Mood Disorders

Question 1

Which variables represent the highest risk for developing major depressive disorder? SATA.

A. Male gender
B. Mood disorder in 1st degree relative
C. Substance abuse
D. Divorced
E. Older adult

Answer 1

B. Mood disorder in 1st degree relative
C. Substance abuse
D. Divorced

Question 2

A client is admitted for major depression. What should the nurse expect to find during assessment?

A. Anhedonia, feelings of worthlessness, and difficulty focusing
B. Depressed mood, guilt, and pressured speech
C. Changes in sleep pattern, tired, and grandiose mood
D. Difficulty focusing, feelings of helplessness, and flight of ideas

Answer 2

A. Anhedonia, feelings of worthlessness, and difficulty focusing

Question 3

A client has just been diagnosed as having major depression. At which time would the nurse expect the client to be at highest risk for self-harm?

A. Immediately after a family visit
B. On the anniversary of significant life events in the client’s life
C. During the first few days after admission
D. Approximately 2 weeks after starting anti-depressant medication

Answer 3

D. Approximately 2 weeks after starting anti-depressant medication

Question 4

Which patient would you refer to ECT? SATA.

A. 1st time inpatient, MDD, constant self-harm attempts
B. 2nd time inpatient, bipolar, depressive episode
C. 2nd time inpatient, schizophrenia, non-command hallucinations
D. 4th time inpatient, bipolar, rapid cycling

Answer 4

A. 1st time inpatient, MDD, constant self-harm attempts
D. 4th time inpatient, bipolar, rapid cycling

Question 5

What are some s/s of mania?

A. Anhedonia
B. Hypersonic
C. Hypoactivity
D. Impulsive behavior

Answer 5

D. Impulsive behavior

Question 6

What is a nursing bipolar priority in the acute phase?

A. Medication adherence
B. Relapse prevention
C. Prevent exhaustion
D. Psychoeducation

Answer 6

C. Prevent exhaustion

Question 7

What is an ideal food choice for an acute bipolar client?

A. Garden salad
B. Mashed potato
C. #2 deluxe spicy chicken sandwich with pepper jack and fries
D. Navy bean soup

Answer 7

C. #2 deluxe spicy chicken sandwich with pepper jack and fries

Question 8

What drug is ideal for a bipolar client in the maintenance phase?

A. Propranolol
B. Imipramine
C. Isocarboxazid
D. Valproic acid

Answer 8

D. Valproic acid

Question 9

An outpatient provider would likely increase the lithium dose if the serum lithium lab results were…

A. 0.7 mEq/L
B. 1.2 mEq/L
C. 0.3 mEq/L
D. 1.6 mEq/L

Answer 9

C. 0.3 mEq/L

Question 10

Which is a risk factor for depression?

A. Recently married
B. 68 years old
C. Male
D. History of poor academic progress

Answer 10

B. 68 years old

Question 11

What are some signs and symptoms of serotonin syndrome?

A. Constipation
B. Mental confusion
C. Syncope
D. Elevated CPK

Answer 11

B. Mental confusion
D. Elevated CPK

Question 12

While taking escitalopram, a patient should avoid…

A. Carbamazepine
B. Citalopram
C. Isocarboxazid
D. Alprazolam

Answer 12

C. Isocarboxazid

Question 13

Which patient who attempted suicide would you assess first? Suicide attempt by…

A. Starvation
B. Gun shot
C. Bludgeoning
D. Jumping out of a car while on the freeway

Answer 13

B. Gun shot

Question 14

Which best explains the neuro chemical processes responsible for depression?

A. Increased activity of dopamine
B. Decreased glucocorticoid activity
C. Decreased serotonin and norepinephrine activity
D. Potential if of the kindling process

Answer 14

C. Decreased serotonin and norepinephrine activity

Question 15

The nurse is planning care for a client with major depression. Which is an appropriate expected outcome?

