mood and affect

A client has just been diagnosed with bipolar disorder and is upset with the diagnosis. The client tells the nurse, "It is probably my mother's fault, she has bipolar too." Which is the best response by the nurse?

"While bipolar disorders are genetic, there are other causes as well."

The physician has placed a client who has suffered the loss of a child on a selective serotonin reuptake inhibitor (SSRI) for depression. The nurse is aware that the greatest risk for suicide would be:

10 to 14 days after the initial medication regime is implemented.

How long does a patient need to wait after stopping a phenelzine before starting paroxetine?

14 days

A first episode of depression that occurs after what age can be a precursor to dementia?

65

Cognitive psychotherapy is most likely to be appropriate in the care of a client who has been diagnosed with what?

Moderate depression

A nurse is instructing the spouse of a client who suffered a stroke about the use of eating devices the client will be using. During the teaching, the spouse starts to cry and states, "One minute he is laughing, and the next he's crying; I just don't understand what's wrong with him." Which statement is the best response by the nurse?

"Emotional lability is common after a stroke, and it usually improves with time."

A client comes to the clinic with a possible mood disorder diagnosis of unipolar depression. What question by the nurse will best help in assessing this client's mental status?

"Have you felt hopeless anytime lately?"

The nurse is caring for a client whose current drug regimen includes mirtazapine 15 mg PO daily. What assessment question should the nurse prioritize?

"How would you describe your mood and energy level today?"

Which statement by a parent would best prepare the toddler for the parent's return if the parent must leave the hospital?

"I will be back after you eat your dinner and SpongeBob goes off."

A nurse is administering venlafaxine capsules to a client diagnosed with depression. What education will the nurse provide to the client about venlafaxine?

"It's best to take the medication with food at the same time each day."

A nurse is counseling several clients for depression. Four of them do not seem to be improving, which leads the nurse to suggesting a referral to a psychiatric nurse practitioner. Which of these clients would be most likely to attend the scheduled appointment?

A 28-year-old female; works nights, willing to try, asking about insurance coverage of appointment.

A client with depression has been taking fluoxetine for the last 3 months and has noticed improvement of symptoms. The nurse inquiries about any side effects being experienced. Which side effect will the client likely report?

A decrease in sexual pleasure during intimacy

The oncology nurse is giving chemotherapy to a client in a short stay area. The client confides that they are very depressed. The nurse recognizes depression as which of the following?

A normal reaction to the diagnosis of cancer.

Which of the following is a clinical manifestation of hypothyroidism?

A pulse rate below 60 beats/minute.

The nurse is reviewing a client's electronic health record and notices that the client has recently experienced dyspareunia. The nurse knows that this is an effect of aging on the female reproductive system. What is the best description of dyspareunia that the nurse can share with the nursing student?

A woman experiences painful sexual intercourse.

Who developed cognitive therapy for persons with depression?

Aaron Beck

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?

An elevated mood that lasts for at least 1 week

What is the term used to identify a person's inability to experience pleasure in things that use to result in pleasure?

Anhedonia

The nurse is caring for a client immediately after receiving electroconvulsive therapy for the treatment of severe depression. What is a priority intervention for this client?

Orient the client to the surroundings.

A client has experienced the death of their spouse. They were married for 50 years and the client depended on the spouse for simple activities of daily living. Which factors would be the priority nursing interventions to reduce the effects of acute stress in this client?

Assess the client's coping skills. Assess the client's physical health. Assess the client's social support. Encourage the client to gain optimism for the future.

A nurse is preparing a presentation for a local community group about health, wellness, and illness. When describing the concept of wellness, which of the following features would the nurse include?

Being able to adjust and adapt Performing to one's best ability Feeling that everything is together Experiencing a feeling of well-being

The la belle indifference occurs in which somatoform disorder?

Conversion disorder

Which type of cue is being used when the client states, "Nothing can help me"?

Covert

The nurse is evaluating a client's social support network. The nurse knows that the network will assist the client in coping with stress when which action is noted?`

Daughter helps mother with laundry.

Depression has various subclassifications distinguished by symptom patterns. Which is that key clinical manifestation of depression with psychotic features?

Delusions or hallucinations

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?

Expansive and grandiose.

Which observation would demonstrate that the adolescent client suffers from attention deficit hyperactivity disorder (ADHD)?

Forgets to turn in homework, does not follow directions, cannot stay in the assigned seat in class and is always talking excessively and inappropriately.

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

The nurse is aware that which medication taken by a client for treatment of mood disorder requires a diet that restricts the amount of tyramine eaten?

Phenelzine

A 15-year-old child has difficulty falling asleep on a nightly basis. The health care provider suspects a lack of melatonin. What endocrine gland secretes melatonin?

Pineal gland

A 6-year-old with leukemia is placed on reverse isolation. What nursing actions could prevent depression and loneliness in this client?

