Chapter 13: Depressive Disorders Flashcards
The nurse is caring for a patient who exhibits disorganized thinking and delusions. The patient repeatedly states, “I hear voices of aliens trying to contact me.” The nurse should recognize this presentation as which type of major depressive disorder (MDD)?
a. Catatonic MDD is marked by nonresponsiveness and extreme psychomotor retardation.
b. Atypical MDD refers to people who have dominant vegetative symptoms such as overeating and oversleeping.
c. Melancholic MDD is characterized by severe apathy, weight loss, profound guilt, and (often) suicidal ideation.
d. Psychotic features of MDD include the presence of disorganized thinking, delusions, hallucinations, or a combination of these symptoms.
d. Psychotic features of MDD include the presence of disorganized thinking, delusions, hallucinations, or a combination of these symptoms.
Which patient statement indicates learned helplessness?
a. Stating that oneself is a horrible person is reflective of Beck’s cognitive triad as it relates to depression.
b. Feeling that the world is “out to get” a person is reflective of Beck’s cognitive triad as it relates to depression.
c. Learned helplessness often occurs during depression if the person feels no control over the outcome of a situation. Patients exhibiting symptoms of learned helplessness feel that undesired events in their lives are self-created, and that nothing can be done to change their outcomes. By blaming herself, the patient has taken accountability for her husband’s actions and assigned blame to herself.
d. Hating oneself is reflective of Beck’s cognitive triad as it relates to depression.
c. Learned helplessness often occurs during depression if the person feels no control over the outcome of a situation. Patients exhibiting symptoms of learned helplessness feel that undesired events in their lives are self-created, and that nothing can be done to change their outcomes. By blaming herself, the patient has taken accountability for her husband’s actions and assigned blame to herself.
The nurse is planning care for a patient with depression who will be discharged to home soon. What aspect of teaching should be the priority on the nurse’s discharge plan of care?
a. Although pharmacological teaching is important, safety is the priority.
b. Safety is always the highest priority in planning care. Even if the patient has not exhibited a risk for self-harm, the potential for such a risk must be addressed with patients who have depression.
c. Awareness of symptoms of increasing depression is important, but safety is the priority.
d. The need for interpersonal contact is not the immediate focus of discharge planning.
b. Safety is always the highest priority in planning care. Even if the patient has not exhibited a risk for self-harm, the potential for such a risk must be addressed with patients who have depression.
The nurse is reviewing orders given for a patient with depression. Which order should the nurse question?
a. A low initial dose of a tricyclic antidepressant to address agitation is considered an appropriate therapy.
b. Selective serotonin reuptake inhibitors (SSRIs) should be given two to five weeks before starting an MAOI to avoid serotonin syndrome. Therefore, the nurse should question this order.
c. Electroconvulsive therapy to treat suicidal thoughts is considered an appropriate therapy.
d. Elavil to address the patient’s agitation is considered an appropriate therapy.
b. Selective serotonin reuptake inhibitors (SSRIs) should be given two to five weeks before starting an MAOI to avoid serotonin syndrome. Therefore, the nurse should question this order.
Which of the following are considered vegetative signs of depression?
a. Although hallucinations and delusions can be symptoms of depression, they are not vegetative signs.
b. Expressions of guilt and worthlessness are affective symptoms of depression.
c. Feelings of helplessness and hopelessness are affective symptoms of depression.
d. Changes in physiological functioning such as appetite and sleep are vegetative signs of depression.
d. Changes in physiological functioning such as appetite and sleep are vegetative signs of depression.
Which assessment question asked by the nurse demonstrates an understanding of comorbid mental health conditions associated with major depressive disorder? Select all that apply.
a. “Do rules apply to you?”
b. “What do you do to manage anxiety?”
c. “Do you have a history of disordered eating?”
d. “Do you think that you drink too much?”
e. “Have you ever been arrested for committing a crime?”
B, C, D
Which chronic medical condition is a common trigger for major depressive disorder?
a. Pain
b. Hypertension
c. Hypothyroidism
d. Crohn’s disease
c. Hypothyroidism
