Mental Health chapter 15
The nurse cares for a client diagnosed with major depressive disorder. Assessment findings include psychosis and repeated threats to murder members of the immediate family. Which treatment modality is most likely for this client?
Electroconvulsive therapy
Which individual has the highest risk for major depression?
55-year-old single female recently diagnosed with rheumatoid arthritis
What statement regarding depression is true? Select all that apply.
Depression can be present 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.
Given a choice of the following entrees, what can the client prescribed a monoamine oxidase inhibitor (MAOI) safely eat?
Fruit and cottage cheese plate
What assessment data are primary risk factors for depression? Select all that apply.
History of physical abuse as a child History of alcohol abuse
The nurse cares for an adult who repeatedly says, "My dead relatives try to talk to me and penetrate my body." This comment is most associated with which disorder?
Psychotic depression
Which assessment data are associated with monoamine oxidase inhibitor (MAOI) therapy? Select all that apply.
Reports dizziness when standing up Weight gain of 5 pounds in last 4 weeks Heart rate 100 beats per minute and irregular Facial twitch noted in left cheek
An adult client diagnosed with depression and recently prescribed paroxetine reports, "My depression might be getting worse. I've started having more difficulty with sleep." Which information should the nurse provide to this client?
Selective serotonin reuptake inhibitors (SSRIs), such as paroxetine, often cause sleep disturbances when first taken. The problem may be short-term.
A client diagnosed with major depressive disorder has vegetative symptoms. Which nursing diagnosis is most applicable to these symptoms?
Self-care deficit
A depressive client is prescribed rapid transcranial magnetic stimulation (rTMS). What information should the nurse give to the client's guardians before performing rTMS to the client?
The client will experience scalp numbness after the therapy.
When preparing a client for electroconvulsive therapy (ECT), what does the nurse discuss with the client?
The initial course of therapy requires 6 to 12 treatments.
A client admitted with a diagnosis of depression has been having angry outbursts with staff and peers on the unit since being admitted. Based on the client's behavior, what is the nurse's primary concern?
This type of behavior places a depressed client at high risk for self-harm.
A depressive client is prescribed monoamine oxidase inhibitors. The nurse gives the diet chart to the client. Which food does the client consume according to the diet chart?
Yogurt
When is a client diagnosed with seasonal affective disorder likely to begin experiencing fewer symptoms?
Spring
A nurse is performing an assessment of a client in the local community clinic. The nurse observes that the client looks older than the age mentioned in the medical record. The client avoids making eye contact with the nurse and speaks in a monotone. On examination the nurse does not find any signs and symptoms of a physical illness. Which assessment tool does the nurse use to assess the client's behavior? 1 Zung Depression Scale 2 Geriatric Depression Scale 3 Psychogeriatric Assessment Scale 4 Montreal Cognitive Assessment
Zung Depression Scale
Over the last two months a client made eight suicide attempts with increasing lethality. The health care provider informs the client and the client's family that electroconvulsive therapy (ECT) is needed. A family member whispers to the nurse, "Isn't this a dangerous treatment?" How should the nurse reply?
"Electroconvulsive therapy is effective when urgent help is needed. Your family member will be carefully evaluated for possible risks."
Which statement made by a depressed client would provide insight into a common feeling associated with depression?
"I still feel bad about my sister dying of cancer. I should have done more for her!"
When the nurse remarks to a depressed client, "I see you are trying not to cry. Tell me what is happening." What should the nurse be prepared to do?
Wait quietly for the client to reply.
Which complaint regarding sleep would the nurse expect from a client diagnosed with major depression?
"I wake up about 4 AM and cannot go back to sleep. I feel tired all the time."
Which statements are associated directly with Beck's cognitive triad? Select all that apply.
"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.
A client has taken citalopram for 2 years for dysthymic disorder. The client's outcomes have been achieved, and the client wants to discontinue the medication. Which information should the nurse provide to the client?
"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.
A 4-year-old cries frequently for no apparent physical reason. An 8-year-old consistently declines offers to play with schoolmates A 15-year-old becomes verbally abusive to siblings
Which individual has the highest risk for experiencing major depression?
A young adult female who recently gave birth to her first child
A depressive client is prescribed tricyclic antidepressants. What appropriate advice does the nurse give to the client's family?
Advise the client to be cautious while driving.
A client 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 complaint?
Anhedonia
What assessment of the thought processes of a client diagnosed with depression is most likely to reveal? 1 Good memory and concentration 2 Delusions of persecution 3 Self-deprecatory ideation 4 Sexual preoccupation
Answer: 3
Which assessment data support the suspicion that a depressed client is demonstrating self-directed anger? Select all that apply.
Hospitalized for alcohol detoxification Diagnosed as being morbidly obese Three-pack-a-day cigarette smoker
A pregnant client is diagnosed with seasonal affective disorder. What appropriate action does the nurse include in the client's treatment plan?
Instruct the client to get exposed to a light source for 30 to 45 minutes daily.
A depressed client tells the nurse, "There is no sense in trying. I am never able to do anything right!" What does this cognitive distortion represent?
Learned helplessness
The nurse is caring for a hospitalized adolescent diagnosed with major depressive disorder. The health care provider prescribes a low-dose antidepressant. In consideration of published warnings about use of antidepressant medications in younger clients, which action should the nurse employ?
Monitor the adolescent closely for evidence of adverse effects, particularly suicidal thinking or behavior.
A client is prescribed tricyclic antidepressants. What should the nurse check for in the client's case history before administering the drug?
Oral contraceptive use
The nurse has developed a plan for a client 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
A client tells the nurse, "No matter what I do, I feel like there's always a dark cloud following me." What is the nurse's priority action?
Say to the client, "Tell me more about what you mean by 'a dark cloud.'"
While caring for a client with HIV, the nurse finds that the client is at risk for self-mutilation. Which symptoms would have led the nurse to this conclusion? Select all that apply.
The client has a feeling of worthlessness. The client has suicidal ideation.
A client who had undergone a hysterectomy has low self-esteem and avoids taking food. Which appropriate method does the nurse choose to reduce anorexia?
The nurse allows family members to remain with the client during meals.
