Exam 3: Chapter 17: Mood Disorders & Suicide

The nurse assesses an adult client who presents with depression. Which question does the nurse include in the health history interview to determine if the client is at risk for suicide? Select all that apply. "Do you have any physical illnesses?" "Do you have a history of alcohol use disorder?" "Have you experienced the loss of a job recently?" "Has anyone in your family ever attempted self-harm?" "Were you subjected to any type of abuse when you were a child?"

"Do you have any physical illnesses?" "Do you have a history of alcohol use disorder?" "Have you experienced the loss of a job recently?" "Has anyone in your family ever attempted self-harm?" "Were you subjected to any type of abuse when you were a child?"

A client with bipolar disorder is receiving lithium therapy. The nurse is reviewing the client's serum plasma drug levels and determines that the client's level is therapeutic based on what? 1.0 mEq/L 1.6 mEq/L 2.0 mEq/L 2.6 mEq/L

1.0 mEq/L NOTE: Serum plasma lithium levels should range from 0.6 to 1.2 mEq/L. Levels above that suggest toxicity (moderate toxicity for levels 1.5 to 2.5 mEq/L; severe toxicity for levels greater than 2.5 mEq/L).

Research has shown that risk of suicide increases within which time frame for initiation of antidepressant therapy? 14 days 28 days 35 days 42 days

14 days NOTE: Studies have shown that the risk for suicide increases within the first 2 to 3 weeks after starting antidepressant medication, usually because the client's mood has not lifted as quickly as physical energy has returned.

Which is an anticonvulsant used as a mood stabilizer? Divalproex Venlafaxine Bupropion Phenelzine

divalproex

The nurse is conducting an interview with an adult client who is being treated for major depression. What question should the nurse prioritize in an effort to determine the client's risk for suicide? "Do you ever feel like your situation is hopeless?" "How would you describe your relationship with your parents?" "Do you feel like your antidepressant is helping your mood?" "What are your plans for the next few days?"

do you ever feel like your situation is hopelessness? NOTE: Hopelessness is a significant risk factor for suicide among persons who are depressed.

Which question should the nurse ask to assess the client's degree of suicide planning when the client states, "Everyone would be better off without me. I will just use my gun to end it all!"? "Do you have access to a firearm?" "How often do you have these thoughts?" "Is this thought increasing in frequency?" "Is there anyone who might keep you from doing this?"

do you have access to firearm

A client was abandoned by the parents at age 3, resulting in the client's perception of the world as a hostile place and the subsequent development of rage against men. This statement is an example of what? A psychodynamic interpretation of the client's major depressive disorder. A reason the client has become lesbian at the age of 23. A biological explanation for the client's depressive disorder. A feminist viewpoint of depression.

a psychodynamic interpretation of the client's major depressive disorder NOTE: Psychodynamic theories postulate that clients with depression have unexpressed and unconscious anger about feeling helpless or dependent on others. Such anger begins in childhood when basic developmental needs are not met. Clients cannot express this anger toward the person or people on whom they feel dependent, so their anger turns inward.

A client has been diagnosed with major depressive disorder. The clinical symptom that would be included when the clinician makes this diagnosis is what? Self-report of being sad after a break up A significant decrease in appetite Demonstrated examples of unwise decisions Claims by family, friends, or coworkers that the client is depressed

a significant decrease in appetite

The community mental health nurse is providing care for a large number of clients. What client should the nurse monitor most closely for the warning signs of suicide? A young male with schizophrenia who is in danger of becoming homeless An adult female who is mourning the death of her husband 5 months ago An older adult client who has recently been diagnosed with early stage Alzheimer disease A middle-aged female client who is receiving treatment for obsessive-compulsive disorder

a young male with schizophrenia who is in danger of becoming homeless NOTE: Being a young male, having a mental illness, and facing a situational crisis are all significant risk factors for suicide.

