Exam 5 Chapter 16

6. An acutely depressed client isolates themselves in their room and just sits and stares into space. Which is the best example of an active communication approach with this client? a. "Do you like exercise?" b. "Come with me. I will go with you to group therapy." c. "Would you like to go to group therapy, stay in bed, or come out to the day lounge for some activities?" d. "Why do you stay in your room all the time?"

"Come with me. I will go with you to group therapy."

7. A client who has been taking sertraline (Zoloft) 50 mg PO bid for depression tells the nurse, "I've been on this medication for almost a week and I don't feel a bit better." What is the most appropriate response by the nurse? a. "Cheer up. You have so much to be happy about." b. "Sometimes it takes a few weeks for the medicine to bring about an improvement in symptoms." c. "I'll report that to the physician. Maybe he will order something different." d. "Try not to dwell on your symptoms. Why don't you join the others down in the dayroom?"

"Sometimes it takes a few weeks for the medicine to bring about an improvement in symptoms."

9. A client whose husband died 6 months ago is diagnosed with major depressive disorder. She says to the nurse, "I start feeling angry that Harold died and left me all alone; he should have stopped smoking years ago! But then I start feeling guilty for feeling that way." What is an appropriate response by the nurse? a. "Yes, he should have stopped smoking. Then he probably wouldn't have gotten lung cancer." b. "I can understand how you must feel." c. "Those feelings are a normal part of the grief response." d. "Just think about the good times that you had while he was alive."

"Those feelings are a normal part of the grief response."

5. A client with depression asks the nurse, "Why would they be checking my thyroid function when I clearly have depression and I'm not overweight?" Which is an accurate response? a. An underactive thyroid gland can manifest as depression. b. Depression has been proven to be a hormonal illness. c. Thyroid hormone replacement is a first-line treatment for most people with depression. d. Abnormal thyroid function predicts positive response to antidepressant medication.

An underactive thyroid gland can manifest as depression.

8. A client reports to the mental health clinic with complaints of feeling more depressed over the last few weeks. The client's score on the Hamilton Depression Rating Scale is 40. What is the priority nursing action at this finding? a. Assess the client's history of treatment for depression. b. Encourage the client to keep weekly follow-up appointments at the clinic. c. Educate the client about treatment options for mild, moderate, and severe depression. d. Assess the client's current risk for suicide.

Assess the client's current risk for suicide.

3. A client expresses interest in alternative treatments for depression with seasonal variations and asks the nurse about bright light therapy. Which evidence-based teaching points should the nurse share with the client? (Select all that apply.) a. Bright light therapy has demonstrated effectiveness that is comparable to antidepressants .b. Bright light therapy should be used regularly until the season changes. c. Bright light therapy should only be used when ECT has proven to be ineffective. d. Side effects such as headache, nausea, or agitation, when they occur, are usually mild and transient. e. Bright light therapy can cause sedation so the best time to use it is before bedtime.

Bright light therapy has demonstrated effectiveness that is comparable to antidepressants Bright light therapy should be used regularly until the season changes. Side effects such as headache, nausea, or agitation, when they occur, are usually mild and transient.

11. What is the priority nursing intervention before starting ECT therapy? a. Take vital signs and record. b. Have the client void. c. Administer succinylcholine. d. Ensure that the consent form has been signed.

Ensure that the consent form has been signed.

2. The goal of cognitive behavior therapy with depressed clients is to: a. Identify and change dysfunctional patterns of thinking. b. Resolve the symptoms and initiate or restore adaptive family functioning. c. Alter the neurotransmitters that are creating the depressed mood. d. Provide feedback from peers who are having similar experiences.

Identify and change dysfunctional patterns of thinking.

1. A client, age 68, is a widow of 6 months. Over the past month they have become socially withdrawn, has lost weight, and told their sister today that they "don't have anything more to live for." The client has been hospitalized with a diagnosis of major depressive disorder. The priority nursing diagnosis for this client is: a. Imbalanced nutrition: Less than body requirements b. Maladaptive grieving c. Risk for suicide d. Social isolation

Risk for suicide

4. A client has just been admitted to the psychiatric unit with a diagnosis of major depressive disorder. Which manifestation might the nurse expect to assess? (Select all that apply.) a. Slumped posture b. Hallucinations c. Feelings of despair d. Appears to have boundless energy e. Anorexia

Slumped posture Feelings of despair Anorexia

10. A client is admitted to the hospital with major depressive disorder and repeatedly makes negative statements about themself. Which intervention will promote positive self-esteem in the client? (Select all that apply.) a. Teach assertive communication skills. b. Make observations to the client when they complete a goal or task. c. Instruct the client that you will not talk with them unless they stop talking negatively about themself. d. Offer to spend time with the client using a nonjudgmental, accepting approach.

Teach assertive communication skills. Make observations to the client when they complete a goal or task. Offer to spend time with the client using a nonjudgmental, accepting approach.