ATI- Engage Mental Health: Mood Disorders and Suicide

A nurse is creating a presentation about depression for a community health fair. The nurse should plan to report that depression is more prevalent among which of the following demographics? -Adult males -Adult females -Adolescents between the ages of 15 and 17 -Children ages 10 to 14

Adult females The nurse should identify that the prevalence of depression in U. S. adults aged 18 or older in 2017 was estimated at 17.3 million, with higher prevalence among females.

A nurse is caring for a client who is hyperactive, pacing down the hallway, and exhibiting poor concentration during group therapy. Which of the following is characteristic of the client's manifestations? -Mania -Depression -Hallucinations -Delusions

Mania The nurse should identify that the client is exhibiting manifestations of mania, which include overactivity, overeating, overspending, poor sleeping habits, and speaking rapidly.

A nurse is caring for a client who has persistent depressive disorder. When educating the client about their illness, which of the following statements should the nurse make? -"Persistent depressive disorder is a mild chronic form of depression." -"Persistent depressive disorder is characterized by delusions and hallucinations." -"Persistent depressive occurs shortly after taking or withdrawing from a substance." -"Persistent depressive is characterized by both manic and depressive episodes."

"Persistent depressive disorder is a mild chronic form of depression." The nurse should identify that persistent depressive disorder is also known as dysthymia and is characterized as a less severe form of depression.

A nurse on an inpatient mental health unit is teaching a newly licensed nurse about suicide prevention. Which of the following statements made by the newly licensed nurse indicates an understanding of the information presented? -"The client can eat their meal alone in their room." -"The blinds in the client's room will need to stay closed to prevent overstimulation." -"All sharp objects should be removed from the client's room." -"Family members should be encouraged to look up the warning signs of suicide."

"All sharp objects should be removed from the client's room." The nurse should identify that all items, including sharp objects or potential weapons, that could be potentially dangerous and used to complete a suicide attempt should be removed from the client's room.

A nurse is caring for a client who is scheduled for transcranial magnetic stimulation. When preparing the client for the procedure, which of the following statements should the nurse make? -"The procedure will last about 1 hour." -"During the procedure, you may notice slight relaxation of the jaw." -"This procedure is effective when combined with psychotherapy." -"The treatments will take about 6 months."

"This procedure is effective when combined with psychotherapy." The nurse should identify that transcranial magnetic stimulation has been proven to be very effective in the treatment of depression when coupled with psychotherapy.

A nurse is discussing findings of depression with a group of clients. Which of the following client statements indicates an understanding of the information? -"Thyroid problems can cause depression." -"Staying awake for days can be a finding of depression." -"Hyperactivity is a finding associated with depression." -"Impulsiveness is a finding that is commonly associated with depression."

"Thyroid problems can cause depression." The nurse should identify that depression can be induced by medical conditions, such as Parkinson's disease, Huntington's disease, Alzheimer's disease, and hypothyroidism.

A nurse on an inpatient mental health unit is evaluating a client who was admitted for suicidal ideation for readiness for discharge. Which of the following statements by the client indicates they may be ready for discharge? -"I plan to go hunting when I get home." -"When I get home, I will reach out to my friends if I start feeling down." -"I am going to make a will as soon as I get home." -"When I get home, I will get even with my boss for firing me from my job."

"When I get home, I will reach out to my friends if I start feeling down." The nurse should identify that this statement by the client indicates future planning and a solution to problems. Clients who are experiencing suicidal ideation do not make future plans and feel trapped without solutions to problems.

A nurse is providing teaching to a client who is to undergo transcranial magnetic stimulation (TMS) for depression. Which of the following information should the nurse provide? -"The procedure will take about 2 hours." -"You will be asleep during the procedure." -"Most people only require one treatment to eliminate their depression." -"You may experience a mild headache following the procedure."

"You may experience a mild headache following the procedure." The nurse should inform the client that it is common to experience a headache following the procedure. The headaches are usually mild and pass without incident.

A nurse is providing teaching to a client who is to undergo electroconvulsive therapy (ECT) for depression. Which of the following information should the nurse provide? -"Electrical current will flow through electrodes placed on your torso." -"You will be awake during the procedure." -"Your provider will likely schedule you for several treatments over a period of weeks." -"It is not necessary to fast before the procedure."

