Mood and Affect
The nurse assesses a client with the diagnosis of bipolar disorder, manic episode. Which clinical findings support the diagnosis? Select all that apply. 1Passivity 2Dysphoria 3Anhedonia 4Grandiosity 5Talkativeness 6Distractibility
Grandiosity Talkativeness Distractibility
A client is receiving carbamazepine (Tegretol) for the treatment of a manic episode of bipolar disorder. What should the nurse include when planning client teaching about this medication? Select all that apply. 1"You have to eat a low-sodium diet every day." 2"You'll have to take a diuretic with this medication." 3"You'll have to take this medication for the rest of your life." 4"You may want to suck on hard candy when you get a dry mouth." 5"We'll need to test your blood often during the first few weeks of therapy."
"You may want to suck on hard candy when you get a dry mouth." "We'll need to test your blood often during the first few weeks of therapy."
A nurse is discharging a client from the mental health unit who has been treated for major depression. Which statement is most therapeutic at this time? 1"I'm going to miss you; we've become good friends." 2"I know that you're going to be all right when you go home." 3"Call the contact number we gave you if you have an emergency." 4"This is my phone number; call and let me know how you're doing."
3"Call the contact number we gave you if you have an emergency."
A nurse is planning an educational program for family members of clients with bipolar disorder. What clinical manifestations indicating the beginning of an episode of mania should the nurse include? Select all that apply. 1Insomnia 2Irritability 3Excessive eating 4Decreased libido 5Financial irresponsibility
1Insomnia 2Irritability 5Financial irresponsibility
A nurse in the mental health clinic is counseling a client with the diagnosis of depression. During the counseling session the client says, "Things always seem the same. They never change." The nurse suspects that the client is feeling hopeless. For what indication of hopelessness should the nurse assess the client? 1Outbursts of anger 2Focused concentration 3Preoccupation with delusions 4Intense interpersonal relationships
1Outbursts of anger
A depressed client has been prescribed a tricyclic antidepressant. How long should the nurse inform the client that it will take before the client notices a significant change in the depression? 4 to 6 days 2 to 4 weeks 5 to 6 weeks 12 to 16 hours
2 to 4 weeks
A nurse is caring for depressed older adults. What precipitating factors for depression are most common in the older adult without cognitive problems? Select all that apply. 1 Dementia 2 Multiple losses 3 Declines in health 4 A milestone birthday 5 An injury requiring hospitalization
2Multiple losses 3Declines in health
A client is admitted to the mental health hospital with the diagnosis of major depression. What is a common problem that clients experience with this diagnosis? 1Loss of faith in God 2Visual hallucinations 3Decreased social interaction 4Ambivalent feelings about the future
3Decreased social interaction
A client with depression is to be given fluoxetine (Prozac). What precaution should the nurse consider when initiating treatment with this drug? 1It must be given with milk and crackers to avoid hyperacidity and discomfort. 2Eating cheese or pickled herring or drinking wine may cause a hypertensive crisis. 3The blood level may not be sufficient to cause noticeable improvement for 2 to 4 weeks. 4The blood level should be checked weekly for 3 months to monitor for an appropriate level
3The blood level may not be sufficient to cause noticeable improvement for 2 to 4 weeks.
A client with major depression is admitted to the hospital. What is the most therapeutic initial nursing intervention? 1Introducing the client to one other client 2Requiring participation in therapy sessions 3Encouraging interaction with others in small groups 4Conveying an attitude of concern that is not intrusive
4Conveying an attitude of concern that is not intrusive
A client whose depression is beginning to lift remains aloof from the other clients on the mental health unit. How can a nurse help the client participate in an activity? 1Find solitary pursuits that the client can enjoy. 2Speak to the client about the importance of entering into activities. 3Ask the health care provider to speak to the client about participating. 4Invite another client to take part in a joint activity with the nurse and the client.
4Invite another client to take part in a joint activity with the nurse and the client.
A nurse is caring for a client who is experiencing a major depression. What feeling should the nurse anticipate that the client will likely have difficulty expressing? 1Need for comforting 2Anger toward others 3Remorse for past behaviors 4Feelings of low self-esteem
Anger toward others
A client is admitted to the mental health hospital with the diagnosis of major depression. What is a common problem that clients experience with this diagnosis? 1Loss of faith in God 2Visual hallucinations 3Decreased social interaction 4Ambivalent feelings about the future
Decreased social interaction
A client is experiencing feelings of sadness and is having difficulty concentrating and sleeping. What are additional common signs and symptoms of depression that the nurse should expect when performing an assessment of this client? 1Rigidity and a narrowing of perception 2Alternating episodes of fatigue and high energy 3Diminished pleasure in activities and alteration in appetite 4Excessive socialization and interest in activities of daily living
Diminished pleasure in activities and alteration in appetite
A client is experiencing feelings of sadness and is having difficulty concentrating and sleeping. What are additional common signs and symptoms of depression that the nurse should expect when performing an assessment of this client? 1Rigidity and a narrowing of perception 2Alternating episodes of fatigue and high energy 3Diminished pleasure in activities and alteration in appetite 4Excessive socialization and interest in activities of daily living
Diminished pleasure in activities and alteration in appetite
Nurses on a psychiatric unit have secluded a client who has the diagnosis of bipolar I disorder, manic episode, and who has been losing control and throwing objects while in the dayroom. The most important intervention for the client who is given a PRN medication and confined to involuntary seclusion is to: 1Continue intensive nursing interactions. 2Evaluate the client's progress toward self-control. 3Determine whether any staff member has been injured. 4Observe the client for side effects of the medication given to the client.