A. The client will avoid causing harm to others
B. The client will be free from stress
C. The client will independently carry out activities of daily living
D. The client will not experience agitation

Answer 15

C. The client will independently carry out activities of daily living

Question 16

Which meal would the nurse provide to best meet the nutritional needs of a client who is manic?

A. Peanut butter sandwich, chips, cola
B. Fried chicken, mashed potatoes, milk
C. Ham sandwich, cheese slices, milk
D. Spaghetti, garlic bread, salad, tea

Answer 16

C. Ham sandwich, cheese slices, milk

Question 17

A client with bipolar disorder is admitted to the psychiatric unit. The client is talking loudly, walking back and forth rapidly, and exhibiting a short attention span. Which nursing intervention should occur first?

A. Decrease the client’s environmental stimuli
B. Give the client feedback about his behavior
C. Introduce the client to other staff on the unit
D. Tell the client about hospital rules and policies

Answer 17

A. Decrease the client’s environmental stimuli

Question 18

A client asks the nurse why he has to go to therapy and cannot just take his prescribed antidepressant medication. Which would be the most therapeutic nursing intervention?

A. Stating the effects of medications will not last forever. You will need to eventually learn to function without them
B. Stating medications will help your brain function better, but the therapy helps you achieve lasting behavior change
C. Stating both are recommended. Since your insurance covers both, that is the best plan for you
D. Asking, “do you have reservations about going to therapy?”

Answer 18

B. Stating medications will help your brain function better, but the therapy helps you achieve lasting behavior change

Question 19

The wife of a client with bipolar disorder calls the nurse expressing distress about recent spending patterns of her husband. The nurse suggests the wife implement the limit-setting skills she has learned in family therapy. In this instance, these nurse’s action would be considered:

A. Inappropriate; the nurse shouldn’t give advice to the wife
B. Inappropriate; the husband has the legal right to spend personal money
C. Appropriate; the wife is responsible for the husband’s actions since he has a mental illness
D. Appropriate; the wife needs support in setting boundaries

Answer 19

D. Appropriate; the wife needs support in setting boundaries

Question 20

Which individual is at highest risk for committing suicide?

A. A 71-year-old male, alcohol user, independent minded
B. A 16-year-old female, diabetic, two best friends
C. A 47-year-old male, schizophrenic, unemployed
D. A 57-year-old female, depression, active in church

Answer 20

A. A 71-year-old male, alcohol user, independent minded

Question 21

Which client is at highest risk for carrying out a suicide plan?

A. A client who plans to take a bottle of sleeping pills
B. A client who says, “My life is over”
C. A client who has a private gun collection
D. A client who says, “I’m going to jump off the next bridge I see”

Answer 21

C. A client who has a private gun collection

Question 22

Which medications have the most potential risk for injury? SATA

A. Amitriptyline
B. Diphenhydramine
C. Colace
D. Alprazolam
E. Buspirone

Answer 22

A. Amitriptyline
B. Diphenhydramine
D. Alprazolam

Question 23

Which combination of drugs should the nurse question? SATA

A. Sertraline with selegiline
B. Alprazolam with Citalopram
C. Buspirone with phenelzine
D. Lithium with Ketorolac
E. St. John’s Wort with Buspirone

Answer 23

A. Sertraline with selegiline
D. Lithium with Ketorolac

Question 24

Which medications have most potential for injury? SATA

A. Amitriptyline to treat fibromyalgia pain
B. Headache while on phenelzine
C. Taking St. John’s Wort with Sertraline
D. Discontinuing escitalopram the day before taking isocarboxazid
E. Peanut butter and jelly sandwich while on selegiline
F. Reporting sore throat, fatigue and low grade fever while on clozapine

Answer 24

A. Amitriptyline to treat fibromyalgia pain
B. Headache while on phenelzine
C. Taking St. John’s Wort with Sertraline
D. Discontinuing escitalopram the day before taking isocarboxazid
F. Reporting sore throat, fatigue and low grade fever while on clozapine