MH: EAQ: Depression

Which individual has the highest risk for major depression? 35-year-old married man who recently lost his job 6-year-old child who has recurrent, frequent ear infections 55-year-old single woman recently diagnosed with rheumatoid arthritis 16-year-old adolescent boy whose family recently moved from one state to another

55-year-old single woman recently diagnosed with rheumatoid arthritis

Which individual demonstrates the greatest risk for experiencing major depression? A male teenager who failed to make the football team A female young adult who recently gave birth to her first child An older adult woman who retired after 25 years of factory work A middle-aged man who is a self-employed small business owner

A female young adult who recently gave birth to her first child

The nurse determines the patient has understood nutritional instructions while taking a prescribed monoamine oxidase inhibitor if the patient selects which food item from the menu? An avocado salad plate A fruit and cottage cheese plate Smoked sausage and sauerkraut A liver and onion sandwich

A fruit and cottage cheese plate

A patient with depression is prescribed tricyclic antidepressants (TCAs). Which appropriate advice would the nurse give to the patient' s family? This medication is contraindicated with cataracts. Do not give full dose to the patient at bedtime. Advise the patient to be cautious while driving. Double the dose if the patient forgets to take the bedtime dose.

Advise the patient to be cautious while driving.

A patient says to the nurse, "I once enjoyed going to parks and museums with my family, but that is not fun anymore." How would the nurse document this report? Anergia Euthymia Anhedonia Self-deprecation

Anhedonia

A patient says to the nurse, "Life doesn 't have any joy in it anymore. Things I once did for pleasure aren 't fun. " Which term would the nurse use to document this report? Dysthymia Anhedonia Euphoria Psychomotor retardation

Anhedonia

Which assessment finding is categorized as a vegetative sign of depression? Select all that apply. One, some, or all responses may be correct. Anorexia Insomnia Joint pain Headache Constipation

Anorexia Insomnia Headache Constipation

Dysthymia cannot be diagnosed unless it has existed for which length of time? At least 1 year At least 2 years At least 6 months At least 3 months

At least 2 years

When planning patient care, which factor would be the least likely concern for a patient with depression who shows psychomotor retardation? Having constipation Being anxious about death Being unable to perform usual activities Being unable to bathe or to dress self

Being anxious about death

A patient with premenstrual dysphoric disorder is prescribed fluoxetine. Which information would the nurse give the patient? Stop the medication immediately if the side effects are severe. Consult their primary healthcare provider if agitation occurs. Take acetaminophen if there is fever. May cause dry mouth and blurred vision.

Consult their primary healthcare provider if agitation occurs.

A nurse is caring for a patient with severe depression. After 4 months of treatment, the nurse tells the patient, "Depression is an illness that is beyond a person ' s voluntary control." In which phase of treatment is this an appropriate statement by the nurse? Acute phase Orientation phase Continuation phase Maintenance phase

Continuation phase

Which side effect is associated with vagus nerve stimulation (VNS)? Select all that apply. One, some, or all responses may be correct. Cough Delusions Neck pain Paresthesia Tachycardia

Cough Neck pain Paresthesia

Which statement regarding depression is true? Select all that apply. One, some, or all responses may be correct. Depression can be seen in association with other mental and physical disorders. While depression coexists with other disorders, it does not affect these disorders. The symptomology of depression is relatively similar regardless of age. Social relationships can suffer when an individual is depressed. Depression can range from mild to severe in its effect on individuals.

Depression can be seen in association with other mental and physical disorders. Social relationships can suffer when an individual is depressed. Depression can range from mild to severe in its effect on individuals.

