EAQs chapters 14-17

which statement is true regarding depression? Select all that apply

Depression is the leading cause of disability worldwide, Men are more likely than women to self-medicate when experiencing depression

Which therapy is most helpful to pts diagnosed with eating disorders to address problems associated with emotional dysregulation?

Dialectical behavior therapy Dialectical behavior therapy is a form of cognitive behavioral therapy adapted to address problems associated with emotion dysregulation.

A pt diagnosed with bulimia nervosa frequently uses enemas and laxatives to purge. Which imbalance might be present with this pt?

Disruption of fluid and electrolyte balance Disruption of the fluid and electrolyte balance is usually the result of excessive use of enemas and laxatives

Which sign or symptom would the nurse expect a pt with a diagnosis of binge-eating disorder (BED) to exhibit? Select all that apply

obesity BED is a type of compulsive overeating in which the pt presents with obesity. Pts with BED report depression, not anxiety. Purging, laxative use and Russell's sign are noted with bulimia nervosa.

A nurse caring for a pt with depression instructs the pt to rest after group activity. The nurse provides warm milk to the pt in the morning and at night. Which change does the nurse expect in the pt after implementation of these interventions?

sleep properly Depressive pts often have insomnia. The nurse should ensure that pts rest adequately after group activity.

A pt is assessed to have low wt, lanugo, cool extremities, and a fear of gaining wt. Which disorder does the nurse suspect is the cause for the presence of these symptoms?

Anorexia nervosa Anorexia nervosa is an eating disorder in which the pt has intense fear of wt gain and refuses to maintain optimal wt. The pt is underweight and presents with lanugo and cool skin on the extremities caused by starvation.

Which factor explains why a pt diagnosed with bulimia nervosa should be carefully assessed for the presence of dental caries?

Excessive vomiting In bulimia nervosa, induced vomiting causes reflux of hydrochloric acid over the tooth enamel, which leads to dental caries.

Which pharmaceutical treatment is considered the "gold standard" for bulimia nervosa?

Fluoxetine Fluoxetine has been approved by the FDA for the treatment of bulimia nervosa and has been regarded as the "gold standard" in the treatment of this disorder.

Which entree can the pt prescribed a monoamine oxidase inhibitor (MAOI) safely eat?

Fruit and cottage cheese plate MAOIs inhibit the breakdown of tyramine, which can lead to high blood pressure, hypertensive crisis, and eventually a cerebrovascular accident.

A pt diagnosed with depression is observed pacing often, pulling at the clothes, and wringing the hands. Which situation do these behaviors indicate?

Psychomotor agitation These behaviors describe the psychomotor agitation sometimes seen in pts with the agitated type of depression.

The nurse cares for an adult who repeatedly says, "My dead relatives try to talk to me and penetrate my body." Which disorder is this pt likely to have?

Psychotic depression Depressive disorders are classified according to symptoms or the situations under which they occur. Delusional thinking is an aspect of psychosis that may be present in cases of psychotic depression

Which pathology do biological theorists suggest is a cause of eating disorders?

Serotonin imbalance Serotonin pathways are abnormal in both anorexia nervosa and bulimia nervosa. Brain scans of pts with these disorders reveal altered serotonin receptors and transporters

Which diagnostic laboratory results is pertinent to assessment of a pt suspected of having bulimia nervosa? Select all that apply

Serum glucose, Thyroid function, Electrolyte levels, Complete Blood Count Medical evaluation usually includes a thorough physical examination, as well as pertinent lab testing, including glucose levels, thyroid function tests, electrolyte levels, and complete blood count.

At which season will a pt diagnosed with seasonal affective disorder be likely to begin experiencing fewer symptoms?

Spring Seasonal affective disorder occurs during the months when sunlight diminishes. Pts may begin to feel effects in the late fall and will be affected throughout the winter. They improve during the spring and feel well during the summer

Which criterion warrants inpatient treatment for a pt diagnosed with an eating disorder?

