and medication interactions.
D: Do you use any herbal remedies? Herbal remedies can interact with medications, yet this question does not address the acute symptoms presented, which are more likely related to food intake and selegiline.
Correct Answer: B
Rationale: B: What have you had to eat or drink today? This question is crucial as the client is on selegiline, which can interact with tyramine-rich foods, potentially leading to hypertensive crises, worsening their symptoms. Assessing dietary intake helps determine if this is a contributing factor to the client's severe headache and other alarming symptoms.
A: When did you last have blood drawn to check your drug level? Monitoring drug levels is important, but it doesn't directly address the immediate symptoms and potential dietary interactions affecting the client’s condition.
C: Are you having any chest pain? While chest pain can indicate serious issues, the immediate context of a severe headache and neck stiffness suggests a more likely relationship with dietary intake and medication interactions.
D: Do you use any herbal remedies? Herbal remedies can interact with medications, yet this question does not address the acute symptoms presented, which are more likely related to food intake and selegiline.
Question 15
Multiple Choice
The nurse is developing a teaching plan for a client who is prescribed escitalopram. Which of the following side effects would the nurse include in this plan? Select all that apply.
Correct!
Incorrect
The correct answer is: A,B,C,F
Rationale
Weight gain, decreased sexual interest, sedation, and dry mouth are all potential side effects of escitalopram that the nurse should include in the teaching plan for the client.
A: Weight gain This side effect frequently occurs with escitalopram, impacting clients' physical health and self-image, thus necessitating discussion in the teaching plan.
B: Decreased sexual interest This effect can lead to significant emotional distress and relationship issues, making it essential to address in the nurse's teaching plan for comprehensive client care.
C: Sedation While sedation is a common side effect, it is not universally experienced by all users of escitalopram, thus making it less critical in the teaching plan.
D: Blurred vision This side effect is less commonly reported with escitalopram and may not be significant enough to warrant inclusion in the primary teaching plan.
E: Urinary retention While some medications may cause urinary issues, escitalopram is not typically associated with urinary retention, making this choice irrelevant for the teaching plan.
Correct Answer: A,B,C,F
Rationale: Weight gain, decreased sexual interest, sedation, and dry mouth are all potential side effects of escitalopram that the nurse should include in the teaching plan for the client.
A: Weight gain This side effect frequently occurs with escitalopram, impacting clients' physical health and self-image, thus necessitating discussion in the teaching plan.
B: Decreased sexual interest This effect can lead to significant emotional distress and relationship issues, making it essential to address in the nurse's teaching plan for comprehensive client care.
C: Sedation While sedation is a common side effect, it is not universally experienced by all users of escitalopram, thus making it less critical in the teaching plan.
D: Blurred vision This side effect is less commonly reported with escitalopram and may not be significant enough to warrant inclusion in the primary teaching plan.
E: Urinary retention While some medications may cause urinary issues, escitalopram is not typically associated with urinary retention, making this choice irrelevant for the teaching plan.
Question 16
Multiple Choice
The nurse is preparing a client for treatment with repetitive transcranial magnetic stimulation. When teaching the client about this procedure, which of the following would the nurse include? Select all that apply.
Correct!
Incorrect
The correct answer is: B,C
Rationale
You will be awake and alert during the procedure, and you can resume your normal activities right after the treatment. This aligns with the nature of repetitive transcranial magnetic stimulation, which is non-invasive and does not require sedation, allowing clients to maintain awareness and continue their daily routines immediately after.
A: You will receive a short-acting anesthetic to relax you. This treatment does not involve anesthesia, as the procedure is designed to be performed while the client is fully conscious and aware.
D: We will need to shave your scalp at the area where the magnet is placed. There is no requirement to shave the scalp for this procedure, as it can be performed without such invasive measures.
E: You might feel a moderate amount of stinging at the site. While some sensations may occur, the emphasis is on the absence of pain or significant discomfort during the procedure.
Correct Answer: B,C
Rationale: You will be awake and alert during the procedure, and you can resume your normal activities right after the treatment. This aligns with the nature of repetitive transcranial magnetic stimulation, which is non-invasive and does not require sedation, allowing clients to maintain awareness and continue their daily routines immediately after.
A: You will receive a short-acting anesthetic to relax you. This treatment does not involve anesthesia, as the procedure is designed to be performed while the client is fully conscious and aware.
D: We will need to shave your scalp at the area where the magnet is placed. There is no requirement to shave the scalp for this procedure, as it can be performed without such invasive measures.
E: You might feel a moderate amount of stinging at the site. While some sensations may occur, the emphasis is on the absence of pain or significant discomfort during the procedure.
Question 17
Regular
When assessing a client with depression, the client states, I just feel so sad and hopeless. I just don?t care anymore. I don?t even enjoy doing the crossword puzzles like I used to. The nurse documents this finding as indicative of which of the following?
Correct!
Incorrect
The correct answer is: B
Rationale
B: Anhedonia. The client's statement about no longer enjoying crossword puzzles reflects anhedonia, a core symptom of depression characterized by a diminished interest or pleasure in activities once found enjoyable. This aligns with the client's feelings of sadness and hopelessness.
A: Dysthymic disorder. Dysthymic disorder involves a chronic form of depression but does not specifically highlight the marked loss of interest or pleasure indicated by the client’s statement.
C: Delusion. Delusions are false beliefs that are firmly held despite evidence to the contrary. The client's expression of sadness and lack of interest does not fit this definition.
D: Psychosis. Psychosis entails a disconnection from reality, often involving hallucinations or delusions. The client's symptoms are related to mood rather than a loss of touch with reality.
