Prep U Ch. 26-27 - Eating & Depressive Disorders
The nurse observes a client sitting alone at a table, looking sad and preoccupied. The nurse sits down and says, "I saw you sitting alone and thought I might keep you company." The client turns away from the nurse. Which of the following is the most therapeutic response by the nurse? a) Remain in place and say, "How are you feeling today?" b) Move to another chair closer to the client and say, "The staff is here to help you." c) Say, "I'll visit with you a little later," and leave the client alone for a while. d) Move to a chair a little further away and say, "We can just sit together quietly."
Move to a chair a little further away and say, "We can just sit together quietly." Explanation: Moving away gives the client more personal space; staying with the client indicates acceptance and genuine interest. It is not necessary for the nurse to talk to the client the entire time; rather, silence can convey that clients are worthwhile even if they are not interacting.
A client was abandoned by her parents at age three, resulting in her perception of the world as a hostile place and the subsequent development of rage against men. This statement is an example of which of the following a) a psychodynamic interpretation of Susan's major depressive disorder. b) why the client has become lesbian at the age of 23. c) a feminist viewpoint of depression. d) a biological explanation for the client's depressive disorder.
a psychodynamic interpretation of Susan's major depressive disorder. Explanation: Psychodynamic theories postulate that clients with depression have unexpressed and unconscious anger about feeling helpless or dependent on others. Such anger begins in childhood when basic developmental needs are not met. They cannot express this anger toward the person or people on whom they feel dependent, so their anger turns inward.
The monoamine hypothesis of depression ... a) holds that depression is caused by sociocultural and psychological factors. b) relates to bipolar disorders, not to depression. c) holds that depression is caused by only one of the biogenic amines. d) holds that depression results from a deficiency in the concentrations or in metabolic disregulation of the monoamines.
holds that depression results from a deficiency in the concentrations or in metabolic disregulation of the monoamines. Explanation: The major monoamine hypothesis about depression is that absolute concentrations of norepinephrine, 5-HT, or both are deficient.
The monoamine hypothesis of depression ... a) relates to bipolar disorders, not to depression. b) holds that depression results from a deficiency in the concentrations or in metabolic disregulation of the monoamines. c) holds that depression is caused by only one of the biogenic amines. d) holds that depression is caused by sociocultural and psychological factors.
holds that depression results from a deficiency in the concentrations or in metabolic disregulation of the monoamines. Explanation: The major monoamine hypothesis about depression is that absolute concentrations of norepinephrine, 5-HT, or both are deficient.
When completing discharge medication education for the client, he asks how long it will take before the selective serotonin reuptake inhibitor medication was help his mood improve. The correct response by the nurse is which of the following? a) 1 to 2 days b) 7-10 days c) 3 to 4 weeks d) 5 to 7 days
3 to 4 weeks Explanation: Most antidepressant medications do not become effective or reach a therapeutic level for at least 3 to 6 weeks.
When a 27-year-old is admitted for treatment of anorexia nervosa, the nurse prepares the client for diagnostic testing that includes (Select all that apply.) a) Serum glucose b) Electrocardiogram (ECG) c) Serum cortisol d) Serum amylase e) Serum uric acid
• Electrocardiogram (ECG) • Serum glucose • Serum amylase • Serum cortisol Explanation: When a 27-year-old is admitted for treatment of anorexia nervosa, the nurse prepares the client for diagnostic testing that includes an electrocardiogram and serum glucose, amylase, and cortisol levels. Serum uric acid would not, however, be part of the panel.
Following a series of visits to her primary care provider and the hospital, a 22-year-old retail clerk has been diagnosed with anorexia nervosa. Which of the client's following statements demonstrates an accurate understanding of her diagnosis? a) "I guess it's probably safe to say that anorexia runs in my family." b) "What no one seems to understand is that I'm concerned about my health, not ignoring it." c) "What you don't understand is that it's way healthier to be skinny than fat, and it looks better." d) "I know that if I could lose this last 10 pounds I'd feel completely different about things."
