NURSING 5 Depressive Disorder Questions

NURSING 5 Depressive Disorder Questions

NURSING 5 Depressive Disorder Questions

Janice is diagnosed with major depressive disorder and is beginning to participate in a cognitive therapy group. As the nurse is orienting Janice to the group, which of the following statements about cognitive therapy are accurate? Select all that apply.

1) Cognitive therapy is designed to focus on emotional dysregulation.
2) Cognitive distortions, such as negative expectations about oneself, serve as the basis for depression.
3) Cognitive therapy focuses on altering mood by changing the way one thinks.
4) Cognitive distortions arise out of a defect in cognitive development.
5) Cognitive therapy explores pent-up rage that has been turned against oneself because of identification with the loss of a loved object.

2, 3, 4

Rationale

Feedback 1: In cognitive therapy the focus is on cognitive distortions. Emotional dysregulation is the central focus of dialectical behavior therapy.

Feedback 2: Beck et al. (1979) postulated that negative and irrational thinking contribute to depression. These are referred to as cognitive distortions.

Feedback 3: A primary assumption in cognitive therapy is that changing the way one thinks will change one’s mood. Specifically, developing patterns of more rational and positive thinking will improve one’s mood.

Feedback 4: In cognitive theory, it is assumed that cognitive distortions arise from a defect in cognitive development, which culminates in an individual thinking that he or she is worthless, inadequate, and rejected by others. These patterns of thinking need to be corrected to promote a positive change in mood.

Feedback 5: The concept of rage turned inward is based in psychoanalytical theory, not cognitive theory.

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Susan is being seen in the emergency department. Her sister brought her in with concern that Susan is depressed and might be suicidal. Which of the following questions are priorities for the nurse to ask when assessing for suicide risk? Select all that apply.

1) “Why are you feeling depressed and suicidal?”
2) “Are you having thoughts of hurting or killing yourself?”
3) “When you have these thoughts, do you have a plan in mind?”
4) “Do you ever feel like you want to hurt someone else?”
5) “Are you currently using any drugs or alcohol?”

 

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Shelly is a patient on the inpatient psychiatric unit and was diagnosed with major depressive disorder. She is staying in her room and sleeping most of the day. Which of the following approaches by the nurse would best facilitate getting Shelly involved in the occupational therapy group on the unit?

1) “Would you like to go to occupational therapy? It is starting right now.”
2) “Let me know what activities you want to be involved in and I’ll give you a schedule.”
3) “If you don’t go to occupational therapy today, you will have to stay in your room for the entire evening.”
4) “Occupational therapy is starting in 30 minutes; I’ll help you get ready.”

NURSING 5 Depressive Disorder Questions

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Hannah is being evaluated for postpartum depression after she reported to her family physician that she just doesn’t think she can take care of her baby. She expresses fear that God will take her children from her for being a bad mother. Which of the following is the highest priority for the nurse to assess during the initial interview?

1) The number of children Hannah is currently trying to care for.
2) Availability of support systems in Hannah’s family.
3) Risks for suicide and/or infanticide.
4) What time of day the symptoms occur.

 

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Bill is a 70-year-old man who is diagnosed with major depressive disorder. He is married and has two adult children who are alcoholics. He currently lives in a rural neighborhood and works part-time at a convenience mart. Which of these demographics is a risk factor for suicide?

1) 70-year-old male
2) Parent of alcoholic children
3) Lives in a rural neighborhood
4) Works part-time

 

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The physician orders fluoxetine (Prozac) for a client diagnosed with depression. Which information is true about this medication?

1) Prozac is a tricyclic antidepressant.
2) The therapeutic effect of Prozac occurs 2 to 4 weeks after treatment is begun.
3) Aged cheese, yogurt, soy sauce, and bananas should not be eaten while the client is taking this drug.
4) Prozac may be administered in combination with monoamine oxidase inhibitors (MAOIs).

 

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When teaching about the tricyclic group of antidepressant medications, which information should the nurse include?

1) Strong or aged cheese should not be eaten while the client is taking this group of medications.
2) The full therapeutic potential of tricyclics may not be reached for 4 weeks.
3) Tricyclics may cause hypomania or recent memory impairment.
4) Tricyclics should not be given with antianxiety agents.

 

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Ursula has sought counseling for persistent depressive disorder. She identifies that she has “always had low self-esteem” and says “I just let people walk all over me.” The nurse is providing psycho-educational groups on improving self-esteem. Ursula would likely benefit from education on which of the following topics?

1) Antipsychotic medications
2) Anger management
3) Assertive communication
4) Alcoholics Anonymous groups

NURSING 5 Depressive Disorder Questions

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Cliff has been attending group counseling for depression and has been expressing more hopelessness in the last few days. When the nurse provides the group with a homework assignment to be completed and returned to the group the next day, Cliff responds “I don’t need to bother.” Which of these responses by the nurse is most appropriate?

1) “Are you having suicidal thoughts?”
2) “Trust me, it will be beneficial.”
3) “Why don’t you want to cooperate?”
4) “This assignment will help you combat the hopelessness.”

