Chapter 15 Review Questions - Evolve
3. Which statement demonstrates a characteristic of depression-associated behaviors that is especially associated with children and adolescents? A. "I don't care that friends say I'm grumpy." B. "I'm so very sad since my sister died." C. "Life is no fun since I lost my sister." D. "I can't go on being so depressed."
A. "I don't care that friends say I'm grumpy." Rationale: Depressed mood most of the day, nearly every day, is an indication of depression (e.g., sad, empty, hopeless). In children and adolescents, this can be demonstrated by an irritable mood.
4. Which statement by a client scheduled for a series of electroconvulsive therapy (ECT) treatments indicates to the nurse that the client has an understanding of the goals of this treatment? A. "It is expected that my chance for remission is very good." B. "If this works, I will likely be able to stop taking lithium." C. "I'm prepared to deal with the certain loss of my short-term memory." D. "My prognosis is so much better since I didn't have any delusional symptoms."
A. "It is expected that my chance for remission is very good." Rationale: ECT is safe and effective, and can achieve a 70% to 90% remission rate in depressed patients within 1 to 2 weeks. ECT is useful in treating patients with major depressive disorder especially when psychotic symptoms are present (e.g., delusions of guilt, somatic delusions, or delusions of infidelity). On awakening from ECT, the patient may be confused and disoriented. Many patients state that they have memory deficits for the first few weeks after treatment. Memory usually, although not always, recovers. ECT is not a permanent cure for depression, and maintenance treatment with TCAs or lithium decreases the relapse rate.
5. The nurse will encourage the client to engage in regular involvement with which formalized groups as an intervention directed toward the treatment of a primary risk factor associated with depression? (Select all that apply.) A. Church associated men's group B. Sexual assault survivors group C. Senior citizens travel group D. New moms support group E. Alcoholics Anonymous (AA)
B. Sexual assault survivors group D. New moms support group E. Alcoholics Anonymous (AA) Rationale: Primary risk factors for depression include experiencing a negative, stressful event (sexual assault), postpartum period (support group), and alcohol or substance abuse (AA). The remaining options do not focus on identified risk factors and so are social in their nature.
1. A client diagnosed with depression has been prescribed various first-line antidepressant agents but has demonstrated only minimal improvement. In preparation for the prescription of a second-line agent, the nurse will educate the client on which classification of antidepressant? A. Atypical B. Tricyclic C. Dual action D. Monoamine oxidase inhibitors
D. Monoamine oxidase inhibitors Rationale: First-line agents include cyclic antidepressants (e.g., TCAs), dual action antidepressants (SSRIs, SNRIs, and NDRIs), and atypical antidepressants while monoamine oxidase inhibitors (MAOIs) are considered second-line agents.
2. Which life event related to a client demonstrating depressive symptoms supports a diagnosis of persistent depressive disorder (PDD)? A. Abruptly ended a long-term romantic relationship B. Lost employment as a result of frequent absences C. 2 unsuccessful suicide attempts over the last year D. Recognized symptoms of depression over 2 years ago
D. Recognized symptoms of depression over 2 years ago Rationale: In persistent depressive disorder (PDD) the symptoms last for at least 2 years and are usually considered mild to moderate. Usually, a person's social or occupational functioning is not as greatly impaired as they are in major depressive disorder (MDD), although they may cause significant distress or some impairment in these areas. The symptoms in a chronic/dysthymic depression (PDD) are often congruent with the person's usual pattern of functioning. The remaining options support a diagnosis of MDD.