"I guess it's probably safe to say that anorexia runs in my family." Explanation: There are known to be both familial and genetic contributors to eating disorders. Weight loss does not relieve the thinking or behaviors that characterize the disorders, and there are serious health consequences to being underweight
The nurse is teaching a 70-year-old man about his depression. Which of the following statements by the client would indicate that teaching has been effective? a) "I never knew depression could just happen for no specific reason." b) "I'm glad I'll feel better in 2 or 3 days." c) "All old people get depressed at times." d) "When I reduce the stress in my life, the depression will go away."
"I never knew depression could just happen for no specific reason." Explanation: Depression can be endogenous, with no external cause or event. Clients must understand that depression is an illness, not a lack of willpower or motivation. Major depression typically involves 2 or more weeks of a sad mood or lack of interest in life activities with at least four other symptoms of depression.
One approach to establish adequate eating patterns for a client with anorexia is to assume a positive expectation of the client. Which is the best statement by the nurse? a) "I'll give you 90 minutes to eat." b) "I will allow you space to eat in peace." c) "I will sit here quietly with you while you eat." d) "There are people who would truly appreciate this food."
"I will sit here quietly with you while you eat." Explanation: This statement reflects the nurse's expectation that the client will eat yet the nurse still will provide adequate supervision. Answers A, B, and D are not appropriate means of assuming a positive expectation of the client.
The nurse has been teaching a client about bulimia. Which of the following statements by the client indicates that the teaching has been effective? a) "I know if I eat pasta, I'll binge." b) "I'll eat small meals and snacks regularly." c) "I'll take my medication when I feel the urge to binge." d) "I'll limit my intake of carbohydrates and fats."
"I'll eat small meals and snacks regularly." Explanation: Teaching is effective when the client recognizes the need to return to nutritious eating patterns. Answers A, C, and D would not be appropriate responses to teaching regarding bulimia nervosa.
The nurse working on a mental health unit is teaching a nursing student learning about depression. The student asks the nurse about what constitutes a diagnosis for major depressive disorder. What is the nurse's best response? a) "The primary diagnostic criterion is one or more major depressive episodes for at least 2 weeks with other symptoms present." b) "Feelings of anxiety and sadness as a response to a life event are the most important qualifiers for depression." c) "The physician diagnosis depression when a client has feelings of sadness several times a year." d) "Depression is a mood variation to life events."
"The primary diagnostic criterion is one or more major depressive episodes for at least 2 weeks with other symptoms present." Explanation: Normal variations in mood (such as sadness, euphoria, and anxiety) occur in response to life events; they are time limited and not usually associated with significant functional impairment. The primary diagnostic criterion for major depressive disorder is one or more major depressive episodes (either a depressed mood or a loss of interest of pleasure in nearly all activities) for at least 2 weeks. Four of seven other symptoms must be present. Thus, the best response from the nurse is "The primary diagnostic criterion is one or more major depressive episodes for at least 2 weeks with other symptoms present."
Research has shown that risk of suicide increases within which time frame for initiation of antidepressant therapy? a) 42 days b) 35 days c) 28 days d) 14 days
14 days Explanation: Studies have shown that the risk for suicide increases within the first 2 to 3 weeks after starting antidepressant medication, usually because the client's mood has not lifted as quickly as physical energy has returned.
A client diagnosed with depression has been switched to an MAOI. Because of the lag period before MAOIs are effective, adequate wash-out periods of which timeframe are recommended between the time that the MAOI is discontinued and another class of antidepressants is started? a) 5 weeks b) 4 weeks c) 2 weeks d) 1 week
5 weeks Explanation: Because of the lag period, adequate washout periods of 5 to 6 weeks are recommended between the times that the MAOI is discontinued and another class of antidepressant is started.
A client has been diagnosed with depression after a series of visits to his primary care provider. Within the context of the behavioral theory of mood disorders, what factors may underlie the client's diagnosis? a) A long-standing pattern of underachievement and public failure that causes him to feel shame b) A family history of inadequate coping skills, unresolved conflict, and fragmented communication that leads to feelings of isolation c) A perception that life's events are beyond his control, leading to feelings of helplessness and hopelessness d) A belief that there is ultimately no higher meaning to life, leading to feelings of fatalism and resignation
A perception that life's events are beyond his control, leading to feelings of helplessness and hopelessness Explanation: Behavioral theorists regard mood disorders as a form of acquired or learned behavior. Clients possess a perception that situations or events are their own fault and are beyond their control and that nothing can be done to change them. This perception promotes feelings of helplessness and hopelessness. Behavioral theory does not emphasize the role of family history, failure, or fatalism, though each may accompany or contribute to mood disorders.