 

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Emily has been receiving treatment for major depressive disorder over several weeks. She is taking an antidepressant and attending cognitive behavioral therapy group once a week. When the nurse evaluates her progress in treatment, which of the following are indications that the depression is improving? Select all that apply.

1) Emily is taking the antidepressant medication as ordered.
2) Emily is expressing hope that she can return to her university classes soon and continue her education.
3) Emily demonstrates ability to make decisions concerning her own self-care.
4) Emily reports that suicide ideas have subsided.
5) Emily is engaging in activities that she enjoys.

 

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Tara experienced the death of a parent 2 years ago. She has not been able to work since the death, cannot look at any of the parent’s belongings, and cries daily for hours at a time. Which nursing diagnosis most accurately describes Tara’s problem?

1) Post-trauma syndrome R/T parent’s death.
2) Anxiety R/T parent’s death.
3) Coping, ineffective, R/T parent’s death.
4) Grieving, complicated, R/T parent’s death.

 

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A client is being treated with sertraline (Zoloft) for major depression. The client tells the nurse, “I’ve been taking this drug for only a week, but I’m sleeping better and my appetite has improved.” Which is the most appropriate response by the nurse?

1) “It will take a minimum of 3 to 4 weeks for therapeutic effects to occur.”
2) “Sleep disturbances and appetite problems are not affected by Zoloft.”
3) “A change in your environment and activity is the reason for this improvement.”
4) “The initiation of Zoloft therapy can improve insomnia and appetite within 1 week.”

 

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The nurse is conducting an assessment for Leroy, a 65-year-old man who presented at the health clinic with complaints of depression. He lists several medications he has been taking. Of the following medications on his list, which are known to produce a depressive syndrome? Select all that apply.

1) Prednisone
2) Cimetidine (Tagamet)
3) Ampicillin
4) Ibuprofen (Advil)
5) Aspirin

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A client is prescribed citalopram (Celexa), 20 mg daily. Available are six 10-mg tablets. This medication will supply the client with the necessary dosage for ________ days.

3 days

Rationale

3 days is the recommended maximum number of days a person with depression should be given at one time to prevent an overdose.

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A client being treated for depression asks the nurse what causes this illness. Which response by the nurse is the most accurate, evidence-based statement?

1) “The etiology of depression is unclear. Evidence supports there may be several different causative factors.”
2) “Depression has been proven to be the result of an imbalance in certain neurotransmitters.”
3) “Depression is transmitted by a specific gene for the illness.”
4) “Depression has been proven to develop as a result of negative thinking patterns.”

NURSING 5 Depressive Disorder Questions

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Chloe is suffering from depression and not responding to antidepressant treatment. She asks the nurse to tell her more about transcranial magnetic stimulation (TMS). Which of the following responses is accurate with regard to this treatment modality?

1) TMS uses magnetic energy to induce a seizure.
2) One study concluded that electroconvulsive therapy was more effective than TMS for short-term treatment of depression.
3) TMS is a safe and inexpensive treatment for depression.
4) TMS has been demonstrated to be more effective than any other treatment modality for depression.

 

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Lamont has been scheduled for electroconvulsive therapy (ECT) and asks the nurse, “Is it true what I heard, that ECT causes brain damage?” Which of these would be the most appropriate, evidence-based response by the nurse?

1) “ECT has no effect on brain function at all.”
2) “ECT has only been shown to cause brain damage in the elderly population.”
3) “There is no evidence that ECT causes permanent changes in brain structure or function.”
4) “Current evidence suggests that brain damage after ECT treatments is related to the anesthetic agents, not the treatment itself.”

 

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A client has been diagnosed with major depression. The psychiatrist prescribes imipramine (Tofranil). Which of the following medication information should the nurse include in discharge teaching? Select all that apply.

1) “The medication may cause dry mouth.”
2) “The medication may cause urinary incontinence.”
3) “The medication should not be discontinued abruptly.”
4) “The medication may cause photosensitivity.”
5) “The medication may cause nausea.”

 

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A client diagnosed with major depression is being discharged from the hospital with a prescription for fluoxetine (Prozac). The nurse’s discharge teaching should include which of the following? Select all that apply.

1) “It may take a few weeks before you begin to feel better; however, continue taking Prozac as prescribed.”
2) “Make sure that you follow up with scheduled outpatient psychotherapy.”
3) “If significant mood elevation is noted, your psychiatrist may discontinue this medication within 6 months to a year.”
4) “You should avoid foods with tyramine, including beer, beans, processed meats, and red wine.”
5) “You can discontinue the Prozac when you are feeling better.”

 

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A client has a history of major depressive disorder (MDD). Police escort the client to the ED after finding the client nude at an ATM, screaming for money to pay off credit card debt. What would make the ED psychiatrist question the client’s prior diagnosis?

1) The client is experiencing symptoms of mania.
2) The client is experiencing symptoms of a severe anxiety disorder.
3) The client is experiencing symptoms of an amnestic disorder.
4) The client is experiencing symptoms of a histrionic personality disorder.