Correct Answer: B
Rationale: B: Anhedonia. The client's statement about no longer enjoying crossword puzzles reflects anhedonia, a core symptom of depression characterized by a diminished interest or pleasure in activities once found enjoyable. This aligns with the client's feelings of sadness and hopelessness.
A: Dysthymic disorder. Dysthymic disorder involves a chronic form of depression but does not specifically highlight the marked loss of interest or pleasure indicated by the client’s statement.
C: Delusion. Delusions are false beliefs that are firmly held despite evidence to the contrary. The client's expression of sadness and lack of interest does not fit this definition.
D: Psychosis. Psychosis entails a disconnection from reality, often involving hallucinations or delusions. The client's symptoms are related to mood rather than a loss of touch with reality.
Question 18
Regular
The plan of care for a client diagnosed with depression includes cognitive interventions. The nurse would expect to assist with which of the following?
Correct!
Incorrect
The correct answer is: C
Rationale
C: Thought stopping. This intervention helps clients recognize and interrupt negative thought patterns, promoting healthier cognitive processes. It directly addresses cognitive distortions associated with depression, making it highly beneficial in the treatment plan.
A: Social skills training focuses on improving interpersonal interactions and is not primarily a cognitive intervention, thus it does not specifically target cognitive distortions in depressed clients.
B: Activity scheduling emphasizes planning and engagement in activities to combat inactivity, but it does not directly involve modifying or interrupting negative thought patterns central to cognitive interventions.
D: Interpersonal therapy centers on relationships and communication rather than cognitive processes. While beneficial for depression, it does not directly engage with cognitive interventions like thought stopping.
Correct Answer: C
Rationale: C: Thought stopping. This intervention helps clients recognize and interrupt negative thought patterns, promoting healthier cognitive processes. It directly addresses cognitive distortions associated with depression, making it highly beneficial in the treatment plan.
A: Social skills training focuses on improving interpersonal interactions and is not primarily a cognitive intervention, thus it does not specifically target cognitive distortions in depressed clients.
B: Activity scheduling emphasizes planning and engagement in activities to combat inactivity, but it does not directly involve modifying or interrupting negative thought patterns central to cognitive interventions.
D: Interpersonal therapy centers on relationships and communication rather than cognitive processes. While beneficial for depression, it does not directly engage with cognitive interventions like thought stopping.
Question 19
Regular
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?
Correct!
Incorrect
The correct answer is: B
Rationale
Family members typically experience significant emotional and practical challenges when a loved one is diagnosed with depression, as the condition profoundly impacts family dynamics and relationships.
B: Depression in one family member affects the entire family. The interconnectedness of family dynamics means that the emotional and psychological burden of depression can ripple through relationships, creating stress and distress for all members.
A: Family members typically can understand how disabling depression can be. While some family members may grasp the severity of depression, not all have the insight or experience necessary to fully comprehend its impact.
C: Abuse of the depressed person is a rare occurrence in families. Abuse can occur in any family dynamic, and depression may exacerbate tensions, potentially leading to increased risk of hostile behaviors.
D: Families of women older than 55 years of age with depression experience the majority of problems. Depression affects individuals across all demographics, and family issues are not limited to one specific age group or gender.
Correct Answer: B
Rationale: Family members typically experience significant emotional and practical challenges when a loved one is diagnosed with depression, as the condition profoundly impacts family dynamics and relationships.
B: Depression in one family member affects the entire family. The interconnectedness of family dynamics means that the emotional and psychological burden of depression can ripple through relationships, creating stress and distress for all members.
A: Family members typically can understand how disabling depression can be. While some family members may grasp the severity of depression, not all have the insight or experience necessary to fully comprehend its impact.
C: Abuse of the depressed person is a rare occurrence in families. Abuse can occur in any family dynamic, and depression may exacerbate tensions, potentially leading to increased risk of hostile behaviors.
D: Families of women older than 55 years of age with depression experience the majority of problems. Depression affects individuals across all demographics, and family issues are not limited to one specific age group or gender.
Question 20
Regular
The nurse is reviewing the medical record of a client diagnosed with depression and notes that the client has been prescribed mirtazapine. The nurse interprets this information, identifying this agent as which type?
Correct!
Incorrect
The correct answer is: D
Rationale
Mirtazapine is classified as an alpha-2 antagonist. This medication works by blocking certain receptors in the brain, which enhances the release of norepinephrine and serotonin, thereby alleviating symptoms of depression.
A: Selective serotonin reuptake inhibitor. Mirtazapine does not primarily act by inhibiting serotonin reuptake, which characterizes this class of antidepressants, thus making this classification inaccurate.
B: Cyclic antidepressant. Mirtazapine is not a cyclic antidepressant; instead, it has a unique mechanism of action that distinguishes it from traditional cyclic medications used for depression.
C: Norepinephrine dopamine reuptake inhibitor. While mirtazapine affects norepinephrine levels, it does not function as a reuptake inhibitor for dopamine, which defines this specific category of antidepressants.
Correct Answer: D
Rationale: Mirtazapine is classified as an alpha-2 antagonist. This medication works by blocking certain receptors in the brain, which enhances the release of norepinephrine and serotonin, thereby alleviating symptoms of depression.
A: Selective serotonin reuptake inhibitor. Mirtazapine does not primarily act by inhibiting serotonin reuptake, which characterizes this class of antidepressants, thus making this classification inaccurate.
B: Cyclic antidepressant. Mirtazapine is not a cyclic antidepressant; instead, it has a unique mechanism of action that distinguishes it from traditional cyclic medications used for depression.
C: Norepinephrine dopamine reuptake inhibitor. While mirtazapine affects norepinephrine levels, it does not function as a reuptake inhibitor for dopamine, which defines this specific category of antidepressants.
Quiz Complete!
Depression:Management of Depressive Moods and Suicidal Behavior
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