A client diagnosed with depression is being treated with Phenelzine (Nardil). The nurse should teach the client to avoid which of the following foods? a) Rice b) Chicken c) Aged cheese d) Oranges
Aged cheese Explanation: Hypertensive crisis is the most serious side effect and is life-threatening when a client prescribed an MAOI ingests tyramine-containing foods, such as aged cheese.
A 34-year-old client with depression is admitted to an inpatient psychiatric unit. The nurse enters her room and initiates interaction with the client. When talking with the client, which approach would be least appropriate? a) Matter-of-fact manner b) Respectful, direct manner c) Quiet and empathetic manner d) Animated and cheerful manner
Animated and cheerful manner Explanation: When communicating with clients who are depressed, the nurse should never use an overly enthusiastic approach. This approach can lead to irritation and block communication.
Cachexia is most likely to be an assessment finding in a client who has been diagnosed with what? a) Anorexia nervosa b) Night eating syndrome (NES) c) Binge eating disorder (BED) d) Bulimia nervosa
Anorexia nervosa Explanation: The low calorie intake associated with anorexia nervosa can often result in the pattern of malnutrition and wasting that is termed cachexia. Individuals with bulimia often have a healthy body weight and may even be slightly overweight. BED and NES do not result in body wasting due to the high calorie intake and the absence of purging.
The preparation for a client undergoing ECT is similar to a) Physical therapy b) MRI c) Any outpatient minor surgical procedure d) Echocardiogram
Any outpatient minor surgical procedure Explanation: The preparation for a client undergoing ECT is similar to any outpatient minor surgical procedure. The client receives nothing by mouth after midnight, removes any fingernail polish, and voids just before the procedure. An IV line is started for the administration of medication.
The genetic theory, when applied to the occurrence of depression, supports that the psychiatric nurse should ... a) Encourage the client to seek genetic counseling before considering a pregnancy b) Prepare the client for diagnostic genetic testing to confirm the diagnosis c) Educate the client regarding the symptoms of related physical disorders d) Assess for depression in the client's family history
Assess for depression in the client's family history Explanation: The genetic theory, when applied to the occurrence of depression, supports that the psychiatric nurse should assess for depression in the client's family history.
A client is suspected of having anorexia nervosa and meets the diagnostic criteria for the disorder. When conducting the physical examination, which of the following would the nurse most likely assess? a) Bradycardia b) Complaints of heartburn c) Hypertension d) Heat intolerance
Bradycardia Explanation: Associated physical exam findings include cold intolerance, complaints of constipation and abdominal pain, hypotension and bradycardia.
For clients with bulimia, nursing interventions are often directed toward improving self-concept and regaining control. The primary interventions include a) Cognitive-behavioral therapy (CBT) and guided self-change (GSC) b) Clearly stated unit rules and a supportive milieu c) One-on-one time with psychiatric staff and antidepressant medication therapy d) Daily reinforcement of sound dietary principles and meditation sessions
Cognitive-behavioral therapy (CBT) and guided self-change (GSC) Explanation: For clients with bulimia, nursing interventions are often directed toward improving self-concept and regaining control. The primary interventions include cognitive-behavioral therapy (CBT) and guided self-change (GSC).
For clients with bulimia, nursing interventions are often directed toward improving self-concept and regaining control. The primary interventions include a) Cognitive-behavioral therapy (CBT) and guided self-change (GSC) b) One-on-one time with psychiatric staff and antidepressant medication therapy c) Clearly stated unit rules and a supportive milieu d) Daily reinforcement of sound dietary principles and meditation sessions
Cognitive-behavioral therapy (CBT) and guided self-change (GSC) Explanation: For clients with bulimia, nursing interventions are often directed toward improving self-concept and regaining control. The primary interventions include cognitive-behavioral therapy (CBT) and guided self-change (GSC).