A patient says to the nurse, "I had my first episode of depression after I got divorced about 10 years ago. I recognized what was happening to me because both of my parents suffer from depression." Which theory regarding the etiology of depression has the patient described? Cognitive theory Biochemical factors Inflammation Diathesis-stress model

Diathesis-stress model

The nurse cares for a patient diagnosed with major depressive disorder. Assessment findings include psychosis and repeated threats to self-harm, including access to a cache of narcotic pain relievers. Which treatment modality is likely for this patient? Light therapy St. John's wort Electroconvulsive therapy (ECT) Cognitive-behavioral therapy (CBT)

Electroconvulsive therapy (ECT)

Which condition is likely to cause depressive symptoms? Select all that apply. One, some, or all responses may be correct Epilepsy Hypothyroidism Urolithiasis Diabetes Hypertension

Epilepsy Hypothyroidism Diabetes

A nurse counsels a patient diagnosed with depression to begin a mild exercise regime. Which physiological basis supports the nurse ' s recommendation? Exercise reduces inflammation. Exercise stimulates serotonin production. Exercise will stabilize the client's sleep pattern. Exercise eliminates toxins from the client's body

Exercise stimulates serotonin production.

Which statement about premenstrual dysphoric disorder (PMDD) is true? PMDD symptoms worsen after menopause. Fluoxetine is one potential treatment option. The disorder will not resume after a pregnancy PMDD means she will always have severe depression.

Fluoxetine is one potential treatment option.

Which assessment datum is a primary risk factor for depression? Select all that apply. One, some, or all responses may be correct. Married Male sex History of alcohol abuse Having an uncle with depression History of physical abuse as a child

History of alcohol abuse History of physical abuse as a child

Which antidepressant medication acts by increasing the available time of noradrenaline and serotonin at the postsynaptic receptor? Bupropion Vilazodone Sertraline Imipramine

Imipramine

The nurse cares for an adult who repeatedly says, "My dead relatives try to talk to me and penetrate my body." This comment is associated with which disorder? Disruptive mood dysregulation disorder Substance-induced depressive disorder Major depressive disorder with psychosis Seasonal affective disorder

Major depressive disorder with psychosis

Beck' s cognitive theory suggests that the etiology of depression is related to which process? Sleep abnormalities Serotonin circuit dysfunction Negative processing of information A belief that one has caused the symptoms purposefully

Negative processing of information

Which risk factor would likely result in a diagnosis of major depressive disorder? Neuroticism Parents' divorce Optimal physical health A cousin with depression

Neuroticism

Which neurotransmitter is considered a main regulator of mood? Select all that apply. One, some, or all responses may be correct. Acetylcholine Dopamine Glutamate Norepinephrine Serotonin

Norepinephrine Serotonin

Subsyndromal depression primarily occurs in which population? Adults Older adults Children Teenagers

Older adults

Which statement about antidepressant medications, in general, can serve as a basis for patient and family teaching? They tend to be more effective for men. Onset of action is from 1 to 6 weeks. Recent memory impairment is observed commonly. They often cause the patient to have diurnal variation.

Onset of action is from 1 to 6 weeks.

A nurse is caring for a patient experiencing depression who is prescribed a selective serotonin reuptake inhibitor (SSRI). The nurse reports to the primary healthcare provider that the patient has delirium, muscle spasms, and elevated blood pressure after taking the medication. The primary healthcare provider prescribes a new medication and says to the nurse, "Stop the previous prescribed medications immediately, and administer this medication to the patient after 5 weeks." Which new drug has been prescribed to the patient? Paroxetine Citalopram Vilazodone Phenelzine

Phenelzine

The nurse has developed a plan for a patient with a severe sleep pattern disturbance to spend 20 minutes in the gym exercising each afternoon. Which intervention should be scheduled upon returning to the unit? Rest Group therapy A protein-based snack Unstructured private time

Rest

An older adult patient being treated for depression has multiple medications. The family finds the patient delirious, spasmodic, hyperpyrexic, and hypertensive. The patient may have overdosed on which class of drugs? Selective serotonin reuptake inhibitors (SSRIs) Serotonin norepinephrine reuptake inhibitors (SNRIs) Norepinephrine and dopamine reuptake inhibitors (NDRIs) Noradrenergic and specific serotonergic antidepressant (NaSSAs)

Selective serotonin reuptake inhibitors (SSRIs)

A patient who is depressed and socially withdrawn tells the nurse, "There is no sense in trying. I am never able to do anything right!" The nurse can begin to deal with this cognitive distortion through which action? Asking, "Is this part of the reason you think no one likes you?" Saying, "That is the most unrealistic thing I have ever heard." Querying, "Tell me what things you think you are not able to do correctly." Suggesting, "Let's look at what you just said, that you can never do anything right.'"