A 35-year-old client with bipolar disorder has a history of discontinuing medication when feeling well and then becoming manic again. During the client's last episode of mania, the client lost several thousand dollars in risky investments. Which intervention will be most helpful in achieving medication adherence? Point out that each time the client stops taking medication, the client becomes manic again. During stabilization, discuss the client's individual signs, symptoms, and consequences of relapse. Ensure that a family member takes responsibility for administering medications. Remind the client that the client owes it to the client's spouse and children to stay well.

during stabilization, discuss the client's individual signs, symptoms, and consequences of relapse NOTE: To help link the importance of taking medication with relapse prevention, the nurse lists target symptoms and identifies signs of imminent relapse. The nurse engages in problem solving with the client about early management of symptoms so severity does not increase.

A client diagnosed with bipolar disorder is admitted to an inpatient psychiatric facility with acute mania and threats of attacking others in the household. Which would be the priority? Ensuring safety Administering mood stabilizers Removing the client to a quiet environment Challenging the client's behavior

ensuring safety

On admission to the psychiatric unit, a client is dressed in a red leotard and exercise bra, with an assortment of chains and brightly colored scarves on the client's head, waist, wrists, and ankles. The client's first words to the nurse are, "I'll punch you, munch you, crunch you," as the client dances into the room, shadow boxing. The client shakes the nurse's hand and says cheerfully, "We need to become better acquainted. I have the world's greatest intellect, and you are probably an intellectual midget." How can the nurse document the client's mood? Belligerent and blunted. Expansive and grandiose. Anxious and unpredictable. Suspicious and paranoid.

expansive and grandiose

A nurse is reviewing the medical record of a young client to determine the client's risk for suicide. Which factor would alert the nurse to an increased risk for this client? fears of growing older diagnosed with an acute illness starting a new business with friends experiencing unemployment that has lasted a year

experiencing unemployment that has lasted a year NOTE: Social factors associated with suicide risk include economic deprivation, unemployment, and poverty, especially among the younger population.

A client has been diagnosed with depression and states that the client is reluctant to receive treatment, stating that the client "would prefer to just wait this out." What is the nurse's most appropriate action? Explain to the client that untreated depression often becomes increasingly severe and frequent over time Document a nursing diagnosis of ineffective denial and choose interventions accordingly Assess the client's knowledge of depression and describe the risks of suicide Document a nursing diagnosis of noncompliance and educate the client about the benefits of treatment

explain to the client that untreated depression often becomes increasingly severe and frequent over time

The nurse is conducting an admission assessment with a 45-year-old client who has been demonstrating signs of bipolar disorder. While conducting the assessment, the client starts speaking in illogical rhymes and using word associations. What is the name for this thought pattern? Delusions of grandeur Flight of ideas Expansive ideas Excessive euphoric speech

flight of ideas

When teaching prevention to the parents of a 15-year-old client who recently attempted suicide by taking an overdose of alprazolam, the nurse describes which behavioral clue? Angry outbursts at significant others Inquiry about doses of lethal drugs Giving away valued personal items Experiencing the loss of a boyfriend or girlfriend

giving away valued personal items

A client in the clinic appears to have elevated self-esteem, is more talkative than usual, and is easily distracted. This client is exhibiting symptoms of what? Anorexia Grandiosity Anxiety Depression

grandiosity

The nurse is assessing a 42-year-old client who is experiencing depression. The client's mother died by suicide 20 years ago. Which statement regarding this client's risk for suicide is correct? The client's risk is equivalent to that of the general population. The client has a greater risk for suicide than the general population. The client's risk for suicide will increase when the client reaches the age of 50. The client would have a greater risk for suicide if the client's father had died by suicide.

he client has a greater risk fro suicide than the general population

The nurse is providing care for a client who deliberately overdosed on acetaminophen several days ago. The nurse should assess the current severity of the client's suicidal ideation by asking what question? "How often are you having thoughts about suicide this morning?" "What caused you to take all those pills last week?" "Do you have access to any more pills that we don't know about?" "Do you see a way out from your depression apart from suicide?"

how often are you having thoughts about suicide this morning NOTE: Asking the client about the quantity and persistence of suicidal thoughts addresses the severity of suicidal ideation.

