Grief, Mood and Affect

During the nurse's conversation with a depressed client, the client states, "I have no reason to be sad. I have a great job and a wonderful spouse and family." Which comment would be best for the nurse to make at this time? A. "Depression can be caused by a chemical imbalance in the brain." B. "Why do you feel you are depressed." C. "You are very fortunate that you have a support system." D. "You have many positive qualities, theres no reason you should be sad."

A. "Depression can be caused by a chemical imbalance in the brain."

The nurse is caring for a client who lost a spouse 4 months ago to a brain tumor, and the client shares a plan to get remarried in a few months. The client states having truly loved the first spouse, but being happy again and excited to move forward with life with the fiancé. What is the nurse's best response? A. "It sounds like you are in a good place in your life now. Congratulations! I wish you all the best in your new marriage." B. "Don't you think that was too soon?" C. "I am happy for you, your ex-spouse must be happy up in heaven." D. "You should consider thinking about this huge decision in your life."

A. "It sounds like you are in a good place in your life now. Congratulations! I wish you all the best in your new marriage."

A nurse assesses an 82-year-old client for depression. Because of the client's age, the nurse's assessment should be guided by which factor? A. Impairment of cognition is normal in this age group. B. Antidepressants are not effective. C. Sadness of mood may be masked by other symptoms. D. Depression is not common in this age group.

C. Sadness of mood may be masked by other symptoms.

Assessment of a client who has just been admitted to the inpatient psychiatric unit reveals an unshaven face, noticeable body odor, visible spots on the shirt and pants, slow movements, gazing at the floor, and a flat affect. Which of the following should the nurse interpret as indicating psychomotor retardation? A. Flat affect B. Visible spots on the shirt/pants C. Slow movements D. Gazing at the floor

C. Slow movements

he nurse is caring for a client who has a new prescription for amitriptyline for depression and is preparing to be discharged. What assessment is the nurse's priority? A. Orthostatic hypotension B. Nausea C. Urinary retention D. Suicidal ideation

D. Suicidal ideation

A parent of a 7-year-old child and a 10-year-old child is concerned about what they should tell their children regarding their spouse's impending death from aggressive breast cancer. How should the nurse respond to the client's spouse? A. Refer the parent to pastoral care services. B. Begin education about strategies for communication with their children. C. Have the HCP give the children the news. D. Ask the parent not to include the children due to their age.

B. Begin education about strategies for communication with their children.

In the community room, a nurse observes a client who suffers from depression. The client paces swiftly around the room, swings both arms, and rubs both hands together. What term should the nurse use to describe these behaviors to members of the health care team? A. Tardive dyskinesia B. Compulsions C. Psychomotor agitation D. Irritability

C. Psychomotor agitation

The nurse is caring for a client who has just undergone electroconvulsive therapy (ECT) for the treatment of severe depression that is unresponsive to medication. What is the nurse's most important intervention immediately post procedure? A. Assess vital signs. B. Administer analgesics. C. Orient the patient to their environment. D. Give the patient water by mouth to hydrate them.

A. Assess vital signs.

The family of a client who died unexpectedly arrives to the care area. In which way should the nurse support the family at this time? Select all that apply. A. Provide emotional support B. Serve as an attentive listener. C. Expect the family to express grief. D. Arrange for the family to view the body. E. Direct the family to the funeral home.

A. Provide emotional support B. Serve as an attentive listener. C. Expect the family to express grief. D. Arrange for the family to view the body.

A client asks the nurse if they are at risk for developing postpartum depression. Which of the following assessment data would further assist the nurse to identify a postpartum depression risk? Select all that apply. A. The client states they have a history of postpartum depression. B. The client has had multiple pregnancies. C. The client states they have a history of depression. D. The clients partner has stated the couple has financial problems. E. The clients pregnancy has had multiple complications.

A. The client states they have a history of postpartum depression. C. The client states they have a history of depression. D. The clients partner has stated the couple has financial problems. E. The clients pregnancy has had multiple complications.

A 32-year-old female client is admitted for treatment of postpartum depression. Select the four (4) strategies the nurse will take when assessing the client's feelings about the condition. A. Use open-ended questions. B. Develop a rapport with the client. C. Listen when the client is speaking. D. Explore the client's perception of the condition. E. Relay a similar situation that occurred with a friend. F. Reassure the client that the hospitalization will be brief. G. Respond when the client's roommate interrupts the conversation.

A. Use open-ended questions. B. Develop a rapport with the client. C. Listen when the client is speaking. D. Explore the client's perception of the condition.