Suggesting, "Let's look at what you just said, that you can never do anything right.'"

Which is the major reason for hospitalization for patients who are experiencing depression? Inability to go to work Suicidal ideation Loss of appetite Psychomotor agitation

Suicidal ideation

Which statement about the physical activity of a patient diagnosed with major depression is true? Select all that apply. One, some, or all responses may be correct. Psychomotor agitation results in purposeful, goal-oriented activity. The individual may present with a reduction in psychomotor activity. Psychomotor agitation is demonstrated in some cases of major depression. A slow pace and stooped posture is characteristic of psychomotor retardation. Fidgeting is a characteristic psychomotor activity associated with depression.

The individual may present with a reduction in psychomotor activity. Psychomotor agitation is demonstrated in some cases of major depression. A slow pace and stooped posture is characteristic of psychomotor retardation. Fidgeting is a characteristic psychomotor activity associated with depression.

Which method would the nurse choose to reduce anorexia in a patient who has low self-esteem and avoids food? The nurse allows family members to remain with the patient during meals. The nurse gives food low in fiber to the patient. The nurse gives a large quantity of low-calorie food to the patient. The nurse gives tea and coffee frequently to the patient.

The nurse allows family members to remain with the patient during meals.

A patient with depression and comorbid anxiety was prescribed vagus nerve stimulation (VNS). Which appropriate teaching does the nurse give to the patient' s family? Select all that apply. One, some, or all responses may be correct. The nurse informs them about voice alteration. The nurse advises, "Turn off the device when needed." The nurse tells them, "Caution: Never turn off the device." The nurse informs them about confusion in the patient. The nurse informs them that the patient may have paralysis.

The nurse informs them about voice alteration. The nurse advises, "Turn off the device when needed."

A nurse is caring for a patient with anorexia. After several weeks, the patient is energetic and has an improved appetite. Which effective nursing intervention did the nurse likely use with the patient? The nurse offered foods that the patient liked. The nurse instructed the patient to avoid exercising. The nurse offered three high-calorie meals during the day. The nurse provided high-fat foods to help the patient gain weight.

The nurse offered foods that the patient liked.

A nurse tries to communicate with a patient with depression who is severely withdrawn and avoids interaction. How would the nurse approach the patient? The nurse should leave the patient alone. The nurse should talk to the patient about the weather. The nurse should say, "Things will be fine, don't be upset." The nurse should ask the patient about their family members.

The nurse should talk to the patient about the weather.

A patient who has depression is prescribed monoamine oxidase inhibitors (MAOIs). The nurse gives the diet chart to the patient. Which food can the patient consume according to the diet chart? The patient eats lot of cheese. The patient eats bananas. The patient eats carrots. The patient eats dried fish.

The patient eats carrots.

A nurse is performing an assessment of a patient with depression who is prescribed antidepressants. The patient reports to the nurse, "I have to drink a lot of water now as I am feeling very thirsty, and I' m not able to pass urine properly." Which interpretation would the nurse make from these observations? The patient is nonadherent to the medications. The patient is experiencing food-drug interactions. The patient is experiencing side effects of mirtazapine. The patient is experiencing side effects of amitriptyline.

The patient is experiencing side effects of amitriptyline.

A patient and spouse seek treatment for what they describe as severe depression. The spouse tells the nurse the patient goes on bouts of "wild gambling." The patient becomes excitable for days and eventually ends up losing large amounts of money. Which determination would the nurse make about this patient's depression? This is a classic case of major depressive disorder. The bouts of gambling are called depressive episodes. The patient may be experiencing early-onset schizophrenia. The patient may have a condition other than major depression.

The patient may have a condition other than major depression.

