Chapter 25 Flashcards

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1
Q

A client is diagnosed with persistent depressive (dysthymia) disorder. Which should a nurse classify as an affective symptom of this disorder?

A

Gloomy and pessimistic outlook on life

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2
Q

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

A

Social isolation R/T poor self-esteem AEB secluding self in room

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3
Q

A nurse assesses a client suspected of having major depressive disorder. Which client symptom would eliminate this diagnosis?

A

The client has maxed-out charge cards and exhibits promiscuous behaviors.

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4
Q

A nurse reviews the laboratory data of a 29-year-old client suspected of having major depressive disorder. Which laboratory value would potentially rule out this diagnosis?

A

Thyroid-stimulating hormone (TSH) level of 6.2 U/mL

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5
Q

A depressed client reports to a nurse a history of divorce, job loss, family estrangement, and cocaine abuse. According to learning theory, what is the cause of this client’s symptoms?

A

Depression is a result of repeated failures.

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6
Q

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

A

Depression is a symptom of several medical conditions.

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7
Q

A nurse is planning care for a child who is experiencing depression. Which medication is approved by the U.S. Food and Drug Administration (FDA) for the treatment of depression in children and adolescents?

A

Fluoxetine (Prozac)

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8
Q

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

A

To rule out neurocognitive disorder

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9
Q

A confused client has recently been prescribed sertraline (Zoloft). The client’s spouse is taking paroxetine (Paxil). The client presents with restlessness, tachycardia, diaphoresis, and tremors. What complication does a nurse suspect, and what could be its possible cause?

A

Serotonin syndrome caused by ingestion of two different SSRIs

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10
Q

A client who has been taking fluvoxamine (Luvox) without significant improvement asks a nurse, “I heard about something called a monoamine oxidase inhibitor (MAOI). Can’t my doctor add that to my medications?” Which is an appropriate nursing reply?

A

“A combination of an MAOI and Luvox can lead to a life-threatening hypertensive crisis.”

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11
Q

A psychiatrist prescribes a monoamine oxidase inhibitor (MAOI) for a client. Which foods should the nurse teach the client to avoid?

A

Pepperoni pizza and red wine

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12
Q

A client who has been taking buspirone (BuSpar) as prescribed for 2 days is close to discharge. Which statement indicates to the nurse that the client has an understanding of important discharge teaching?

A

“It is going to take 2 to 3 weeks in order for me to begin to feel better.”

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13
Q

A client is admitted to the psychiatric unit with a diagnosis of major depressive disorder. The client is unable to concentrate, has no appetite, and is experiencing insomnia. Which should be included in this client’s plan of care?

A

A simple, structured daily schedule with limited choices of activities

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14
Q

An isolative client was admitted 4 days ago with a diagnosis of major depressive disorder. Which nursing statement would best motivate this client to attend a therapeutic group being held in the milieu?

A

“I’ll walk with you to the day room. Group is about to start.”

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15
Q

A client who is diagnosed with major depressive disorder asks the nurse what causes depression. Which of these is the most accurate response?

A

The exact cause of depressive disorders is unknown. A number of things, including genetic, biochemical, and environmental influences, likely play a role.

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16
Q

What client information does a nurse need to assess prior to initiating medication therapy with phenelzine (Nardil)?

A

The client’s cognitive ability to understand information about the medication

17
Q

A client diagnosed with major depressive disorder states, “I’ve been feeling ‘down’ for 3 months. Will I ever feel like myself again?” Which reply by the nurse will best assess this client’s affective symptoms?

A

“Help me understand what you mean when you say, ‘feeling down’?”

18
Q

A nurse is implementing a one-on-one suicide observation level with a client diagnosed with major depressive disorder. The client states, “I’m feeling a lot better, so you can stop watching me. I have taken up too much of your time already.” Which is the best nursing reply?

A

“Because we are concerned about your safety, we will continue to observe you.”

19
Q

A newly admitted client is diagnosed with major depressive disorder with suicidal ideations. Which would be the priority nursing intervention for this client?

A

Carefully and unobtrusively observe on the basis of assessed data, at varied intervals around the clock.

20
Q

The nurse is providing counseling to clients diagnosed with major depressive disorder. The nurse chooses to help the clients alter their mood by learning how to change the way they think. The nurse is functioning under which theoretical framework?

A

Cognitive theory

21
Q

Which client statement expresses a typical underlying feeling of clients diagnosed with major depressive disorder?

A

“Nothing will help me feel better.”

22
Q

A 75-year-old client with a long history of depression is currently on doxepin (Sinequan), 100 mg daily. The client takes a daily diuretic for hypertension and is recovering from the flu. Which nursing diagnosis should the nurse assign highest priority?

A

Risk for injury R/T orthostatic hypotension

23
Q

A client is admitted with a diagnosis of persistent depressive disorder. Which client statement would describe a symptom consistent with this diagnosis?

A

“I am sad most of the time and I’ve felt this way for the last several years.”

24
Q

A client diagnosed with major depressive disorder was raised in a strongly religious family where bad behavior was equated with sins against God. Which nursing intervention would be most appropriate to help the client address spirituality as it relates to his illness?

A

Encourage the client to bring into awareness underlying sources of guilt.

25
Q

A nurse is caring for four clients taking various medications, including imipramine (Tofranil), doxepine (Sinequan), ziprasidone (Geodon), and tranylcypromine (Parnate). The nurse orders a special diet for the client receiving which medication?

A

Parnate

26
Q

A client admitted to the psychiatric unit following a suicide attempt is diagnosed with major depressive disorder. Which behavioral symptoms should the nurse expect to assess?

A

Lack of attention to grooming and hygiene

27
Q

A newly admitted client diagnosed with major depressive disorder states, “I have never considered suicide.” Later the client confides to the nurse about plans to end it all by medication overdose. What is the most helpful nursing reply?

A

“Bringing this up is a very positive action on your part.”

28
Q

A 20-year-old female has a diagnosis of premenstrual dysphoric disorder. Which of the following should a nurse identify as consistent with this diagnosis? Select all that apply.

A. Symptoms are causing significant interference with work, school, and social relationships.
B. Patient-rated mood is 2/10 for the past 6 months
C. Mood swings occur the week before onset of menses
D. Patient reports subjective difficulty concentrating
E. Patient manifests pressured speech when communicating

A

A, C, D

29
Q

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? Select all that apply.

A. Gender differences in social opportunities that occur with age
B. Drastic temperature and barometric pressure changes
C. Increased levels of melatonin
D. Variations in serotonergic functioning
E. Inaccessibility of resources for dealing with life stressors

A

B, C, D

30
Q

A client is prescribed phenelzine (Nardil). Which of the following client statements should indicate to a nurse that discharge teaching about this medication has been successful? Select all that apply.

A. “I’ll have to let my surgeon know about this medication before I have my cholecystectomy.”
B. “Guess I will have to give up my glass of red wine with dinner.”
C. “I’ll have to be very careful about reading food and medication labels.”
D. “I’m going to miss my caffeinated coffee in the morning.”
E. “I’ll be sure not to stop this medication abruptly.”

A

A, B, C, E