A nurse is caring for a client who will undergo ECT for treatment of depression. When assessing a client immediately following ECT, the nurse expects which of the following? a) Full of energy b) Confusion c) Numbness and tingling in the extremities d) Long-term memory impairment
Confusion Explanation: After ECT treatment, the client may be mildly confused or briefly disoriented. He or she is very tired and often has a headache. The client will have some short-term memory impairment. Numbness and tingling in the extremities is not an expected symptom.
A nurse is caring for a client who will undergo ECT for treatment of depression. When assessing a client immediately following ECT, the nurse expects which of the following? a) Numbness and tingling in the extremities b) Long-term memory impairment c) Confusion d) Full of energy
Confusion Explanation: After ECT treatment, the client may be mildly confused or briefly disoriented. He or she is very tired and often has a headache. The client will have some short-term memory impairment. Numbness and tingling in the extremities is not an expected symptom.
A client was admitted to the eating disorder unit with bulimia nervosa. When the nurse assesses for a history of complications of this disorder, which of the following are expected? a) Metabolic acidosis and constricted colon b) Bacterial GI infections and overhydration c) Respiratory distress and dyspnea d) Dental erosion and chronic edema
Dental erosion and chronic edema Explanation: In bulimia, dental erosion (from frequent vomiting) and chronic edema (from fluid imbalances) are common. Dyspnea, bacterial GI infections, and metabolic acidosis are not characteristics of bulimia
Which of the following is the most common disorder found in clients with bulimia nervosa? a) Anxiety b) Depression c) Substance Abuse d) Psychosis
Depression Explanation: Mood disorders, anxiety disorders, and substance abuse/dependence are frequently seen in clients with eating disorders. Of those, depression and obsessive-compulsive disorder are most common.
When working with a client with anorexia nervosa, which of the following nursing diagnoses is most difficult to resolve successfully? a) Social isolation b) Imbalanced nutrition: less than body requirements c) Disturbed body image d) Deficient knowledge (nutritious eating patterns)
Disturbed body image Explanation: The client's dissatisfaction with body image is an enduring belief pattern that is firmly ingrained and, therefore, very difficult to change. Imbalanced nutrition: less than body requirements, deficient knowledge (nutritious eating patterns), and social isolation are nursing diagnoses that can be worked through with education and support more easily than the diagnosis of disturbed body image
Which disorder is characterized by at least 2 years of depressed mood for more days than not with some additional, less severe symptoms that do not meet the criteria for a major depressive episode? a) Dysthymic disorder b) Seasonal affective disorder c) Cyclothymic disorder d) Hypomania
Dysthymic disorder Explanation: Dysthymic disorder is characterized by at least 2 years of depressed mood for more days than not with some additional, less severe symptoms that do not meet the criteria for a major depressive episode. Cyclothymic disorder is characterized by 2 years of numerous periods of hypomanic symptoms that do not meet the criteria for bipolar disorder. Seasonal affective disorder occurs in the winter or spring. Hypomania is a period of abnormally and persistently elevated, expansive, or irritable mood lasting 4 days.
A client with severe depression after immigrating to the United States and the loss of an infant expresses increasing suicidal ideation to the primary nurse. The priority nursing intervention should be ... a) Exploring the grief and loss issues concerning the baby's death. b) Encouraging the client to express feelings of isolation following the recent immigration. c) Ensuring that the client is not permitted to use anything that would be potentially dangerous. d) Encouraging attendance at group cognitive-behavioral therapy on the unit.
Ensuring that the client is not permitted to use anything that would be potentially dangerous. Explanation: Although grief, loss, and isolation may be influencing the client's depressed state, the priority intervention is to prevent self-harm. All the interventions listed are appropriate, but ensuring safety from potential danger is the priority.
The nurse is caring for an adolescent female who reports amenorrhea, weight loss, and depression. Which additional assessment finding would suggest that the woman has an eating disorder? a) Moist skin b) Tachycardia c) Excessive exercise d) Wearing tight-fitting clothing
Excessive exercise Explanation: Clients with eating disorders utilize excessive exercise to burn as many calories as possible. Medical complications of eating disorders include bradycardia, hypotension, and dry, cracking skin due to dehydration. The client will wear loose-fitting clothes to hide his or her body.