"Your provider will likely schedule you for several treatments over a period of weeks." The nurse should inform the client that, to be effective, ECT usually requires several treatments over a period of several weeks.

The nurse is reviewing the medical record. {Click to highlight the findings that require immediate follow-up. To deselect a finding, click on the finding again.} -altered mental status -blurry vision -dry oral mucous membranes, poor skin turgor, pronounced intention tremor. -low back pain after helping friends move a piano out of the house. -Ibuprofen 600 mg by mouth three times a day -Sodium 145 mEq/L, Potassium 3.5 mEq/L -BUN 48 mg/dL, Creatinine 2.4 mg/dL -Serum glucose 118 mg/dL -Lithium level 2.5 mEq/dL -12-lead ECG revealed sinus bradycardia rate 52

-altered mental status -blurry vision -dry oral mucous membranes, poor skin turgor, pronounced intention tremor. -Ibuprofen 600 mg by mouth three times a day -BUN 48 mg/dL, Creatinine 2.4 mg/dL -Lithium level 2.5 mEq/dL -12-lead ECG revealed sinus bradycardia rate 52 When evaluating outcomes, the nurse should recognize that altered mental status and blurred vision are associated with lithium toxicity and require immediate follow-up. Tremor is one of the earliest findings of lithium intoxication and nurses should be vigilant to recognize this finding. Dry mucous membranes and poor skin turgor are signs of dehydration and can raise lithium levels to toxic levels. The nurse should recognize the patient's use of ibuprofen as a nonsteroidal anti-inflammatory drug three times a day can cause changes in lithium concentrations. The elevated BUN and creatinine suggest altered fluid balance and altered renal function. The lithium value is elevated. Bradycardia with these other symptoms is indicative of lithium toxicity and warrants further follow-up.

A public health nurse is preparing a suicide prevention program for patrons of the local library. The nurse should inform the attendees that suicide is the second leading cause of death in which of the following age groups? -10 to 34 years of age -35 to 44 years of age -45 to 54 years of age -Over 65 years of age

10 to 34 years of age The nurse should inform the attendees that, according to the CDC, suicide is the second leading cause of death for people 10 to 34 years of age.

A nurse is caring for a child who is exhibiting tantrums, dysfunction in school, trouble with peers, and suicidal ideation. Which of the following should the nurse identify as being consistent with the client's findings? -Disruptive mood dysregulation disorder -Dysthymia -Bipolar I disorder -Bipolar II disorder

Disruptive mood dysregulation disorder The nurse should identify that disruptive mood dysregulation disorder is a disorder diagnosed in children who exhibit extreme irritability, tantrums, and trouble in school.

A nurse on a mental health unit is using the SAD PERSONS scale to assess the risk of suicide among several clients. Which of the following clients should the nurse identify as having the highest risk? -A 43-year-old female client -A 21-year-old female client -A 35-year-old male client -A 15-year-old male client

A 15-year-old male client The nurse should identify that clients who are less than 19 years of age and older than 45 years of age have an increased risk of suicide. Clients who are male also have an increased risk of suicide.

{Complete the following sentence by using the list of options} The nurse should first address the client's ________ as evidenced by the client's ________ A: -lack of interset -safety -support system -medication regimen B: -statements -noncompliance -lack of interest

A: Safety B: Statements The nurse should analyze cues when using Maslow's hierarchy of needs to meet the client's need for safety. Suicidal ideation is an emergent need requiring immediate intervention. The nurse should address the client's support system because they mentioned they lacked interest in seeing them and being with their family. The nurse should address the client's medication regimen and noncompliance. It is important to instruct the client about how long it takes to expect a decrease in manifestations of depression.

A school nurse is preparing a presentation about suicide prevention for high school. Which of the following should the nurse include as modifiable risk factors for suicide? -Sexual orientation -Access to firearms -Ethnicity -Race

Access to firearms The nurse should identify that firearms are one of the most common means of suicide. The family or client can modify the risk of suicide by removing access of firearms.

A school nurse is preparing a presentation for high school students on the relationship between substances and depression. Which of the following substances should the nurse plan to include as a contributing factor in the development of substance-induced depressive disorder? -Amphetamines -Selective serotonin reuptake inhibitors -Nonsteroidal anti-inflammatory drugs -Monoamine oxidase inhibitors

Amphetamines The nurse should identify that substance/medication-induced depressive disorder occurs soon after a client begins taking or withdrawing from a substance, with the most common occurrences when the client is using alcohol, phencyclidine, hallucinogens, inhalants, opioids, and amphetamines.