Evaluate the client's progress toward self-control
During a home visit the nurse obtains information about a postpartum client's behavior and suspects that she is experiencing postpartum depression. Which assessments support this conclusion? Select all that apply. 1Lethargy 2Ambivalence 3Emotional lability 4Increased appetite 5Long periods of sleep
Lethargy Ambivalence Emotional lability
An effective mood-stabilizing drug used in clients with bipolar disorder in the acute treatment of mania and prevention of recurrent mania and depressive episodes is: 1Doxepin (Sinequan) 2Clozapine (Clozaril) 3Amitriptyline (Elavil) 4Lithium carbonate (Lithium)
Lithium carbonate (Lithium)
A client is admitted with a bipolar disorder, depressed episode. The nursing history indicates a progressive increase in depression over the past month. What should the nurse expect the client to display? 1Elated affect related to reaction formation 2Loose associations related to a thought disorder 3Physical exhaustion related to decreased physical activity 4Paucity of verbal expression related to slowed thought processes
Paucity of verbal expression related to slowed thought processes
A client is admitted with the diagnosis of borderline personality disorder/possible depression. The client has a history of abusive acting-out behavior. What is most important to assess when caring for this client? 1Degree of anger 2Potential for suicide 3Level of intelligence 4Ability to test reality
Potential for suicide
A client with major depression that includes psychotic features tells the nurse, "All of my relatives have been killed because I've been sinful and need to be punished." What is the primary focus of nursing interventions? 1Protecting the client against any suicidal impulses 2Supporting the client's interest in the outside world 3Helping the client manage the concern for family members 4Reassuring the client that past behaviors are not being punished
Protecting the client against any suicidal impulses
Two weeks after a client has been admitted to the mental health hospital, the client's depression begins to lift. The nurse encourages involvement with unit activities, primarily because this type of activity: 1Supports self-confidence 2Provides for group interaction 3Limits opportunities for suicide 4Allows verbalization of repressed feelings of hostility
Provides for group interaction
A nurse is caring for a client with bipolar I disorder. What should the plan of care for this client include? Select all that apply. 1Touching the client to provide reassurance 2Providing a structured environment for the client 3Ensuring that the client's nutritional needs are met 4Engaging the client in conversation about current affairs 5Designing activities that require the client to maintain contact with reality
Providing a structured environment for the client Correct 3 Ensuring that the client's nutritional needs are met
A client is admitted to the hospital with a diagnosis of depression. What clinical manifestations of depression does the nurse expect when assessing this client? 1Flight of ideas 2Suspicion of others 3Psychomotor retardation 4Intrusive social behaviors
Psychomotor retardation
A client with the diagnosis of manic episode of bipolar disorder attends a mental health day treatment program. What supervised activity will be most therapeutic for this client during the early phase of treatment? 1Doing a needlepoint project 2Joining a brief swimming competition 3Walking around the facility with a nurse 4Playing a board game with another client
Walking around the facility with a nurse
A client with a diagnosis of bipolar I disorder with rapid cycling is readmitted 4 months after discharge. On the first day on the unit the client continually interrupts the nurse and is increasingly talkative and loud. What is the most therapeutic response by the nurse? 1"You seem to have a need to interrupt me." 2"How's your relationship with your spouse?" 3"Do you realize that you're talking loud and fast?" 4"Tell me about the medication you've been taking."
"Tell me about the medication you've been taking."
The nurse notices that one of her clients, who has depression, is sitting by the window crying. The most appropriate response by the nurse is: 1 "It's OK. No need to cry or worry while you're here. We all feel down now and then." 2 "Please don't consider suicide. It really isn't an appropriate way out of your troubles." 3"You seem to be experiencing a sad moment. I'll sit here with you for a while and talk if you would like." 4"Why don't you go into the dayroom and join the card game going on? That'll take your mind off of your problems for a while."
"You seem to be experiencing a sad moment. I'll sit here with you for a while and talk if you would like."
When caring for a client with major depression, nurses usually have the most difficulty dealing with the: 1Client's lack of energy 2Negative nonverbal responses 3Client's psychomotor retardation 4Pervasive quality of the depression
4Pervasive quality of the depression
When used in combination with certain foods and drugs, monoamine oxidase inhibitors (MAOIs) can cause serious side effects. Which condition could occur in clients treated with MAOIs for depression? 1 A serious drop in blood pressure 2 A serious increase in blood pressure 3 A significant increase in liver enzymes 4 A significant increase in cholesterol levels
A serious increase in blood pressure
A client with depression has not responded to a tricyclic antidepressant and outpatient electroconvulsive therapy (ECT). The health care provider prescribes selegiline (Eldepryl), and the nurse teaches the client about food to be avoided while taking this medication. Which foods identified by the client allow the nurse to conclude that the instructions have been understood? Select all that apply. 1Fresh fish 2Aged cheese 3Fried chicken 4Chocolate drinks 5Leafy vegetables
Aged cheese Chocolate drinks
When teaching parents about childhood depression the nurse should say that it: 1May appear as acting-out behavior 2Does not respond to conventional treatment 3Looks almost identical to adult depression 4Is short in duration and has an early resolution
May appear as acting-out behavior
A client is not responding to antidepressant medications for treatment of major depression with suicidal ideation. After learning about electroconvulsive therapy (ECT), the client discusses the advantages and disadvantages with the primary nurse. The nurse concludes that the client understands the disadvantages of ECT when he states that one major disadvantage of ECT is that: 1The seizures may cause bone fractures. 2Relief of symptoms requires many weeks of treatment. 3Memory is impaired just before and after the treatment. 4Loss of mental function occurs and continues for a long time.
Memory is impaired just before and after the treatment.