The patient tells their pastor, "I want to return to heaven." Which action is the pastor's best course of action, knowing the patient has firearms? The patient requires emergency intervention. The pastor should inform the patient's family. There is no way for the pastor to stop the patient. The pastor should inform the patient that suicide is a sin.

The patient requires emergency intervention.

An 8-year-old patient has been showing signs of disruptive mood regulation disorder, including irritability, tantrums, and anger. Which other factor must be considered to confirm the diagnosis? The symptoms must be present daily. The symptoms must occur at school. The symptoms must occur in two different settings. The symptoms must be noticed by members of the family.

The symptoms must occur in two different settings.

Which assessment datum supports the suspicion that a patient with depression is demonstrating self-directed anger? Select all that apply. One, some, or all responses may be correct. Multiple failed marriages Declared bankruptcy twice Three-pack-a-day cigarette smoker Diagnosed as being morbidly obese Hospitalized for alcohol detoxification

Three-pack-a-day cigarette smoker Diagnosed as being morbidly obese Hospitalized for alcohol detoxification

When the nurse remarks to a patient with depression, "I see you are trying not to cry. Tell me what is happening." The nurse would be prepared to take which action? Wait quietly for the patient to reply. Prompt the patient if the reply is slow. Repeat the question if the patient does not answer promptly. Review the patient's medical record to support the patient's response.

Wait quietly for the patient to reply.

Which statement made by a patient with depression provides insight into a common feeling associated with depression? "I still pray and read my Bible every day." "I've heard others say that depression is a sign of weakness." "My mother wants to move in with me, but I want to be independent." "I still feel bad about my sister dying of cancer. I should have done more for her!"

"I still feel bad about my sister dying of cancer. I should have done more for her!"

Which statement would show acceptance of a patient who is depressed, withdrawn, and silent? "I will be spending time with you each day to try to improve your mood." "I would like to sit with you for 15 minutes now and again this afternoon." "Each day we will spend time together to talk about things that are bothering you." "It is important for you to share your thoughts with someone who can help you evaluate your thinking."

"I would like to sit with you for 15 minutes now and again this afternoon."

Which statement is associated directly with Beck' s cognitive triad? Select all that apply. One, some, or all responses may be correct "I'm not worth much; I can't do anything right." "Things will only get worse; they never get better." "I'll never find anyone who loves or values me." "I don't think other people are worthless." "Good luck happens to good people."

"I'm not worth much; I can't do anything right." "Things will only get worse; they never get better." "I'll never find anyone who loves or values me."

It is likely that a patient diagnosed with seasonal affective disorder will begin to experience fewer symptoms beginning in which season? Fall Winter Spring Summer

Spring

Which food can be included in the diet of a depressive patient who is prescribed a monoamine oxidase inhibitor? Chocolate Yogurt Ginseng Fava beans

Yogurt

A patient diagnosed with depression admitted with suicidal ideation is prescribed amitriptyline. The patient asks, "Why did the healthcare provider give me a prescription for only 7 days of this medication?" Which reply would the nurse give? "Amitriptyline is lethal in overdose, so this is a safety precaution." "Amitriptyline is very expensive, so you will have to buy fewer at a time." "The healthcare provider wants to see which side effects occur within the first week of administration." "The healthcare provider is interested in how you respond to the first week of medication before extending the prescription."

"Amitriptyline is lethal in overdose, so this is a safety precaution."

A patient hospitalized for major depression has been taking sertraline for the past week and has verbalized increased energy and improved sleep. Which question is the highest priority the nurse would ask? "Do you think your depression is less severe?" "Are you having any thoughts of harming yourself?" "Have you experienced any side effects from this drug?" "How has your appetite changed since starting this drug?"

"Are you having any thoughts of harming yourself?"

A patient has been taking citalopram for 2 years for depression. The patient' s outcomes have been achieved, and the patient wants to discontinue the medication. After consultation with the healthcare provider, which information should the nurse provide? "Citalopram is an antidepressant medication that usually is taken for life." "Stopping this medication suddenly can cause serotonin syndrome." "Because your depression is alleviated, you may discontinue the medication." "It's important for you to gradually stop taking this drug over 2 to 4 weeks."