Which behavior is the priority concern as the nurse begins a care plan for a client in the manic phase of bipolar disorder? Bizarre, colorful, inappropriate dress Grandiose thinking and poor concentration Insulting, provocative behavior directed at staff Hyperactivity, dismissing meals, and sleep disturbance

hyperactivity, dismissing meals, and sleep disturbance NOTE: A client who has not eaten or slept for several days and has been extremely hyperactive may be at risk for exhaustion and malnutrition and the implications of those states.

The nurse is interviewing a client with a diagnosis of depression and the client states, "Honestly, I know my family would be a lot better off if I wasn't around to be a burden on them. That's just between you and me, though, okay?" What is the nurse's best response? "I'm obliged to share what we talk about with the other people on your care team." "Why is it important to you that this be kept between you and I?" "In my experience, nothing good ever comes of keeping secrets." "What can I do to get your permission to share with the other members of the care team?"

i am obligated to share what er talk about with the other people on your care team

A client comes to the clinic for an evaluation of headache, fatigue, and an overall feeling of being "down." When assessing the client, which statement by the client would alert the nurse to suspect possible suicide? Select all that apply. "I've been drinking about three or four more beers every night." "I've been going out with my friends about once or twice a week." "I'm so tired that all I ever want to do is sleep all the time." "Most times, I feel like I'm trapped with no way out." "I'm looking for a new job because my job is so stressful."

i have been drinking about three or four more beers every night i am so tired that all i ever want to do is sleep all the time most times, i feel like i ma trapped with no way out

The nurse provides care for a client who is depressed and expresses hopelessness with the current situation. Which client statement indicates a need to implement safety precautions? "I haven't been able to sleep for the past week because I am anxious." "I just started my new medication and I hope to feel better soon." "I decided that I should stop drinking alcohol for a while." "I just started a new job so at least I have that."

i have not been able to sleep for the past week because i am anxious

Which is the priority nursing action to prevent suicide and promote mental health? Intervene to change suicidal behavior. Identify a client who is thinking about suicide. Assess a client to determine the suicidal threat. Institute interventions to prevent future suicidal behavior episodes.

identify a client who is thinking about suicide NOTE: The beginning evidence points to four steps in preventing suicide and promoting long-term mental health: (1) identification of those thinking about suicide (case finding), (2) assessment to determine an imminent suicidal threat, (3) intervening to change suicidal behavior associated with a specific suicidal threat, and (4) institution of effective interventions to prevent future episodes of suicidal behavior.

Which could be incorporated into the plan of care for a client receiving an antidepressant who is experiencing orthostatic hypotension? Increase hydration Take medication with food Get daily exercise Eat a nutritionally balanced diet

increase hydration

A client with major depression is admitted to the health facility and expresses feelings of worthlessness and abandonment by significant others. Which replies by the nurse would convey empathy? "I can understand what is going on with you." "Are you feeling like others have abandoned you?" "It sounds like this is a really difficult time for you." "Can you tell me what you are thinking right now?"

it sounds like this is a really difficult time for you NOTE: "It sounds like this is a really difficult time for you" is an empathetic response that signifies that the nurse understands the client's ideas and feelings

A client taking lithium therapy has a serum therapeutic level of 0.8 mEq/L. What priority dietary instruction should the nurse include in the teaching plan? Limit fluid intake to 6-8 oz (180-340 mL) glasses a day. Maintain daily sodium intake. Switch to a DASH diet. Monitor weight pattern.