A school nurse interviews the parent of a middle school student who is exhibiting behavioral problems, including substance use disorder, following a sibling's suicide. The parent says "I'm a single parent who has to work hard to support my family, and now I've lost one child and my other child is acting out and making me crazy! I just can't take all this stress!" Which concern regarding this family has top priority at this time?

A. the potential suicidal thoughts/plans of both family members

A young adult client with severe depression and suicidal ideation has been started on the selective serotonin reuptake inhibitor (SSRI) sertraline. Which client statement would indicate the client needs further teaching about sertraline? A. "I can take this medication with food to reduce nausea." B. "Being on sertraline will significantly decrease the chances that I might hurt myself." C. "This medication will take 2 to 8 weeks to take effect." D. "I will experience sexual side effects on this medication."

B. "Being on sertraline will significantly decrease the chances that I might hurt myself."

The partner of a postpartum client asks the nurse what is wrong with the infant's birth parent and why the birth parent isn't more joyful about the birth of their child. Which would be the most appropriate response by the nurse? A. "What is their sleeping schedule?" B. "How many days has it been since they gave birth?" C. "Is there a history of depression in their family?" D. "Have they sleeping enough lately?"

B. "How many days has it been since they gave birth?"

A client is admitted to a mental health unit with a diagnosis of depression and is participating in group sessions. The client asks a nurse if they are married or in a romantic relationship. What is the best response by the nurse to maintain a therapeutic relationship? A. "Group therapy is not the appropriate time to discuss my relationships." B. "I'm curious about your question but I want to know how you are feeling today." C. "I am happily married to my husband." D. "Why are you asking me this?"

B. "I'm curious about your question but I want to know how you are feeling today."

The nurse is working with a client with depression and suicidal ideation. The nurse heard the client say, "I am disappointed because I thought I'd be feeling better by now since I started medication and therapy a week ago." What would be the primary nurse therapist's most therapeutic response? A. "It took a while to get into this state, be patient with yourself." B. "It takes time and can be frustrating to experience the physical and emotional symptoms of depression all while you learn more about yourself and try new strategies as your medication takes effect." C. "The medication takes a few weeks to start working." D. "Why do you feel disappointed, you should be proud you started therapy."

B. "It takes time and can be frustrating to experience the physical and emotional symptoms of depression all while you learn more about yourself and try new strategies as your medication takes effect."

A spouse brings the client to the emergency department. The spouse reports that since the death of their 7-month-old child 8 weeks earlier, the client has been neglecting the housework and family, has lost 20 lb (9.1 kg), and has not left the house. Which additional assessment findings would indicate to the nurse that the client may be experiencing extreme depression? Select all that apply. A. Discussing how beautiful the child was. B. Obvious neglect of personal hygiene. C. Speaking in soft monotone voice. D. Inconsolable weeping E. Meticulously folding clothes to place in the drawer.

B. Obvious neglect of personal hygiene. C. Speaking in soft monotone voice. D. Inconsolable weeping

A client with a history of suicidal thoughts and depression has just attended an outpatient day therapy group session. The nurse hears from the client that they plan to forgo lunch and the afternoon session, stating, "I just need to go home and have a nap." What would be the day therapy nurse's best response? A. Encourage the patient to go get some rest. B. Ask if they do not like the food that they serve at lunch. C. Ask the client to sit for a few minutes to discuss missing the afternoon session. D. Ask if the patient is angry.

C. Ask the client to sit for a few minutes to discuss missing the afternoon session.

A person on parole robs a bank in a small town and wounds two police officers during a shoot-out while trying to escape. The robber is fatally shot. The police officers are being hailed as heroes in the news, and the robber's previous and current criminal history is prominently featured. The nurse is caring for the bank robber's sibling, who is in the emergency department with emotional problems and suicidal ideation. Which type of grief may the sibling be experiencing, which could be contributing to the current emotional state? A. Dysfunctional B. Anticipatory C. Disenfranchised D. Uncomplicated

C. Disenfranchised

When caring for an adolescent diagnosed with depression, the nurse should remember that depression manifests differently in adolescents than it does in adults. In an adolescent, signs and symptoms of depression are likely to include: A. hypersomnolence, an obsession with body image, and valuing of peers' opinions. B. helplessness, hopelessness, hypersomnolence, and anorexia C. curfew breaking, stealing, truancy, and oppositional behavior. D. truancy, a change of friends, social withdrawal, and oppositional behavior.

D. truancy, a change of friends, social withdrawal, and oppositional behavior.