During a physical assessment, the nurse would recognize that there is the potential for medication-induced weight loss in a client who is being treated with which of the following medications? a) Fluoxetine (Prozac) b) Risperidone (Risperdal) c) Ziprasidone (Geodon) d) Olanzapine (Zyprexa)
Fluoxetine (Prozac) Explanation: Atypical antipsychotics are often associated with weight gain, while some antidepressants such as fluoxetine (Prozac) tend to induce weight loss.
Clients with anorexia nervosa become totally absorbed in their quest for weight loss and thinness. An exacerbation of anorexia nervosa results from the client's effort to ... a) Manipulate family members b) Gain control of one part of her life c) Live up to family expectations d) Diminish conflict
Gain control of one part of her life Explanation: A client with anorexia nervosa is unconsciously attempting to gain control over the only part of her life she feels she can control. Anorexia does not incorporate manipulation of family members or as a means of diminishing conflict. This eating disorder carries with it a high incidence in families that emphasize achievement.
Which of the following would not be associated with learned helplessness? a) Impulsivity b) Passivity c) Negative expectations d) Hopelessness
Impulsivity Explanation: Behaviors that define learned helplessness include passivity, negative expectations, and feelings of helplessness, hopelessness, and powerlessness.
Cognitive psychotherapy is most likely to be appropriate in the care of a client who has been diagnosed with which of the following? a) A mood disorder due to a general medical condition b) Postpartum psychosis c) Anaclitic depression d) Moderate depression
Moderate depression Explanation: Cognitive psychotherapy is as effective as antidepressant medication in the treatment of mild-to-moderate depression. It is less likely to address depression that has a demonstrated medical etiology. The primary treatment for postpartum psychosis is medication. Therapy is not relevant in cases of anaclitic depression since the problem occurs in infants.
Which of the following is a true statement regarding depressive disorders? a) They are more prevalent in men than women. b) Depression in older adults is easier to diagnosis. c) It is the leading cause of U.S. disability in clients older than 44 years of age. d) Norepinephrine, dopamine, and serotonin have been implicated.
Norepinephrine, dopamine, and serotonin have been implicated. Explanation: The monoamines that have been implicated in depression are norepinephrine (NE), dopamine (DA), and serotonin (5-HT). Disturbances in mood may result when absolute concentrations of NE, 5-HT, or both are deficient. Depressive disorders are more prevalent in women than in men. Depression in older adults may be difficult to diagnose because many older people have co-morbid diseases. It is currently the leading cause of U.S. disability in clients 15 to 44 years of age.
According to the Learned Helplessness behavioral theory, the psychiatric nurse shows an understanding of therapeutic supportive care of a client depressed over the loss of employment when a) Determining how the client reacted to stressors like this before in order to evaluate the effectiveness of his coping skills b) Helping the client realize he was not responsible for the loss of his job but rather it is a result of circumstances outside of his control c) Providing positive reinforcement concerning the client's ability to find another job by helping him identify his employable skills d) Providing a list of community services to reassure the client that resources are available to help until employment is found
Providing positive reinforcement concerning the client's ability to find another job by helping him identify his employable skills Explanation: According to the Learned Helplessness behavioral theory, the psychiatric nurse shows an understanding of therapeutic supportive care of a client depressed over the loss of employment when providing positive reinforcement concerning the client's ability to find another job by helping him identify his employable skills.
A combination of medications and which of the following is considered the most effective treatment for depressive disorders? a) Psychotherapy b) Vagal nerve stimulation c) ECT d) Deep brain stimulation
Psychotherapy Explanation: A combination of psychotherapy and medications is considered the most effective treatment for depressive disorders.
Which type of antidepressants are rarely fatal in overdose? a) Atypical b) MAOIs c) Tricyclics d) SSRIs
SSRIs Explanation: SSRIs are rarely fatal in overdose, but cyclic and MAOI antidepressants are potentially fatal. Prescriptions may need to be limited to only a 1-week supply at a time if concerns linger about overdose.