"It's important for you to gradually stop taking this drug over 2 to 4 weeks."

A patient has taken citalopram for 2 years for dysthymic disorder. The patient' s outcomes have been achieved, and the patient wants to discontinue the medication. After consultation with the healthcare provider, which information would the nurse provide? "Citalopram is an antidepressant medication that is usually taken for life." "It's important for you to gradually stop taking this drug, over 2 to 4 weeks." "Because your depression is alleviated, you may now discontinue the medication." "Stopping this medication suddenly can cause neuroleptic malignant syndrome."

"It's important for you to gradually stop taking this drug, over 2 to 4 weeks."

Which child or teenager is demonstrating classic depression-related behavior? Select all that apply. One, some, or all responses may be correct. A 4-year-old who cries frequently for no apparent physical reason A 6-year-old who demands to sleep with mom when dad is away An 8-year-old who consistently declines offers to play with schoolmates An 11-year-old who cries when a beloved family pet runs away A 15-year-old who becomes verbally abusive to siblings

A 4-year-old who cries frequently for no apparent physical reason An 8-year-old who consistently declines offers to play with schoolmates A 15-year-old who becomes verbally abusive to siblings

Which statement regarding how depression affects patients in varying age ranges is true? Select all that apply. One, some, or all responses may be correct. Children and older adults share similar symptoms of depression. Depression among older adults is believed to be a normal occurrence related to aging. Depression increases the risk for suicide among those older adults experiencing the disorder. Incidence of depression among children between ages 12 and 17 warrants screening of that population. The younger one is when the initial episode of depression occurs, the higher the risk of recurring episodes.

Depression increases the risk for suicide among those older adults experiencing the disorder. Incidence of depression among children between ages 12 and 17 warrants screening of that population. The younger one is when the initial episode of depression occurs, the higher the risk of recurring episodes.

Which teaching point would be most beneficial for the parents of a teenager who was admitted several weeks ago after a suicide attempt? Depression is beyond voluntary control, but it can be managed. The patient needs to be able to express anger directly at the parents. The parents should also seek therapeutic help because depression is hereditary. The patient should stop taking prescribed medicines if the patient mentions suicide.

Depression is beyond voluntary control, but it can be managed.

A patient who has been assessed by the nurse as moderately depressed is given a prescription for daily doses of a selective serotonin reuptake inhibitor. The patient mentions, "I will take the medication along with the St. John ' s wort that I take daily." The nurse would take which action? Explain the high possibility of an adverse reaction. Suggest that the patient also use a sun lamp daily. Caution the patient to drink several glasses of water daily. Agree that taking the drugs at the same time will help the patient to remember them daily.

Explain the high possibility of an adverse reaction.

A patient diagnosed with depression begins a new prescription for phenelzine. Which food is safe for this patient to consume? Fresh fish Pepperoni Chocolate Guacamole

Fresh fish

During an assessment, the nurse says to the patient with breast cancer, "You are wearing a pretty dress." Which patient activity is the reason for giving this statement? Behaving irritably Looking very worried Not interacting with the nurse Frequently looking at her outfit

Not interacting with the nurse

A nurse caring for a patient with depression instructs the patient to rest after group activity. The nurse provides warm milk to the patient in the morning and at night. Which change would the nurse expect to find in the patient after implementation of this these interventions? The patient sleeps several hours. The patient interacts with the nurse. The patient maintains good hygiene. The patient has an increased appetite

The patient sleeps several hours.

A patient who is depressed is prescribed transcranial magnetic stimulation (TMS). Which information would the nurse give to the patient' s guardians before performing TMS on the patient? The patient will have slight memory loss after the therapy. The patient will be made unconscious during the therapy. The patient will experience scalp tingling after the therapy. The patient will be confused and disoriented for a few weeks after the therapy.

The patient will experience scalp tingling after the therapy.