maintain daily sodium intake

Limit setting is most appropriate in which client population? Manic Anxious Depressed Suicidal

manic

Which medication classification is considered first-line drug therapy for bipolar disorder? Antipsychotics Mood stabilizers Anticonvulsants Antidepressants

mood stabilizers

Which is a true statement regarding depressive disorders? They are more prevalent in men than women. Depression in older adults is easier to diagnosis. Norepinephrine, dopamine, and serotonin have been implicated. It is the leading cause of U.S. disability in clients older than 44 years of age.

norepinephrine, dopamine, and serotonin have been implicated

A client with bipolar disorder is experiencing a major depressive episode. Which would the nurse expect to assess? Select all that apply. Flight of ideas Obsessive rumination Hypersomnia Widespread shopping sprees Difficulty concentrating

obessive rumination hypersomnia difficulty concentrating

A newly admitted client's history includes multiple suicide attempts. How can the nurse on the psychiatric-mental health unit best protect the client's safety? Performing vigilant assessment and close observation Establishing a no-suicide contract with the client Administering the client's prescribed selective serotonin reuptake inhibitor Facilitating a referral for cognitive behavioral therapy

performing vigilant assessment and close observation

A client is admitted to a mental health unit with reports of fatigue, poor appetite, and difficulty making decisions. The client also reports having felt unhappy most of the time for "as long as I can remember." Which diagnosis should the nurse anticipate for this client? Persistent depressive disorder Bipolar disorder Rapid cycling disorder Mild depressive disorder

persistent depressive disorder NOTE: Persistent depressive disorder, or dysthymic disorder, is relatively mild compared to major depressive disorder but is chronic. It is diagnosed when the depressed mood exists for most days for at least 2 years with two or more of the following symptoms: poor appetite or overeating, insomnia or oversleeping, low energy or fatigue, low self-esteem, poor concentration or difficulty making decisions, and feelings of hopelessness.

A 27-year-old woman has a 4-month-old baby. For the past 3 months, the client has been experiencing intense sadness, anxiety, and hopelessness. After having thoughts of killing her baby, she decided to seek help. What is the likely the cause of this client's experience? Dysthymic disorder Postpartum depression Major depression Postpartum blues

postpartum depression

A client was admitted to the psychiatric unit after being picked up by police officers who found the client frantically running back and forth across the freeway. The client's spouse reports that the client stayed up all night, ate very little, and talked incessantly. Additional assessment findings that indicate a manic episode include what? Psychomotor retardation, fatigue, and apathy Pressured speech, combative behavior, and impaired judgment Catatonic excitement, loose associations, and recurrent illusions Self-destructive behavior, overidealization, and devaluation

pressured speech, combative behavior, and impaired judgement

The primary nursing goal for a client who is admitted for suicidal ideation or attempt would be what? Assist him or her in the expression of sad and helpless feelings. Assess the cause of his or her depression. Develop rapport based on trust and understanding. Prevent self-destructive behavior.

prevent self-destructive behavior

A high risk for suicide would be assessed as what? Support systems available Previous suicidal behavior Feelings of self-worth Adequate sleep pattern

previous suicidal behavior

A client has admitted to the nurse that the client is "tempted to end it all." How can the nurse prevent a future malpractice lawsuit if the client makes a suicide attempt? Promptly act on, and document, the client's statement. Verbally communicate the client's statement to the psychiatrist immediately. Facilitate a prompt referral to the psychiatric-mental health advanced practice registered nurse. Inform a colleague about the client's statement as soon as possible.

promptly act on, and document the client's statement

A client was admitted to the psychiatric unit with major depression after a suicide attempt. In addition to the client's feelings of sadness and hopelessness, the nurse would expect to assess what? Increased focus Decreased complaints of pain Psychomotor retardation Increased energy level

psychomotor retardation NOTE: Associated signs and symptoms of depression include an inability to think or concentrate, increased complaints of pain, psychomotor retardation, and lack of energy and fatigue.