Systolic blood pressure less than 70 mm Hg A systolic blood pressure of less than 70 mm Hg is one of the established criteria signaling the need for hospitalization of a pt diagnosed with anorexia nervosa. This finding suggests severe cardiovascular compromise.

Which statement regarding sleep would be expected from a pt diagnosed with major depression?

"I wake up around 4AM and cannot go back to sleep. I feel tired all the time." Change in sleep pattern is a cardinal sign of depression. Often, ppl experience insomnia, wake frequently, and have a total reduction in sleep, especially deep-stage sleep.

Which medical complication may present in a pt diagnosed with anorexia nervosa? Select all that apply

Acrocyanosis, Decreased bone density, Elevated blood carotene Acrocyanosis, or blue discoloration of extremities, can be seen in a pt diagnosed with anorexia nervosa resulting from the presence of cool extremities caused by starvation. Decreased bone density also occurs b/c of low calcium intake caused by malnourishment and starvation. Carotenemia, or elevated levels of blood carotene, is seen as the pt restricts the diet to prevent wt gain.

Which medical complication is possible with the diagnosis of anorexia nervosa? Select all that apply

Acrocyanosis, Leukopenia, Hematuria Possible medical complications caused by anorexia include acrocyanosis, leukopenia, and hematuria.

A pt states, "I once enjoyed going to parks and museums with my family but that is not fun anymore." Which term would be used to document this statement?

Anhedonia Anhedonia means that there is no pleasure or joy to life. It is a common finding with depression.

Which clinical finding is expected with a pt diagnosed with anorexia nervosa? Select all that apply

Dry skin, emaciation, decreased urine output Anorexia nervosa causes imbalance in nutrition leading to dehydration and dry skin. It can also lead to emaciation (significant body weight loss). In some pts, fluid intake is also decreased, leading to decreased urine output. Pts with anorexia nervosa usually have low BP caused by deficiency of proteins. The low urine output results in increased concentration of urine

Which clinical manifestation is identified as a symptom of anorexia nervosa? Select all that apply

Emaciation, dehydration, and yellow skin

Which assessment finding is a primary risk factor for depression? Select all that apply

Hx of physical abuse as a child, Hx of alcohol abuse Primary risk factors of depression include early childhood trauma and hx of alcohol or other substance abuse

Which antidepressant medication acts by increasing the availability time for noradrenaline and serotonin at the postsynaptic receptors?

Imipramine Imipramine belongs to the class of tricyclic antidepressants that act by increasing the availability time or noradrenaline and serotonin at the postsynaptic receptors.

which medical complications are associated with the diagnosis of bulimia nervosa? Select all that apply

Russell's sign, Hypochloremia, Parotid gland enlargement Medical complications of bulimia nervosa include Russell's sign (callus on knuckles from self-infuced vomiting), parotid gland enlargement associated with elevated serum amylase levels, and hypochloremia (low levels of chloride in blood)

Which thought process is likely to present in a pt diagnosed with depression?

Self-deprecatory ideation Depressed pts never feel good about themselves. They have a negative, self-deprecating view of the world.

Which term describes the growth of fine, downy hair on the face and back of a pt diagnosed with anorexia nervosa?

Lanugo Lanugo is the growth of fine, downy hair on the face and back.

A pt has been prescribed fluoxetine for the treatment of bulimia nervosa. Which assessment would the nurse perform related to this treatment? Select all that apply

Mood, weight, VS, suicide risk, BMI The nurse would assess the response to the medication by assessing the pt's mood, weight, VS, and BMI. Fluoxetine carries an increased risk for suicide, so the nurse would assess for suicide ideation.

Which statement is true of pts diagnosed with bulimia nervosa?

They often appear to have a normal weight Pts diagnosed with bulimia nervosa are often at or close to ideal body weight and do not appear physically ill

Which brain stimulation therapy requires an implant to be placed in the pt's chest?

Vagus nerve stimulation (VNS) VNS involves implanting a device in the chest that will stimulate the vagus nerve, which then stimulates areas of the brain that affect mood. DBS involves surgical implantation of electrodes into certain areas of the brain affected by depression.