Which report regarding sleep would the nurse expect from a patient diagnosed with major depression? "I usually take a nap for about 30 minutes in the afternoon." "It takes me about 15 minutes to fall asleep. I often have vivid dreams." "I wake up about 4 am and cannot go back to sleep. I feel tired all the time." "I often fall asleep in the middle of an activity. When I wake up, I feel better."

"I wake up about 4 am and cannot go back to sleep. I feel tired all the time."

Which statement by a patient indicates understanding of the medication teaching provided concerning a prescribed selective serotonin reuptake inhibitor (SSRI)? "I will make sure to get plenty of sunshine and not use sunscreen to avoid a skin reaction." "I will not take any over-the-counter medication while on this medication." "I will immediately report any symptoms of high fever, fast heartbeat, or abdominal pain." "I will report increased thirst and urination to my healthcare provider."

"I will immediately report any symptoms of high fever, fast heartbeat, or abdominal pain."

A patient diagnosed with major depressive disorder has vegetative symptoms. With which aspect is the patient likely to have the most difficulty? Grooming Anger at God Hallucinations Excessive eating

Grooming

Which is the recommended starting dose of selective serotonin reuptake inhibitors in older adult patients with depression? The lowest adult dose The normal adult dose Half the lowest adult dose Half the normal adult dose

Half the lowest adult dose

A patient who has depression tells the nurse, "There is no sense in trying. I am never able to do anything right!" The nurse can identify this cognitive distortion as an example of which feature of depression? Self-blame Catatonia Helplessness Discounting positive attributes

Helplessness

A pregnant patient is diagnosed with seasonal affective disorder. After consultation with the primary healthcare provider, which appropriate action does the nurse include in the patient' s treatment plan? Administer St. John's wort ( Hypericum perforatum) regularly. Administer selective serotonin reuptake inhibitors regularly. Advise the patient to rest and avoid strenuous activity. Instruct the patient to get exposed to a light source for 30 to 45 minutes daily

Instruct the patient to get exposed to a light source for 30 to 45 minutes daily

A patient was admitted to an intensive care unit after reporting chest pain, an elevated heart rate, and a very high body temperature. The patient' s family reported to the nurse that the patient was taking antidepressants. They also reported that the patient started having chest pain after eating avocados and cheese. Which antidepressant medication was the patient likely taking that would have caused this interaction? Duloxetine Trazodone Desipramine Isocarboxazid

Isocarboxazid

Antidepressants administered alone can cause an adverse reaction in patients with bipolar disorder. Which additional drug class should be prescribed? Sedative Anxiolytic Antipsychotic Mood stabilizer

Mood stabilizer

Which should the nurse check for in the patient' s case history before administering tricyclic antidepressants? Suicidal ideation Loss of appetite Narrow-angle glaucoma Insomnia

Narrow-angle glaucoma

A patient who is experiencing depression is noted to pace most of the time, pull at clothes, and wring hands. This behavior is consistent with which disorder? Senile dementia Hypertensive crisis Psychomotor agitation Serotonin syndrome

Psychomotor agitation

A patient with depression is in the acute phase of treatment for depression. The nurse plans the patient's care, with which factor describing the goal of care? Phasing out medication Relapse prevention Prevention of future depression Reducing depressive symptoms

Reducing depressive symptoms

The nurse would educate the patient regarding which side effect of repetitive transcranial magnetic stimulation? Select all that apply. One, some, or all responses may be correct Seizures Dementia Headache Hallucinations Unconsciousness

Seizures Headache

When preparing a patient for electroconvulsive therapy (ECT), the nurse discusses which aspect with the patient? Confusion after the treatment is unusual. The initial course of therapy requires 6 to 12 treatments. This form of therapy frequently takes the place of antidepressant medications. You will be awake during the procedure and instructed to breathe deeply during the treatment

The initial course of therapy requires 6 to 12 treatments.

Which food is safe for a patient taking monoamine oxidase inhibitors (MAOIs)? Avocados Pineapple Chocolate Cheddar cheese

Pineapple