Play a game while in the room. Spend extra time to talk while in the room. Read a story while in the room.

The nurse is providing hygiene care for a 70-year-old client in a nursing home who states that the client does not like the physician. Later, when the physician enters the room, the nurse notes that the client is very friendly with the physician, complimenting the physician's care. Which defense mechanism is this client displaying?

Reaction-formation

A nurse working in a psychiatric facility identifies the goal of cognitive therapy (CT) to be what?

Restructure how a person perceives events.

The nurse is preparing a client who may have a psychobiologic disorder for a diagnostic test which compares a client's brain activity pattern with a computerized database of electrophysiological abnormalities. The nurse is aware that this brain mapping will help determine if the client is dealing with which disorders?

Schizophrenia Dementia Depression

A nurse's response to aggressive behavior on the unit is influenced by which characteristic of the nurse?

Self-awareness of reactions to aggression by others

A client suffers from low mood and disturbed sleep. This client is most likely experiencing a change in which neurotransmitter?

Serotonin

A client is brought to the emergency department by a sibling, who reports that the client became very agitated and "started hallucinating." Further assessment reveals tachycardia, incoordination, vomiting, and diarrhea. The sibling states that the client is taking paroxetine for depression. Which condition should the nurse most likely suspect?

Serotonin syndrome

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?

Situational low self-esteem

The community nurse is preparing a presentation for a health fair illustrating successful pregnancies. Which component should the nurse prioritize as the most critical to ensure a positive psychological experience with the pregnancy by the mother?

Social support

The nurse is reviewing the assessment data from a 4-year-old child admitted to the hospital for management of early onset sepsis. Which finding supports the diagnosis?

The child is irritable.

A nurse is studying the medical records of a client with conduct disorder. The nurse finds that the client was prescribed lithium. What would be the most likely reason for prescribing this drug for this client?

The presence of aggression

A nurse is caring for an 18-month-old girl undergoing traction therapy in a rehabilitation unit. The nurse understands that the girl is in the second phase of separation anxiety when she observes what behavior?

The toddler is quiet, looks sad, and is disinterested in playing.

A nurse is caring for a client. The nurse believes the client has been abusing opiates. Which assessment findings would the nurse document as evidence supporting recent opiate use?

euphoria and constricted pupils

A 16-year-old client is highly disruptive in class and has been in trouble at home. The parent recently found the adolescent torturing a cat. When questioned, the adolescent laughed. What condition might the client be suffering from?

conduct disorder

The structure of the brain associated with emotional control, memory, and learning is what?

limbic system

A nurse is caring for a client with schizoaffective disorder. The client is scheduled for the first round of electroconvulsive therapy (ECT). What is the priority nursing action post-ECT?

performing a respiratory assessment

A nurse is caring for a client in the postpartum period. When observing the client's condition, the nurse notices that the client tends to speak incoherently. The client's thought process is disoriented, and the client frequently indulges in obsessive concerns. The nurse notes that the client has difficulty in relaxing and sleeping. The nurse interprets these findings as suggesting which condition?

postpartum psychosis

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?

psychomotor retardation

An older adult client is diagnosed with depression. Which medication category will the nurse anticipate will be prescribed for this client?

selective serotonin reuptake inhibitor (SSRI)

A 15-year-old student has been referred by the homeroom teacher to the school nurse for evaluation. The teacher is concerned that the student may be suffering from major depression. Who should be the primary source of information to investigate the concerns about the student?

the student

A nurse is teaching the parents of a client with attention deficit/hyperactivity disorder (ADHD) about medications. Which statement by the parents indicates the need for further education?

"If our child takes this medicine, he will no longer have ADHD."

The nurse is helping with the health assessment of a school-age client with special needs for attendance at summer camp. The mother tears up, saying that she wishes the child would not attend. What is the best response by the nurse?

"It is not unusual for you to have strong feelings about this."

The telephone triage nurse answers the call from a stay-at-home father of an infant; the father is unable to describe clearly the signs and symptoms the child displays but keeps saying, "She doesn't act like herself," and "Things with her are just not right." The best response by the nurse is:

"Please bring the child to the clinic to be seen. You seem concerned."

While interviewing a depressed adolescent, it is revealed that the client has considered hurting oneself. What question is the nurse's priority?

"Tell me exactly how you would hurt yourself."

Benzodiazepines increase which neurotransmitter function?

GABA

A client is exhibiting a behavioral response to grief. When obtaining a health history, the nurse would expect which assessment finding to be noted?

Hostility

After educating a class about depression, the instructor determines that additional class time is needed for teaching when the class identifies which of the following as an indicator of depression?

Increased concentration

When assessing a client for manifestations of posttraumatic stress disorder (PTSD), which of the following would the nurse expect to assess?

Lack of impulse control Nightmares Strong startle response