Mental Health EAQs 4

an antidepressant is prescribed for a depressed older client after 1 week the clients son expresses concern that there does not seem to be much improvement how should the nurse respond? 1. antidepressant therapy requires several weeks before it becomes effective 2. antidepressant therapy will be most effective as the physical condition improves 3. additional medications may be required before behavioral changes will be observed 4. additional time is needed for the medication to become effective because of the prolonged depression

1. antidepressant therapy requires several weeks before it becomes effective

the nurse is working with a client who talks freely about feeling depressed during the interaction the client states "things will never change" what findings support the nurses conclusion that the client is experiencing hoplessness? select all that apply 1. bouts of crying 2. self destructive acts 3. presence of delusions 4. feelings of worthlessness 5. intense interpersonal relationships

1. bouts of crying 2. self destructive acts 4. feelings of worthlessness

a nurse is assigned to care for a group of clients who have been found to have depression. which clinical manifestations does the nurse anticipate? select all that apply 1. labiality to affect 2. specific food cravings 3. neglect of personal hygiene 4. i dont know answers to questions 5. apathetic response to the environment

1. labiality to affect 3. neglect of personal hygiene 4. i dont know answers to questions 5. apathetic response to the environment

during a home visit the nurse obtains info regarding a postpartum clients behavior and suspects that she is experiencing postpartum depression which assessments support this conclusion? select all that apply 1. lethargy 2. ambivalece 3. emotional liability 4. increased appetite 5. long periods of sleep

1. lethargy 2. ambivalece 3. emotional liability

a depressed client has been sitting alone in a chair most of the day and displays no interest in eating. how should the nurse plan to meet this clients nutritional needs? 1. stay w the client during meals 2. take the client to the dining room 3. bring the client a tray of finger foods 4. talk with the client about the importance of nutrition

1. stay w the client during meals active support is demonstrated when sitting w client

a client who was forced into early retirement is found to have severe depression the client says "i feel useless and ive got nothing to do" what is the best initial response by the nurse? 1. tell me more about feeling useless 2. volunteering can help you fill your time 3. your illness is adding to your current feelings 4. lets talk about what youd like to be doing right now

1. tell me more about feeling useless

a depressed client says "im no good im better off dead" what is the priority nursing intervention 1. responding "ill stay with you until youre less depressed" 2. replying "i think youre good you should think about living" 3. alerting the staff to schedule 24 hr observation of the client 4. unobtrusively removing those articles that may be used in suicide attempt

3. alerting the staff to schedule 24 hr observation of the client

what is the greatest difficulty for nurses caring for the severely depressed client? 1. clients lack of energy 2. negative cognitive processes 3. contagious quality of depression 4. clients psychomotor retardation

3. contagious quality of depression

a client is admitted to the hospital with a diagnosis of depression what clinical manifestation of depression does the nurse expect when assessing this client? 1. flight of ideas 2. suspicion of others 3. psychomotor retardation 4. intrusive social behaviors

3. psychomotor retardation

a nurse is caring for a group of depressed clients. what should the nurse attempt to provide? 1. a variety of stimuli 2. many varied activities 3. opportunities to make decisions 4. an uncomplicated daily schedule

4. an uncomplicated daily schedule

a depressed client is admitted to the mental health unit. what factor should the nurse consider most important when evaluating the clients current risk for suicide? 1. history of suicide attempts 2. lack of interest in appearance 3. how long the depression has existed 4. impending anniversary of the loss of a loved one

4. impending anniversary of the loss of a loved one

a client with a history of sleeplessness, lack of interest in eating, and excessive purchases on charge accounts is seen in the mental health clinic. whats the adaptation that the nurse should expect the client to exhibit? 1. depressed mood 2. increased insight into behavior 3. decreased psychomotor activity 4. intrusive involvement with environmental activities

4. intrusive involvement with environmental activities

a nurse is working with a client experiencing a major depressive episode. what is a long term outcome for this client? 1. talking openly about the depressed feelings 2. identifying and using a new defense mechanisms 3. discussing the unconscious source of the anger 4. verbalizing realistic perceptions of self and others

4. verbalizing realistic perceptions of self and others

which feelings and behaviors can be observed in early preschool children in response to the divorce of parents? select all that apply 1. regressive behaviors 2. increased tantrums 3. blaming themselves for the divorce 4. depression and immature behavior 5. bewilderment regarding all human relationships

1. regressive behaviors 2. increased tantrums 3. blaming themselves for the divorce

the nurse identifies that a client who had extensive abdominal surgery appears depressed. whats the most appropriate nursing action? 1. talking with the client and encouraging exploration of feelings 2. asking the client primary HCP to prescribe an antidepressant medication 3. understanding that the clients depression is an expected response to surgery 4. reassuring the client that feelings of depression will lift after returning home