After assessing a client, the nurse identifies that the client is at risk for suicide. Which would be the nurse's priority intervention? Communicate a desire to help the client. Remove means of suicide from the client's access. Determine the course of the client's suicidal thoughts. Provide mood-stabilizing medications per physician order.

remove means of suicide from the client's access NOTE: Immediate interventions involve removing the means of suicide to reduce the risk of it happening. If the person is hospitalized, methods may include ensuring pills or medications are not available to clients or that they are not taking any measures to accumulate needed drugs. If in a community or home care setting, nurses may enlist the help of family or friends to remove the means and to provide immediate support.

After observing a bipolar client on the mental health unit, the nurse determines that the client is at risk for violence. Which would be an appropriate intervention? Ask the client to sit alone and write a letter. Restrict the client to the client's room until the client can calm down. Encourage the client to participate in an activity with other clients. Tell the client that if the client is violent, the client will be sent home.

restrict the client to the client's room until the client can calm down NOTE: If clients are determined to be at risk for violence, establishing geographic boundaries, such as room or half-hall restriction, is part of ongoing monitoring.

Which would be the priority diagnosis for the client in the manic phase of bipolar disorder who is exhibiting aggressive behavior? Ineffective health maintenance Risk for other-directed violence Disturbed thought processes Impaired social interaction

risk for other-directed violence

A nursing student is caring for an elderly client who is taking sertraline for depression. The instructor quizzes the student about the medication and its actions. To what classification of drugs should the student assign sertraline? Cyclic antidepressant Monoamine-oxidase inhibitor Selective serotonin reuptake inhibitor Serotonin 2 antagonist

selective serotonin reuptake inhibitor (SSRIs)

A nurse is caring for a client diagnosed with bipolar disorder. The client is experiencing a manic episode. The nurse would be especially alert for signs indicating what? Self-injury Sleep disruption Dehydration Weight loss

self-injury

A client taking lithium for bipolar disorder is having mild diarrhea. The nurse informs the client that this is an example of what? Toxic effect Side effect Desired effect Therapeutic effect

side effect

The nurse is working with a 50-year-old client admitted for a major depressive episode. The client has remained isolated and withdrawn since admission and is reluctant to speak. Which therapeutic communication skill is most likely to encourage the client to verbalize the client's feelings? Direct confrontation Reality orientation Projective identification Silence and active listening

silence and active thinking

Before a client became depressed, the client was an active, involved parent with three children, often attending their school functions and serving as a volunteer. The client is hospitalized for a major depressive episode and now reveals that the client feels like an unnecessary burden on the client's family. Which nursing diagnosis is most appropriate? Anxiety related to side effects of medication Situational low self-esteem Ineffective coping related to marital disagreements Ineffective activity planning related to depression

situational low self-esteem

Which is a primary risk factor for suicide? Social isolation Unemployment Poverty Economic deprivation

social isolation

A nurse is providing a presentation about suicide for a group of health professionals. Which would the nurse address as a major contributor to the rising suicide rate among men? Substance abuse Media influences Lack of conflict resolution skills Parenting practices

substance abuse

A parent of four small children lost a spouse in an automobile accident 3 months ago and is admitted to the hospital with severe depression. Since the spouse's death, the client's mood has been somber; until now, the client has refused treatment. What is this client at high risk for? Bipolar disorder Suicide Schizophrenia Dysthymic disorder

suicide

The nurse is assessing a client who has presented to the emergency department in emotional distress. What client data represents the greatest risk for suicide? The client overdosed on pills 2 years earlier The client states, "Everything just seems really dark right now." The client has been treated with a variety of antidepressants over the years. The client sits silently after being asked several of the assessment questions

the client overdosed on pills 2 years earlier NOTE: any previous attempt of suicide has potential to have great risk for suicide in the future

