Depression

Question 1

What is depression?

Answer 1

A mood affective disorder characterized by feelings of sadness, despair, and pessimism

Question 2

What are common comorbidities of depression?

Answer 2

Anxiety, psychotic disorders, substance use disorders, eating disorders, personality disorders

Question 3

What classifies depression in the DSM-5?

Answer 3

Depressed mood, sleeping too much or too little, decreased concentration, suicide ideation, change in motor activity, change in weight, fatigue, or low self-esteem lasting a minimum of two weeks.

Question 4

If a person with diagnosed depression experiences hallucinations or delusions, what would this be classified as?

Answer 4

Psychotic features

Question 5

What is persistent depressive disorder?

Answer 5

A milder form of depression that lasts at least two years, with three clinical features.

Question 6

What are the three phases of nursing care in patients with depression?

Answer 6

Acute: 6-12 weeks to reduce manifestations and assess SI
Continuation: 4-9 months to prevent relapse through medication and therapy
Maintenance: Lasts years to prevent future episodes

Question 7

What is the most significant risk factor for depression?

Answer 7

Family history and previous personal history of depression

Question 8

What would you expect to see in the MSE when assessing a patient with depression?

Answer 8

Blunted affect, poor grooming, slowed speech, social isolation, decreased verbalization

Question 9

What is the first-line medication class used to treat depression?

Answer 9

SSRIs

Question 10

Which of the following SSRI is higher risk in pregnancy?
Fluoxetine
Sertraline
Paroxetine
Citalopram

Answer 10

Paroxetine

Question 11

Why should a patient avoid taking two serotonergic medications at once?

Answer 11

Higher risk of serotonin syndrome

Question 12

What anti-depressants inhibit the uptake of serotonin and norepinephrine?

Answer 12

SNRIs

Question 13

What class of medications should be discontinued at least 14 days prior to starting serotonergic medication therapy?

Answer 13

MAOIs

Question 14

What is a complication of SSRIs and SNRIs that is more common when taking diuretics?

Answer 14

Hyponatremia

Question 15

A patient comes into the clinic with concerns about their medication, an amitriptyline. Upon further assessment you discover agitation and mental confusion. What do you suspect?

Answer 15

Toxicity

Question 16

What is the major concern to monitor for in patients taking an MAOI?

Answer 16

Hypertensive crisis

Question 17

What foods should you caution a patient to avoid while taking an MAOI?

Answer 17

Tyramine-rich foods: aged cheese, avocados, figs, caffeine, chocolate…

Question 18

What medication is given to patients who are unable to tolerate sexual dysfunction adverse affects?

Answer 18

Bupropion

Question 19

A nurse receive report on a patient who was just admitted with MDD, the reporting nurse states that the patient is exhibiting signs of SI such as making the statement, “I can’t do this anymore.” What is the nurse’s number one priority upon entering the patient room?

Answer 19

Assessing risk for suicide and initiating safety precautions.

Question 20

Which of the following is not an expected finding of a patient with depression?
Anhedonia
Changes in eating
Insomnia
Increased sexual activity

Answer 20

Increased sexual activity