Module 16: Mood Disorders and Suicide

A nurse is caring for a client in an outpatient clinic.0800: Adult client whose spouse died recently reports headache and fatigue. "I worry that I am just getting worse." Reports being "always tired" yet waking "well before the alarm." Headache is dull but persistent despite intervention. Client reports no appetite and no interest in doing anything. Client has had troubles at work because they "cannot seem to concentrate."Client alert and oriented. Thought process clear. Client tearful during interview, stating, "I'm sad all the time."0900: Client reports being active with family and friends until 3 months ago. "I feel like I have nobody." "I thought the death of my spouse was hard. It seems the months after have been worse. I am not sure I can do this anymore. My family doctor prescribed me some medicine for my depression but I stopped taking it after a week because it did nothing for me.

The nurse should address the client's: b. safety As evidenced by the client's: c. statements

A nurse is caring for a client in a behavioral health clinic. 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 of I drink imported beer, but I must avoid wine." e. "I love overripe bananas. I am glad I don't have to give them up."

a. "I can expect my blood pressure to go up with this medication." d. "It is okay of I drink imported beer, but I must avoid wine." e. "I love overripe bananas. I am glad I don't have to give them up."

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? a. "Persistent depressive disorder is a mild chronic form of depression." b. "Persistent depressive disorder is characterized by delusions and hallucinations." c. "Persistent depressive disorder occurs shortly after taking or withdrawing from a substance." d. "Persistent depressive disorder is characterized by both manic and depressive disorder."

a. "Persistent depressive disorder is a mild chronic form of depression."

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

a. "Thyroid problems can cause depression"

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? a. 10-34 years old b. 35-44 years old c. 45-54 years old d. over 65 years old

a. 10-34 years old

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? a. Amphetamines b. Selective serotonin reuptake inhibitors (SSRIs) c. Nonsteroidal anti-inflammatory drugs (NSAIDs) d. Monoamine oxidase inhibitors (MAOIs)

a. Amphetamines

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? a. Disruptive mood disregulation disorder b. Dysthmia c. Bipolar I disorder d. Bipolar II disorder

a. Disruptive mood disregulation disorder

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? a. Mania b. Depression c. Hallucinations d. Delusions

a. Mania

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? a. "The procedure will last about 1 hour." b. "During the procedure you may notice slight relaxation of the jaw." c. "This procedure is effective when combined with psychotherapy." d. "The treatments will take about 6 months."

c. "This procedure is effective when combined with psychotherapy."

The nurse is reviewing the medical record. Select the findings that require immediate follow-up. Client was brought into the emergency department by emergency medical services from their extended care facility for reports of altered mental status and decreased oral intake for past 2 days because of nausea. Client claims to be unaware of the reason for ED visit and reports blurry vision and feeling tired. Client is somnolent yet easily arousable. Client's speech is slow but answers simple questions. Observed dry dry oral mucous membranes, poor skin turgor, pronounced intention tremor.

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/d Llithium level 2.5 mEq/dL 12-lead ECG revealed sinus bradycardia rate 52

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? a. "I plan to go hunting when I get home." b. "When I get home, I will reach out to my friends if I start to feel down." c. "I am going to make a will as soon as I get home." d. "When I get home, I will eventually get even with my boss for firing me from my job."

b. "When I get home, I will reach out to my friends if I start to feel down."

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? a. Sexual orientation b. Access to firearms c. Ethnicity d. Race

b. Access to firearms

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? a. Adult males b. Adult females c. Adolescents between the ages of 15 and 17 d. Children ages 10 to 14

b. Adult females

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? a. The client is giving away their possessions b. The client is demonstrating risky behavior c. The client is sleeping excessively d. The client states they feel worthless

b. The client is demonstrating risky behavior

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? a. "The client can eat their meal alone in their room." b. "The blinds in the client's room will need to stay closed to prevent overstimulation." c. "All sharp objects should be removed from the clients room." d. "Family members should be encouraged to look up the warning signs of suicide."

c. "All sharp objects should be removed from the clients room."

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? a. "Electrical current will flow through electrodes placed on your torso." b. "You will be awake during the procedure." c. "Your provider will likely schedule you for several treatments over a period of weeks." d. "It is not necessary to fast before the procedure."

c. "Your provider will likely schedule you for several treatments over a period of weeks."

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? a. How lethal are the client's thoughts of self-harm? b. Does the client have access to committing self-harm? c. Does the client have a suicide plan? d. Does the client have someone to call when they are feeling suicidal?

c. Does the client have a 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? a. Living in a rural area b. Being raised by a single parent c. Early exposure to violence d. Being in a family with numerous siblings

c. Early exposure to violence

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? a. "The procedure will take about two hours." b. "You will be asleep during the procedure." c. "Most people only require one treatment to eliminate their depression." d. "You may experience a mild headache following the procedure."

d. "You may experience a mild headache following the procedure."

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. A 43-year-old female client b. A 21-year-old female client c. A 35-year-old male client d. A 15-year-old male client

d. A 15-year-old male client

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? a. Client is hyperactive b. Client has had a recent intentional weight loss c. Client reports sleeping 8 hours each night d. Client reports having thoughts of death

d. Client reports having thoughts of death

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? a. Teach coping and problem-solving skills b. Strengthen access to and delivery of suicide care c. Promote connectedness d. Create a protective environment

d. Create a protective environment

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? a. Tyramine restrictions when taking a monoamine oxidase inhibitor (MAOI) b. The prevalence of postpartum depression c. Signs and manifestations of lithium toxicity d. Factors that contribute to suicide

d. Factors that contribute to suicide