The nurse is working with an outpatient who has a history of depression and suicide attempts. What assessment finding should the nurse interpret as indicating a high degree of planning for a future attempt? The client recently purchased a large bottle of over-the-counter analgesics The client stopped attending a depression support group, despite initially benefiting from it The client told the nurse, "I just want to stop being a burden to my wife and kids." The client has told the nurse, "I'm pretty sure my meds aren't working."

the client recently purchased a large bottle of OTC analgesics

A mental health nurse has formed a nursing diagnosis of hopelessness related to poor self-concept for a client with depression. An appropriate outcome for this nursing diagnosis would include what? The client will discuss the cause of the fatigue. The client will demonstrate improved ability to express self. The client will identify factors that reduce activity tolerance. The client will differentiate between reality and fantasy.

the client will demonstrate improved ability to express self

A client who has just been prescribed lithium for bipolar disorder is being given education from the nurse about this medication. Which is important for the nurse to include in teaching? The higher the potassium level, the lower the lithium level will be. The higher the sodium level, the lower the lithium level will be. Changes in diet will not affect lithium levels. Lithium has few interactions with other drugs.

the higher the sodium level, the lower the lithium level will be NOTE: Lithium is a salt, so the interaction between lithium and sodium levels in the body and between lithium level and fluid volume in the body are crucial issues to consider. The higher the sodium levels, the lower the lithium level will be and vice versa.

The nurse working on a mental health unit is teaching a nursing student. The student asks the nurse about what constitutes a diagnosis for major depressive disorder. What is the nurse's best response? "Depression is a mood variation to life events." "The primary diagnostic criterion is one or more major depressive episodes for at least 2 weeks with other symptoms present." "The physician diagnoses depression when a client has feelings of sadness several times a year." "Feelings of anxiety and sadness as a response to a life event are the most important qualifiers for depression."

the primary diagnostic criterion is one or more depressive episodes for at least 2 weeks with other symptoms present

When conducting a suicide risk assessment with a client, the nurse should identify the client as a high imminent risk if which statement is made? "There are no solutions to my problems." "My son is really the only reason I stick around." "I think about starving myself to death sometimes" "I just need someone to talk to"

there are no solutions to my problem NOTE: Hopelessness is the pervasive belief that undesirable events are likely to occur coupled with the belief that one's situation is unlikely to improve. A significant evidence base has been established linking hopelessness, loneliness, and other cognitive symptoms to suicide ideation. Depressed persons who are hopeless are more likely to consider suicide than those who are depressed but hopeful about the future

When completing a baseline assessment of a client with depression, which diagnostic tests would the nurse anticipate? Renal function tests Coagulation profile Thyroid function tests Abdominal ultrasound

thyroid function tests

A 51-year-old client with a history of an alcohol use disorder and depression has committed suicide. The care team has subsequently taken steps to organize a postvention. What is the goal of a postvention? To provide a chance for the client's family and friends to reminisce about the client. To allow the client's family and other close acquaintances to express their feelings about the suicide. To identify the clues that should have been acted upon in the days leading up to the client's suicide. To teach the client's close friends and family coping skills that they will need in the months ahead.

to allow the client's family and other close acquaintance to express their feeling about the suicide `

A 38-year-old client has been diagnosed with major depressive disorder. The client is being placed on an antidepressant and the nurse is providing medication teaching. Which would be appropriate information to provide to the client? "You should notice an immediate improvement in your mood." "You may not notice an improvement in your symptoms for 2 to 6 weeks." "If you do not notice an improvement in your symptoms in 1 to 2 weeks, a different antidepressant will be prescribed." "The antidepressant's ability to affect the neurons in your brain will take between 2 to 6 weeks."

you may not notice an improvement in your symptoms for 2 to 6 weeks NOTE: Their effects include changing the receptor itself, altering metabolism and breakdown of the neurochemical, or blocking reuptake of the neurochemical at the presynaptic receptor. These changes occur soon after the medication is administered; however, reduction in depressive signs and symptoms usually takes between 2 to 6 weeks, depending on the drug.