A client with major depression is prescribed paroxetine (Paxil). The nurse develops an education plan for the client based on the understanding that this drug belongs to which class of drugs? a) Tricyclic antidepressants b) Selective serotonin reuptake inhibitors c) Serotonin norepinephrine reuptake inhibitors d) Monoamine oxidase inhibitors
Selective serotonin reuptake inhibitors Explanation: Paroxetine is a selective serotonin reuptake inhibitor. Serotonin norepinephrine reuptake inhibitors (SNRIs) include venlafaxine (Effexor), nefazodone (Serzone), duloxetine (Cymbalta), and desvenlafaxine (Pristiq). Amitriptyline is an example of a tricyclic antidepressant. Monoamine oxidase inhibitors (MAOIs) include phenelzine (Nardil), tranylcypromine (Parnate), isocarboxazid (Marplan), and selegiline (Emsam)
A client has been diagnosed with major depressive disorder. A common symptom would include which of the following? a) Assertiveness b) Ability to sleep without interruption c) Self-blame d) Increased energy
Self-blame Explanation: Symptoms of major depressive disorder include self-blame, feelings of worthlessness, decreased energy, insomnia, and difficulty making decisions.
According to the biochemical theory of mood disorders, a client with a diagnosis of depression is likely to have alterations in the levels and function of which of the following neurotransmitters? a) Serotonin, norepinephrine, and dopamine b) Acetylcholine, adenosine, and glutamate c) Epinephrine, histamine, and melatonin d) Aspartate, GABA, and serine
Serotonin, norepinephrine, and dopamine Explanation: Monoamines such as serotonin, norepinephrine, and dopamine have been implicated in the etiology of mood disorders such as depression.
An adolescent female has been diagnosed with anorexia nervosa. Which of the following interventions should be included in the client's plan of care? a) Set up a strict eating plan for the client b) Provide privacy during meals c) Restrict visits with the family until the client begins to eat d) Encourage the client to exercise, which will reduce her anxiety
Set up a strict eating plan for the client Explanation: Establishing a consistent eating plan and monitoring the client's weight are important for this disorder. The family should be included in the client's care. The client should be monitored during meals - not given privacy. Exercise must be limited and supervised.
A father of four small children lost his wife in an automobile accident 3 months ago and is admitted to the hospital with severe depression. Since his wife's death, his mood has been somber; until now, he has refused treatment. For what is this client at high risk? a) Suicide b) Schizophrenia c) Dysthymic disorder d) Bipolar disorder
Suicide Explanation: If depression persists over time and is left untreated, it has a significant negative effect on quality of life and increases the risk of suicide.
A mental health nurse has formed a nursing diagnosis of hopelessness related to poor self-concept for a client with depression. An appropriate outcome for this nursing diagnosis would include which of the following? a) The client will identify factors that reduce activity tolerance. b) The client will discuss the cause of the fatigue. c) The client will demonstrate improved ability to express self. d) The client will differentiate between reality and fantasy.
The client will demonstrate improved ability to express self. Explanation: An appropriate outcome would include demonstrating improved ability to express self.
A group of nursing students is reviewing information about drug therapy for depression. The students demonstrate an understanding of the information when they identify that monoamine oxidase inhibitors are advantageous in treating which of the following? a) Depression refractory to electroconvulsive therapy b) Treatment resistant depression c) Persistent depressive disorder d) Mild depression
Treatment resistant depression Explanation: The efficacy of the MAOIs is well established, however, this classification of medications are infrequently prescribed due to potentially fatal side effects associated with use of these medications. In treatment resistant depression, MAOIs can be used with careful monitoring of side effects. Evidence suggests their distinct advantage in treating a specific subtype of depression, so-called atypical depression (characterized by increased appetite, reverse diurnal mood variation, and hypersomnia), depression with panic symptoms, and social phobia (Schatzberg & Nemeroff, 2009). Given their dietary restrictions, MAOIs usually are reserved for clients whose depression fails to respond to other antidepressants, or clients who cannot tolerate typical antidepressants. Electroconvulsive therapy is reserved for depression that is refractory to antidepressant therapy.