1. talking with the client and encouraging exploration of feelings

which activity is the least therapeutic for severely depressed client? 1. simple short term activity 2. activity selected by the client 3. monotonous repetitive activity 4. specific activity to be followed

2. activity selected by the client

nursing is caring for depressed older adult 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

2. multiple losses 3. declines in health

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 1. touching the client to provide reassurance 2. providing a structured environment for the client 3. ensuring that the client nutritional needs are met 4. engaging the client in conversation about current affairs 5. designing activities that require the client to maintain contact w reality

2. providing a structured environment for the client 3. ensuring that the client nutritional needs are met structure decreases anxiety

the nurse is reviewing the medical data of four clients with depression. which client is most likely to exhibit the clinical manifestation of irritability 1. 2 yr old 2. 3 yr old 3. 13 yr old 4. 35 yr old

3. 13 yr old

a depressed client has feelings of failure and a low self esteem in what activity should the client initially be encouraged to become involved? 1. joining other clients in playing a board game 2. singing in a karaoke contest to be held at the end of the week 3. assisting a staff member in working on monthly bulletine board 4. selecting the movie to be played during the evening recreation period

3. assisting a staff member in working on monthly bulletine board

a client is admitted to the mental health hospital with the diagnosis of major depression. whats a common problem that clients experience with this diagnosis? 1. loss of faith in god 2. visual hallucinations 3. decreased social interaction 4. feelings about the future are absent

3. decreased social interaction

a health care provider prescribes divalproex (depakote) what does the nurse consider an appropriate indication for the use of this drug? 1. control of acute agitation of schizophrenia 2. treatment of the agitated phase of a paranoid state 3. management of manic episodes of bipolar disorder 4. modification of the depressive phase of major depression

3. management of manic episodes of bipolar disorder

a client with the diagnosis of bipolar disorder, depressive episode, has been hospitalized on a psychiatric unit for 1 week. whats the most appropriate activity for this client? 1. completing a jigsaw puzzle alone 2. playing cards with several other clients 3. talking with the nurse several times during the day 4. engaging in a game of table tennis with another client

3. talking with the nurse several times during the day talking one on one provides low anxiety giving the message that the client is important which also supports self esteem

a client who has been diagnosed with bipolar disorder has been admitted to the psychiatric unit the nurse recognizes that providing adequate nutrition during the manic phase may be a challenge why would adequate nutritional intake be a challenge? 1. the client is too depressed to eat 2. the client lacks the energy to eat 3. the client is too busy keeping active to eat 4. the client is on restricted diet limiting cheese and other fav foods

3. the client is too busy keeping active to eat

a woman with bipolar disorder, manic episode, has been spending thousands of dollars on clothing and makeup she has been partying in bars every night rarely sleeps or eats the nurse in the outpatient clinic knowing that this clinic rarely eats recognizes that her eating problems most likely result from what? 1. feelings of guilt 2. need to control others 3. desire or punishment 4. excessive physical activity

4. Excessive physical activity

nurse is caring for a client with the diagnosis of bipolar disorder manic episode. which clinical findings support the diagnosis? select all that apply. 1. passivity 2. dysphoria 3. anhedonia 4. grandiosity 5. talkativeness 6. distractibility

4. grandiosity 5. talkativeness 6. distractibility

during an interview a 32 yr old man describes symptom of decreased appetite, insomnia, anhedonia, and feelings of worthlessness that have been present for the past few weeks. he reports having had a few episodes of feeling depressed in the past but says that the feelings subsided. recently he has felt worse and he is now concerned that his symptoms are negatively affecting his job performance and fears he may lose his job "if someone doesnt help me soon" the nurse suspects these symptoms are related to which disorder? 1. schizphrenia 2. bipolar disorder 3. dysthymic disorder 4. major depressive disorder

4. major depressive disorder

a client in an acute mental health unit appears severely depressed. the client doesnt initiate conversations or perform personal care. questions are answered with a barely audible one or two word response the nurse sits with the client and makes no demands on what premise is the nurse intervention for this client based? 1. nurses are required to spend time with assigned clients 2. environmental stimulation helps depressed clients feel more worthwhile 3. nurses are expected to initiate one-to-one interactions on an acute care unit 4. spending time with depressed clients demonstrates that they are worthy of attention

4. spending time with depressed clients demonstrates that they are worthy of attention

a client is lonely and extremely depressed and the health care provider prescribes a tricyclic antidepressant. the client asks the nurse what the medication will do. whats the best response by the nurse? 1. this drug will help you forget why youre lonely and depressed 2. the medication will increase your appetite and make you feel better 3. youll start to feel much better after taking this medication for 2 or 3 days 4. youll feel less depressed when you take this with the monoamine oxidase inhibitor

2. the medication will increase your appetite and make you feel better