A loss of pleasure or interest in a client diagnosed with depression would be documented as what? Anhedonia Flat affect Hopelessness Discouragement

anhedonia NOTE: A person with depression has a sustained period of feeling depressed, sad, or hopeless and may experience anhedonia (loss of interest or pleasure). The client may report "not caring anymore" or not feeling any enjoyment in activities that were previously considered pleasurable.

A nurse is reviewing information about medications used to treat bipolar disorders. The nurse demonstrates understanding by identifying which medication classification as effective in stabilizing moods in people with bipolar disorder? Anticonvulsants Antianxiety Anticoagulants Antibiotics

anticonvulsants

The nurse has been asked to assess a client to determine if the client has a suicide plan. Which question would assist the nurse in assessing this area? "Are you a religious person?" "Do you have people in your life who are supportive of you?" "Are you thinking about killing yourself right now?" "How do you generally cope with problems in your life?"

are you thinking about killing yourself right now

The genetic theory, when applied to the occurrence of depression, supports that the psychiatric nurse should ... assess for depression in the client's family history. prepare the client for diagnostic genetic testing to confirm the diagnosis. educate the client regarding the symptoms of related physical disorders. encourage the client to seek genetic counseling before considering a pregnancy.

assess for depression in the client's family history

A client with bipolar disorder has been ordered a medication that is classified as an anticonvulsant. Which drug does the nurse know falls within this class of medications? Mannitol Lithium Carbamazepine Methyldopa

carbamazepine NOTE: Carbamazepine is an anticonvulsant with mood-stabilizing effects.

The client's spouse calls the health clinic stating that the client is having a manic episode. What information should alert the nurse to recommend that the client should go to the emergency room for treatment? Client has stayed up most of the night watching television. Client has experienced work-related stress. Client is pacing around the bedroom. Client is avoiding eye contact and visibly shaking.

client avoiding eye contact and visibly shaking

A client has just been admitted to the inpatient psychiatry unit following a suicide attempt. During the client's first 24 hours of care, what outcome should be identified? Client will express that the client feels safe on the unit Client will implement strategies for managing stress Client will participate actively in cognitive behavioral therapy Client will state that the client feels optimistic about the client's future

client will express that the client feel safe on the unit

The major difference between bipolar I and bipolar II disorder is what? Clients with bipolar I have no symptoms of mania, but only depression. The prognosis for bipolar I is much better than for bipolar II. Clients with bipolar II disorder do not have symptoms of mania that interfere enough to cause marked functional disturbances. Both disorders are the same, except that clients with bipolar I disorders have a much higher incidence of suicide.

client with bipolar II disorder do not have symptoms of mania that interfere enough to cause marked functional disturbances NOTE: Bipolar II disorder is characterized by a major depressive episode (either current or past) and at least one hypomanic episode. The hypomanic symptoms are not severe enough to cause marked social or occupational dysfunction.

The nurse is providing client education to an individual who has recently been diagnosed with bipolar disorder and is starting divalproex sodium therapy. What priority information should the nurse include in the plan of care? Find out the name of the client's pharmacy. Confirm baseline labs have been ordered prior to starting therapy. Monitor for weight loss. Draw weekly blood levels to monitor serum levels.

confirm baseline labs have been order prior to stating therapy NOTE: Prior to the initiation of divalproex sodium therapy, baseline CBC with differential and liver function tests should be taken. Because this medication can lead to hepatotoxicity, it is important to both establish a baseline and continue to monitor on a weekly basis to verify therapeutic levels.