Susan was abandoned by her parents at age 3, resulting in her perception of the world as a hostile place and the subsequent development of rage against men. This statement is an example of ... a) a biophysiological explanation for Susan's depressive disorder. b) a feminist viewpoint of depression. c) a psychodynamic interpretation of Susan's major depressive disorder. d) why Susan has become lesbian at the age of 23.
a psychodynamic interpretation of Susan's major depressive disorder. Explanation: Psychodynamic theories postulate that clients with depression have unexpressed and unconscious anger about feeling helpless or dependent on others. Such anger begins in childhood when basic developmental needs are not met. They cannot express this anger toward the person or people on whom they feel dependent, so their anger turns inward.
Susan was abandoned by her parents at age 3, resulting in her perception of the world as a hostile place and the subsequent development of rage against men. This statement is an example of ... a) why Susan has become lesbian at the age of 23. b) a feminist viewpoint of depression. c) a psychodynamic interpretation of Susan's major depressive disorder. d) a biophysiological explanation for Susan's depressive disorder.
a psychodynamic interpretation of Susan's major depressive disorder. Explanation: Psychodynamic theories postulate that clients with depression have unexpressed and unconscious anger about feeling helpless or dependent on others. Such anger begins in childhood when basic developmental needs are not met. They cannot express this anger toward the person or people on whom they feel dependent, so their anger turns inward.
Carrie, age 20, was admitted to your unit following a suicide attempt. She is disheveled, disorganized, and dehydrated. The priority for her care during the first 24 hours of her admission is ... a) assisting Carrie with her activities of daily living, including a shower and clean clothing. b) assessing Carrie's current suicidal ideation and putting her on suicide precautions. c) assessing Carrie's recent suicide attempt and identifying factors that may have contributed to it. d) rehydrating Carrie by forcing fluids.
assessing Carrie's current suicidal ideation and putting her on suicide precautions. Explanation: The first step is to provide for Carrie's safety by assessing her risk for suicide. Because Carrie has attempted suicide, the nurse immediately places her on suicide precautions with frequent or continuous one-to-one observation and reassessment
Carrie, age 20, was admitted to your unit following a suicide attempt. She is disheveled, disorganized, and dehydrated. The priority for her care during the first 24 hours of her admission is ... a) rehydrating Carrie by forcing fluids. b) assisting Carrie with her activities of daily living, including a shower and clean clothing. c) assessing Carrie's recent suicide attempt and identifying factors that may have contributed to it. d) assessing Carrie's current suicidal ideation and putting her on suicide precautions.
assessing Carrie's current suicidal ideation and putting her on suicide precautions. Explanation: The first step is to provide for Carrie's safety by assessing her risk for suicide. Because Carrie has attempted suicide, the nurse immediately places her on suicide precautions with frequent or continuous one-to-one observation and reassessment.
A client who has been prescribed fluoxetine for depression and has just had his dosage increased comes the emergency department. The nurse suspects serotonin syndrome based on assessment of which of the following? a) Ataxia b) Constipation c) Hyporeflexia d) Diaphoresis e) Change in mental status f) Fever
• Change in mental status • Diaphoresis • Ataxia • Fever Explanation: The symptoms of serotonin syndrome include altered mental status, autonomic dysfunction, and neuromuscular abnormalities. At least three of the following must be present for a diagnosis: mental status changes, agitation, myoclonus, hyperreflexia, fever, shivering, diaphoresis, ataxia, and diarrhea.
When assessing a child with major depression, which of the following would the nurse need to keep in mind? Select all that apply. a) The risk for suicide is less in children than adults. b) Children more often have anxiety symptoms c) Somatic complaints are rarely noted. d) Children have more interaction with their peers than adults do. e) Mood may be more irritable than sad.
• Children more often have anxiety symptoms • Mood may be more irritable than sad. Explanation: Children with depressive disorders have similar symptoms to those seen in adults with a few exceptions. They are more likely to have anxiety symptoms, such as fear of separation, and somatic symptoms, such as stomach aches and headaches. They may have less interaction with their peers and avoid play and recreational activities that they previously enjoyed. Mood may be irritable, rather than sad, especially in adolescents. The risk of suicide, which peaks during the mid-adolescent years, is very real in children and adolescents.
