DEPRESSION | SITUATIONAL EXAMPLES Flashcards
A patient diagnosed with major depressive disorder tells the nurse, “I feel like there’s no point in living anymore.” What is the nurse’s priority action?
A. Encourage the patient to talk about their feelings.
B. Notify the healthcare provider immediately.
C. Ask the patient directly if they have suicidal thoughts.
D. Provide emotional support and reassurance.
C. Ask the patient directly if they have suicidal thoughts.
Rationale: Direct questioning about suicidal ideation helps assess the severity of the risk and determine the need for immediate intervention.
A patient reports feeling “down” for the past two years, with occasional days of low energy and hopelessness but no psychotic symptoms. What type of depression is most likely?
A. Major depressive disorder
B. Dysthymia
C. Bipolar disorder
D. Postpartum depression
B. Dysthymia
Rationale: Dysthymia (Persistent Depressive Disorder) is characterized by chronic, mild depressive symptoms lasting at least two years without psychotic features.
The nurse is caring for a patient with newly diagnosed major depression. Which lab finding is most consistent with the physiological theory of depression?
A. Elevated thyroid-stimulating hormone (TSH)
B. Increased serotonin levels
C. Elevated cortisol levels
D. High dopamine levels
C. Elevated cortisol levels
Rationale: Depression is associated with decreased serotonin, dopamine, and norepinephrine, along with elevated cortisol levels due to increased stress.
A patient with depression is withdrawn, refusing to eat, and expressing feelings of worthlessness. What is the priority nursing diagnosis?
A. Risk for suicide
B. Imbalanced nutrition: Less than body requirements
C. Self-care deficit
D. Ineffective coping
A. Risk for suicide
Rationale: Risk for suicide is always the priority diagnosis when a patient shows signs of severe depression and hopelessness.
A patient with major depression says, “I’m a burden to everyone. They’d be better off without me.” Which intervention should the nurse implement first?
A. Leave the patient alone to rest.
B. Inform the family about the patient’s statement.
C. Initiate one-to-one supervision.
D. Encourage the patient to express feelings.
C. Initiate one-to-one supervision.
Rationale: Statements indicating suicidal ideation require immediate intervention, including close observation to prevent self-harm.
A patient with depression is prescribed fluoxetine (Prozac). Which teaching is most important for the nurse to provide?
A. “You will feel better within 24 hours of starting the medication.”
B. “Avoid tyramine-rich foods while taking this medication.”
C. “It may take 2 to 4 weeks to notice improvement in symptoms.”
D. “You should stop the medication once you feel better.”
C. “It may take 2 to 4 weeks to notice improvement in symptoms.”
Rationale: SSRIs like fluoxetine take several weeks to reach therapeutic levels and show noticeable effects.
A patient undergoing cognitive-behavioral therapy (CBT) for depression states, “I’m a complete failure.” What is the best nursing response?
A. “Why do you feel like a failure?”
B. “Let’s look at the facts. Can you name something you’ve succeeded in?”
C. “You shouldn’t think that way. Stay positive.”
D. “Don’t worry; you’ll feel better soon.”
B. “Let’s look at the facts. Can you name something you’ve succeeded in?”
Rationale: CBT focuses on challenging negative thought patterns and reframing them with evidence-based, positive thinking.
An elderly patient presents with fatigue, poor appetite, and social withdrawal. Which action should the nurse take first?
A. Encourage participation in social activities.
B. Assess for suicidal ideation.
C. Recommend an antidepressant.
D. Educate about nutrition and hydration.
B. Assess for suicidal ideation.
Rationale: Older adults with depression are at increased risk for suicide, making assessment for suicidal thoughts the priority.
A patient with severe depression reports not feeling hungry and losing 10 pounds in two weeks. What is the best intervention?
A. Provide three large, high-calorie meals per day.
B. Encourage small, frequent meals throughout the day.
C. Offer only liquid supplements to maintain hydration.
D. Allow the patient to skip meals if they are not hungry.
B. Encourage small, frequent meals throughout the day.
Rationale: Small, frequent meals are less overwhelming and more manageable for patients experiencing appetite loss.
The nurse is preparing discharge teaching for a patient with major depression. Which statement indicates the patient understands the teaching?
A. “I’ll stop taking my medication once I feel better.”
B. “Exercise can help improve my mood.”
C. “If I feel suicidal, I should wait and see if it passes.”
D. “I don’t need follow-up care if I’m feeling okay.”
B. “Exercise can help improve my mood.”
Rationale: Regular exercise has been shown to improve mood and can be an effective adjunct to medication and therapy.