When assessing a client immediately following electroconvulsive therapy (ECT), the nurse expects what in a client? Confusion Long-term memory impairment Full of energy Numbness and tingling in the extremities

confusion

Which client is most likely to benefit from electroconvulsive therapy (ECT)? A client with bipolar disorder who is not compliant with the blood testing necessary for lithium therapy A client with a diagnosis of bipolar II disorder who has recently begun experiencing a manic episode A client whose major depression has not responded appreciably to antidepressants A client whose recent strange behavior has been attributed to cyclothymic disorder

a client whose major depression had not responded appreciably to antidepressants

A client who otherwise is healthy is admitted for depression and reports feeling "all alone" following a recent divorce. The client admits to drinking at least 12 beers every day. The client has which risk factors for the depression? Select all that apply. Medical comorbodity Current substance use or abuse Life and environmental stressors Lack of coping abilities Family history of depression

Current substance use or abuse Life and environmental stressors Lack of coping abilities

A nurse is preparing to administer pharmacotherapy as part of the treatment plan for a client with bipolar disorder. The nurse understands that this therapy is designed to achieve which goal? Select all that apply. Cure of the disorder Rapid control of symptoms Decreased frequency of manic episodes Prevention of future episodes Decreased severity of manic episodes

Rapid control of symptoms Decreased frequency of manic episodes Prevention of future episodes Decreased severity of manic episodes

A client with major depression is prescribed paroxetine. The nurse develops an education plan for the client based on the understanding that this drug belongs to which class of drugs? Selective serotonin reuptake inhibitors Serotonin norepinephrine reuptake inhibitors Monoamine oxidase inhibitors Tricyclic antidepressants

SSRI's

A 46-year-old client comes to the community mental health center because the client thinks they might be suffering from depression. When assessing this client, which symptom would the nurse identify as being necessary for the diagnosis of major depressive disorder to be made? Euphoria along with poor decision making ability Disregard for personal hygiene including cleanliness and appearance A loss of interest or inability to derive pleasure for previously enjoyed activities A stooped posture and nonverbal signs of a depressed mood

a loss of interest or inability to derive pleasure for previously enjoyed activities

A nurse is providing psycho-education to a client who has been admitted to the inpatient mental health unit for a manic episode. In order to ensure the teaching is effective, the nurse must first determine which regarding the client? Ability to concentrate and process the information Likelihood to assume responsibility for self-care Cognitive awareness and intellectual abilities Interest in learning about the disorder

ability to concentrate and process the information

The nurse is told by a client that the client is having suicidal thoughts. Which intervention has lowest priority? Assessing the client for past history of suicidal attempts Determining the client's concerns and if the client has a plan Administering a mental status exam to assess for psychosis Maintaining a safe, secure environment

administering a mental status exam to assess for psychosis

The nurse is seeing a 26-year-old client and the client's family. The client's family describes the client as being "very, very different." The family describes a history of periods of unpredictable behavior and disregard for consequences occurring a few times each year. The client has recently been diagnosed with bipolar I disorder, a condition that is characterized by what? The presence of objective signs of depression without the presence of anhedonia An elevated mood that lasts for at least 1 week Failure to respond to conventional pharmacological treatments for mood disorders The client's admission of a mood disorder

an elevated mood that lasts for at least 1 week

The nurse is seeing a 43-year-old client whose spouse just died by suicide. Which is a common emotional response that the nurse should anticipate from this client? Anger toward the loved one who committed suicide The development of a panic disorder Turning toward alcohol or drugs Unpredictable behavior and a potential for risk-taking behaviors

anger toward the loved one who committed suicide NOTE: Some of the emotional responses suicide survivors may experience include feelings of unreality, shock, disbelief, and emotional numbness; grief, sadness, and despair; confusion over not knowing why the loved one chose suicide; anger toward the mental health practitioner, another family member, or a friend for failing to prevent the suicide; self-anger and guilt for failing to prevent the suicide; feelings of anger toward and betrayal by the loved one who committed suicide; and social stigmatization and isolation.

A client is admitted to the unit in an acute manic episode. The client has had three major depressive episodes in the past 10 years and two other hospitalizations for mania. Which disorders would reflect the client's symptom profile? Bipolar II Cyclothymic disorder Bipolar I Euthymic state

bipolar I