A nurse is reviewing the medical record of a client who has major depressive disorder. Which of the following assessment findings should the nurse expect for a client who has major depressive disorder? -Client is hyperactive -Client has had a recent intentional weight loss -Client reports sleeping 8 hr each night -Client reports having thoughts of death

Client reports having thoughts of death The nurse should expect a client who has major depressive disorder to report experiencing recurrent thoughts of death (not just fear of dying), suicidal ideation, or suicide attempts.

A nurse is caring for a client who was admitted with suicidal ideation. The client tells the nurse they have several guns in their home. Which of the following types of interventions is the priority for the nurse to initiate? -Teach coping and problem-solving skills -Strengthen access to and delivery of suicide care -Promote connectedness -Create a protective environment

Create a protective environment Utilizing the safety/risk reduction priority framework, the nurse should identify that it is important for a client who has suicidal ideation to have reduced access to lethal means of self-harm. The nurse may need to recruit the help of others, such as a social worker or the client's family, to create a protective environment for the client by removing the guns from their home.

A nurse in an outpatient clinic is caring for a client who has major depressive disorder and has reported suicidal thoughts. Which of the following is the first information the nurse should try to obtain from the client? -How lethal are the client's thoughts of self-harm? -Does the client have access to committing self-harm? -Does the client have a suicide plan? -Does the client have someone to call when they are feeling suicidal?

Does the client have a suicide plan? Using the safety/risk reduction priority framework, the first information the nurse should try to obtain is whether the client has a definite suicide plan.

A nurse in a mental health clinic is taking a medical history on a client. The nurse should identify that which of the following factors in the client's history increases their risk for mental illness? -Living in a rural area -Being raised by a single parent -Early exposure to violence -Being in a family with numerous siblings

Early exposure to violence The nurse should identify that early exposure to violence, abuse, and neglect in childhood can have long-term effects on clients, as shown in the Adverse Childhood Experiences Study done by the CDC. The CDC has therefore advocated for early and intensive intervention when children display mood disorders related to trauma.

A school nurse is creating a presentation about mental health for a group of middle school students. Which of the following topics should the nurse prioritize when preparing this presentation? -Tyramine restrictions when taking a monoamine oxidase inhibitor (MAOI) -The prevalence of postpartum depression. -Signs and manifestations of lithium toxicity Factors that contribute to suicide

Factors that contribute to suicide The nurse should identify that the greatest risk to these clients is suicide. Suicide is the second leading cause of death in clients ages 10 to 34. Assessing for and educating about risk factors for suicide is a task that should be prioritized to maintain client safety. By educating this group about factors that can contribute to suicide, the nurse is providing information that can help prevent self-harm.

A nurse is assessing a client who has a diagnosis of mania related to bipolar disorder. Which of the following behaviors should the nurse expect the client to exhibit? -The client is giving away their possessions. -The client is demonstrating risky behavior. -The client is sleeping excessively. -The client states they feel worthless.

The client is demonstrating risky behavior. The nurse should expect a client who is experiencing mania to exhibit risky behavior. Other behaviors of mania include impulsivity, overactivity, pacing, sleeplessness, fast speech, and being overconfident.

The nurse is providing education to the client regarding phenelzine. {Which of the following 3 statements indicate that the client needs further instruction?} a) "I can expect my blood pressure to go up with this medication." b) "I need to avoid smoked meats when taking this medication." c) "I will check with my provider before taking cold medications." d) "It is okay if I drink imported beer, but I must avoid wine." e) "I love overripe bananas. I am glad that I don't have to give them up."

a, d, e When taking actions, including educating clients, the nurse will also evaluate client understanding of the information. The nurse understands that the client needs further instructions if the client states they can drink imported beer, eat overripe bananas, and should expect an increase in blood pressure. The nurse should reiterate the risk of adverse hypertensive reaction and elevated levels of tyramine. Elevated blood pressure may indicate a high level of tyramine, which can cause cerebral and death. Eating foods such as overripe bananas and consuming beer and wine can cause the tyramine level to rise, causing an adverse hypertensive reaction.