Chapter. 27 Flashcards
A client is diagnosed with dysthymic disorder. Which should a nurse classify as an affective symptom of this disorder?
A.Social isolation with a focus on self
B.Low energy level
C.Difficulty concentrating
D.Gloomy and pessimistic outlook on life
D
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.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
B
A nurse assesses a client suspected of having major depressive disorder. Which client symptom would eliminate this diagnosis?
A.The client is disheveled and malodorous.
B.The client refuses to interact with others.
C.The client is unable to feel any pleasure.
D.The client has maxed-out charge cards and exhibits promiscuous behaviors.
D
A nurse reviews the laboratory data of a 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
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
A
A depressed client reports to a nurse a history of divorce, job loss, family estrangement, and cocaine abuse. Which theoretical principle best explains the etiology of this client’s depressive symptoms?
A.According to psychoanalytic theory, depression is a result of anger turned inward.
B.According to object-loss theory, depression is a result of abandonment.
C.According to learning theory, depression is a result of repeated failures.
D.According to cognitive theory, depression is a result of negative perceptions.
C
What is the rationale for a nurse to perform a full physical health assessment on a client admitted with a diagnosis of major depressive disorder?
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.
B
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.Paroxetine (Paxil) B.Sertraline (Zoloft) C.Citalopram (Celexa) D.Fluoxetine (Prozac)
D
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 bipolar disorder
B.To rule out schizophrenia
C.To rule out senile dementia
D.To rule out a personality disorder
C
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.Neuroleptic malignant syndrome caused by ingestion of two different seratonin reuptake inhibitors (SSRIs)
B.Neuroleptic malignant syndrome caused by ingestion of an SSRI and a monoamine oxidase inhibitor (MAOI)
C.Serotonin syndrome caused by ingestion of an SSRI and an MAOI
D.Serotonin syndrome caused by ingestion of two different SSRIs
D
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.“This combination of drugs can lead to delirium tremens.”
B.“A combination of an MAOI and Luvox can lead to a life-threatening hypertensive crisis.”
C.“That’s a good idea. There have been good results with the combination of these two drugs.”
D.“The only disadvantage would be the exorbitant cost of the MAOI.”
B
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
B.Bagels with cream cheese and tea
C.Apple pie and coffee
D.Potato chips and diet cola
A
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.“I cannot drink any alcohol with this medication.”
B.“It is going to take 2 to 3 weeks in order for me to begin to feel better.”
C.“This drug causes physical dependence and I need to strictly follow doctor’s orders.”
D.“I can’t take this medication with food. It needs to be taken on an empty stomach.”
B
A client is admitted to the psychiatric unit with a diagnosis of major depression. 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
B.A daily schedule filled with activities to promote socialization
C.A flexible schedule that allows the client opportunities for decision making
D.A schedule that includes mandatory activities to decrease social isolation
A
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.“We’ll go to the day room when you are ready for group.”
B.“I’ll walk with you to the day room. Group is about to start.”
C.“It must be difficult for you to attend group when you feel so bad.”
D.“Let me tell you about the benefits of attending this group.”
B
Sertraline (Zoloft) has been prescribed for a client complaining of poor appetite, fatigue, and anhedonia. Which consideration should the nurse recognize as influencing this prescriptive choice?
A.Zoloft is less expensive for the client.
B.Zoloft is extremely sedating and will help with sleep disturbances.
C.Zoloft has less adverse side effects than other antidepressants.
D.Zoloft begins to improve depressive symptoms quickly.
C