Chapter 25: Depression: Nursing Care of Persons with Depressive Moods and Suicidal Behavior

Format: Multiple Choice

Client Needs: Psychosocial Integrity

Cognitive Level: Apply

Integrated Process: Nursing Process

Objective: 3

Page and Header: 431, Other Depressive Disorders

1. The nurse is making a home visit to an adult client who is diagnosed with persistent depressive disorder. When developing this client’s plan of care, which assessment would the nurse need to keep in mind?

A) The client’s symptoms of major depressive disorder have lasted for 2 years.

B) The client’s condition is considered to be of a shorter duration.

C) The client typically experiences an elevated mood.

D) The client experiences symptoms that are intermittent.

Page and Header: 424, Managing Side Effects

2. A nurse is caring for a client in the outpatient setting who has been diagnosed with a depressive disorder. Before the client is given a prescription for a tricyclic antidepressant, assessment for which of the following would be most important?

A) Suicide

B) Hypersomnia

C) Cardiac dysrhythmias

D) Erectile dysfunction

Page and Header: 424, Managing Side Effects

3. A client diagnosed with major depression was prescribed imipramine and has been taking this medication for one week. The client is brought to the ER when family members strongly suspect the client has overdosed on the medication around 9 pm. The family has been told that symptoms of an overdose will develop by what time?

A) 1 AM

B) 4 AM

C) 6 AM

D) 9 AM

Page and Header: 432, Summary of Key Points

4. A nurse is caring for a client diagnosed with major depression. The client tells the nurse that the client “just isn’t sure that life is worth living.” The nurse documents which nursing diagnosis as the priority?

A) Self-esteem, low, related to depressive episode

B) Hopelessness related to symptoms of depression

C) Anxiety related to lack of energy for self-care activities

D) Thought processes, disturbed, related to memory loss and depression

Page and Header: 413, Neurobiologic Hypotheses

5. After educating a group of nursing students about the neurobiologic theories of depression, the instructor determines the need for additional education when the students identify which neurotransmitter as playing a role?

A) Gamma-aminobutyric acid (GABA)

B) Norepinephrine

C) Serotonin

D) Dopamine

Page and Header: 429, Promoting Safety

6. A nurse is preparing to assess a middle-aged client who was brought to the emergency department by the client’s spouse. The spouse reports that the client has been “extremely depressed lately.” When assessing this client, which would be a priority assessment?

A) Changes in sleeping patterns

B) Thoughts of self-harm

C) Appetite changes

D) Level of fatigue

Page and Header: 427, Serotonin Syndrome, Box 25.9

7. A client diagnosed with depression is prescribed fluoxetine. On a return visit to the clinic, the client tells the nurse about also taking St. John’s wort to feel better. The nurse assesses the client for which potential side effect?

A) Water intoxication

B) Increased depressive symptoms

C) Serotonin syndrome

D) Hypertensive crisis

Page and Header: 424, Managing Side Effects

8. A client comes to the emergency department reporting a severe pounding headache in the temples and a stiff neck. The client is flushed and diaphoretic, and the client’s pulse is racing. The client states that the client is being treated for depression with an MAOI. Which question by the nurse would be most important to ask at this time?

A) “When did you last have blood drawn to check your drug level?”

B) “What have you had to eat or drink today?”

C) “Are you having any chest pain?”

D) “Do you use any herbal remedies?”

Page and Header: 443, Mental Status and Appearance

9. During assessment of a client diagnosed with depression, the client states, “I just feel so sad and hopeless. I just don’t care anymore. I don’t even enjoy doing the crossword puzzles like I used to.” The nurse documents this finding as indicative of which condition?

A) Dysthymic disorder

B) Anhedonia

C) Delusion

D) Psychosis

Page and Header: 454, Enhancing Cognitive Functioning

10. The plan of care for a client diagnosed with depression includes cognitive interventions. A nurse would expect to assist with which intervention?

A) Social skills training

B) Activity scheduling

C) Thought stopping

D) Interpersonal therapy

Page and Header: 415, Family Response to Disorder

11. A nurse is preparing a presentation for family members of clients who have been diagnosed with depression. When describing the family response to depression, which would the nurse include?

A) Family members typically can understand how disabling depression can be.

B) Depression in one family member affects the entire family.

C) Abuse of the depressed person is a rare occurrence in families.

D) Families of women older than 55 years of age with depression experience the majority of problems.

Page and Header: 423, Wellness Challenges; 425, Box 25.6

12. The nurse is reviewing the medical record of a client diagnosed with depression and notes that the client has been prescribed mirtazapine. The nurse identifies this agent as which drug type?

A) Selective serotonin reuptake inhibitor

B) Cyclic antidepressant

C) Norepinephrine dopamine reuptake inhibitor

D) Alpha-2 antagonist

Page and Header: 424, Managing Side Effects; 411, Table 25.1

13. A client diagnosed with depression who is receiving antidepressant therapy comes to the clinic for a follow-up appointment. The client tells the nurse, “I’ve been having trouble moving my bowels since I started this medicine. Is there something I can do to help?” After teaching the person about measures to address this problem, which statement by the client indicates the need for additional teaching?

A) “I will try to get more exercise in each day.”

B) “I’ll be sure to drink no more than 4 glasses of water daily.”

C) “I’ll get some more fresh fruits in my diet.”

D) “I can try eating more whole grains.”

Page and Header: 411, Older Adults

14. The psychiatric–mental health nurse is working with a group of older adults diagnosed with depression. Which client would the nurse identify as being at highest risk for suicide?

A) 61-year-old

B) 69-year-old

C) 72-year-old

D) 79-year-old

Page and Header: 412, Epidemiology and Risk Factors

15. A group of nurses is reviewing information about the epidemiology of depressive disorders. The nurses demonstrate understanding of the information when they identify which factor as increasing the risk for depression? Select all that apply.

A) History of substance abuse as a teenager

B) Little social support

C) Inadequate coping skills

D) Prior episode of anxiety disorder

E) Concomitant medical illnesses

Page and Header: 410, Depressive Disorders Across the Life-Span

16. A psychiatric–mental health clinical nurse specialist is preparing a seminar about major depression. What would the nurse most likely include? Select all that apply.

A) Depression in children manifests in the same manner as in adults.

B) The risk for suicide is especially high during the mid-adolescent years.

C) Response to treatment in older adults is slower than that for younger adults.

D) People older than age 65 years have the lowest suicide rates of any age group.

E) Episodes of depression tend to occur more frequently over time.

F) Depressive disorders are most often treated in the primary care setting.

Page and Header: 423, Wellness Challenges; 424, Box 25.5

17. A nurse is developing an education plan for a client who is prescribed escitalopram. Which side effect would the nurse include in this plan? Select all that apply.

A) Insomnia

B) Constipation

C) Sedation

D) Blurred vision

E) Urinary retention

F) Dry mouth

Page and Header: 428, Repetitive Transcranial Magnetic Stimulation

18. The nurse is preparing a client for treatment with repetitive transcranial magnetic stimulation. When educating the client about this procedure, which would the nurse include? Select all that apply.

A) “You will receive a short-acting anesthetic to relax you.”

B) “You will be awake and alert during the procedure.”

C) “You can resume your normal activities right after the treatment.”

D) “We will need to shave your scalp at the area where the magnet is placed.”

E) “You might feel a moderate amount of stinging at the site.”