Chapter 23- Depression- Management of Depressive Moods and Suicidal Behavior The nurse makes a home visit to a client who has dysthymic disorder. Which of the 1. following would the nurse expect to assess? A) Low energy B) Intense concentration C) Agitation D) Normal appetite A client has been diagnosed with major depression. The client reports that he often wakes up during the night and has trouble returning to sleep. The nurse interprets this finding as 2. suggesting which of the following? A) Initial insomnia B) Terminal insomnia C) Hypersomnia D) Middle insomnia The nurse is caring for a client in the outpatient setting who has been diagnosed with a depressive disorder. Before the client is given a prescription for a tricyclic antidepressant, 3. assessment for which of the following would be most important? A) Suicide B) Hypersomnia C) Cardiac arrhythmia D) Erectile dysfunction 4. A client diagnosed with major depression was prescribed imipramine (Tofranil) and has been taking this medication for 1 week. The client took his last dose of imipramine WWW.TESTBANKTANK.COM (Tofranil) at 9:00 PM. The client is scheduled to have blood drawn to monitor the medication level the next morning. The nurse should instruct the client to have his blood drawn as close as possible to which time? A) 6:00 AM B) 7:00 AM C) 8:00 AM D) 9:00 AM The nurse is caring for a client with major depression. The client tells the nurse that she just isn’t sure that life is worth living. The nurse documents which nursing 5. diagnosis as the priority? A) Self-esteem, Low, related to depressive episode B) Hopelessness related to symptoms of depression C) Anxiety related to lack of energy for self-care activities D) Thought Processes, Disturbed, related to memory loss and depression A client is prescribed phenelzine (Nardil) to treat her depression. She is at a local café for lunch with a friend. Which of the following items on the menu would be least appropriate 6. for the client to order? A) Roast beef, mashed potatoes, and gravy B) A Cobb salad with blue cheese and Roquefort salad dressing C) Scrambled eggs, toast, and grape jelly D) Medium-well steak, French fries, and broccoli A 34-year-old client with depression is admitted to an inpatient psychiatric unit. The nurse enters her room and initiates interaction with the client. When talking with the 7. client, which approach would be least appropriate? A) Quiet and empathetic manner B) Animated and cheerful manner WWW.TESTBANKTANK.COM C) Matter-of-fact manner D) Respectful, direct manner A client is hospitalized on a psychiatric unit secondary to a suicide attempt. He has been diagnosed with depression. He has been consistently depressed. When assessing the client, which of the following would alert the nurse that the client’s suicidal risk has 8. worsened? A) He tells the nurse that he feels more depressed than ever. B) He is lethargic, remaining isolated from other clients. C) He says he feels better as he interacts more with other clients. D) His energy level and degree of depression remain the same. A group of nursing students is reviewing information about the epidemiology of depressive disorders. The students demonstrate understanding of the information when 9. they identify which of the following as possible risk factors? Select all that apply. A) History of substance abuse as a teenager B) Little social support C) Inadequate coping skills D) Prior episode of anxiety disorder E) Concomitant medical illnesses A nursing instructor is preparing a class discussion about major depression. Which of the 10. following would the instructor expect to include? A) Depression in children is manifested in the same manner as in adults. B) The risk for suicide is especially high during the mid-adolescent years. C) Response to treatment in older adults is slower than that for younger adults. D) People older than age 65 years have the lowest suicide rates of any age group. E) Episodes of depression tend to occur more frequently over time. F) Depressive disorders are most often treated in the primary care setting. WWW.TESTBANKTANK.COM After teaching a group of nursing students about the neurobiologic theories of depression, the instructor determines the need for additional teaching when the students identify 11. which neurotransmitter as playing a role? A) Gamma-amino butyric acid (GABA) B) Norepinephrine C) Serotonin D) Dopamine A nurse is preparing to assess a middle-aged male client who was brought to the emergency department by his wife. She reports that the client has been extremely depressed lately. When assessing this client, which of the following would be a priority 12. assessment? A) Changes in sleeping patterns B) Thoughts of self-harm C) Appetite changes D) Level of fatigue A client with depression is prescribed fluoxetine. On a return visit to the clinic, the client tells the nurse that he also just started taking St. John’s wort to feel better. The nurse 13. assesses the client for which of the following? A) Water intoxication B) Increased depressive symptoms C) Serotonin syndrome D) Hypertensive crisis 14. A client comes to the emergency department complaining of a severe pounding headache in the temples and a stiff neck. The client is flushed and diaphoretic, and his pulse is racing. The client states that he is being treated for depression with selegiline. Which WWW.TESTBANKTANK.COM question by the nurse would be most important to ask at this time? A) When did you last have blood drawn to check your drug level? B) What have you had to eat or drink today? C) Are you having any chest pain? D) Do you use any herbal remedies? The nurse is developing a teaching plan for a client who is prescribed escitalopram. Which of the following side effects would the nurse include in this plan? Select all that 15. apply. A) Weight gain B) Decreased sexual interest C) Sedation D) Blurred vision E) Urinary retention F) Dry mouth The nurse is preparing a client for treatment with repetitive transcranial magnetic stimulation. When teaching the client about this procedure, which of the following would 16. the nurse include? Select all that apply. A) You will receive a short-acting anesthetic to relax you. B) You will be awake and alert during the procedure. C) You can resume your normal activities right after the treatment. D) We will need to shave your scalp at the area where the magnet is placed. E) You might feel a moderate amount of stinging at the site. When assessing a client with depression, the client states, I just feel so sad and hopeless. I just don’t care anymore. I don’t even enjoy doing the crossword puzzles like I 17. used to. The nurse documents this finding as indicative of which of the following? A) Dysthymic disorder WWW.TESTBANKTANK.COM B) Anhedonia C) Delusion D) Psychosis The plan of care for a client diagnosed with depression includes cognitive interventions. 18. The nurse would expect to assist with which of the following? A) Social skills training B) Activity scheduling C) Thought stopping D) Interpersonal therapy A nurse is preparing a presentation for family members of clients who have been diagnosed with depression. When describing the family response to depression, which of 19. the following would the nurse include? A) Family members typically can understand how disabling depression can be. B) Depression in one family member affects the entire family. C) Abuse of the depressed person is a rare occurrence in families. Families of women older than 55 years of age with depression experience the D) majority of problems. The nurse is reviewing the medical record of a client diagnosed with depression and notes that the client has been prescribed mirtazapine. The nurse interprets this information, 20. identifying this agent as which type? A) Selective serotonin reuptake inhibitor B) Cyclic antidepressant C) Norepinephrine dopamine reuptake inhibitor D) Alpha-2 antagonist Answer Key WWW.TESTBANKTANK.COM 1. A 2. D 3. A 4. D 5. B 6. B 7. B 8. C 9. B, C, E 10. B, C, E, F 11. A 12. B 13. C 14. B 15. A, B 16. B, C 17. B 18. C 19. B 20. D WWW.TESTBANKTANK.COM
