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Varcarolis' Chapter 14 Depressive Disorders 2024/2025 graded A+ by experts
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Varcarolis' Chapter 14 Depressive Disorders 2024/2025 graded A+ by experts
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Varcarolis' Chapter 14 DepressiveDisorders
What is the major reason for hospitalization of the depressed patient?
A. Inability to go to work
B. Suicidal Ideation
C. Loss of appetite
D. Psychomotor agitation - ANSAnswer: B
Suicidal thoughts are a major reason for hospitalization for patients with major depression. It is
imperative to intervene with such patients to keep them safe from self-harm. The other options
describe symptoms of major depression but aren't by themselves the major reason for
hospitalization
A client admitted with major depression and suicidal ideation with a plan to overdose is
preparing for discharge and asks you, "Why did I get a prescription for only 7 days of
amitriptyline?" The nurse's response is based on what fact?
A. Amtriptyline is very expensive, so the patient may have to buy fewer at a time.
B. The goal is to see how the client responds to the first week of medication to evaluate its
effectiveness.
C. The health care provider wants to see whether any side effects occur within the first week of
administration
D. Amtriptyline is lethal in overdose. - ANSAnswer: D
Amitriptyline is a tricyclic antidepressant (TCA); these drugs are known to be lethal in smaller
doses than other antidepressants. Because the patient had a plan of overdose, the best course
of action is to give a small prescription requiring her to visit her provider's office more often for
monitoring of suicidal ideation and plan. Tricyclics are not known to be expensive.
Antidepressant therapy usually takes several weeks to produce full results, so the patient would
not be evaluated after only 1 week. Side effects are always a consideration but not the most
important consideration with TCAs.
When the nurse asks whether a client is having any thoughts of suicide, the client becomes
angry and defensive, shouting, "I'm sick of you people! Are you ever do is ask me the same
question over and over. Get out of here!" The nurse's response is based on what fact
concerning hostility?
A. The client is getting better and is able to be assertive.
,B. The client may be at high risk for self-harm.
C. The client is probably experiencing transference.
D. The client may be angry at someone else and projecting that anger to staff. - ANSAnswer: B
Overt hostility is highly correlated with suicide; therefore the patient may be considered high
risk, and appropriate precautions should be taken. The other responses are incorrect with no
evidence to support them
A client prescribed fluoxetine demonstrates an understanding of the medication teaching when
making which statement?
A. "I will make sure to get plenty of sunshine and not use sunscreen to avoid a skin reaction."
B. "I will not take any over-the-counter medication while on the fluoxetine."
C. "I will report any symptoms of high fever, fast heartbeat, or abdominal pain to my provider
right away."
D. "I will report increased thirst and urination to my provider." - ANSAnswer: C
This describes symptoms of serotonin syndrome, a life-threatening complication of SRRI
medication. The other options are incorrect because the patient should be wearing sunscreen to
avoid sunburn, may take over-the-counter medications if sanctioned by the provider, and would
not have been educated to report increased thirst and urination as a side effect of fluoxetine.
A 38-year-old patient is admitted with major depression. Which statement made by the patient
alerts the nurse to a common accompaniment to depression?
A. "I still pray and read my Bible every day."
B. "My mother wants to move in with me, but I want to independent."
C. "I still feel bad about my sister dying of cancer. I should have done more for her!"
D. "I've heard others say that depression is a sign of weakness." - ANSAnswer: C
Guilt is a common accompaniment to depression. A person may ruminate over present or past
failings. Praying and reading the Bible describes a coping mechanism; the other responses do
not describe a common accompaniment to depression.
Which statement would best show acceptance of a depressed, mute client?
A. "I will be spending time with you each day to try to improve your mood."
B. "I would like to sit with you for 15 minutes now and again this afternoon."
C. "Each day we will spend time together to talk about things that are bothering you."
D. "It is important for you to share your thoughts with someone who can help you evaluate your
thinking." - ANSAnswer: B
Spending time with the client without making demands is a good way to show acceptance.
While not inappropriate, the other options are less accepting
, A depressed, socially withdrawn client tells the nurse, "There is no sense in trying. I am never
able to do anything right!" The nurse can best address this cognitive distortion with which
response?
A. "Let's look at what you just said, that you can 'never do anything right.'"
B. "Tell me what things you think you are not able to do correctly."
C. "Is this part of the reason you think no one likes you?"
D. "That is the most unrealistic thing I have ever heard." - ANSAnswer: A
Cognitive distortions can be refuted by examining them, but to examine them the nurse must
gain the client's willingness to participate. None of the other options examines the underlying
cause of the feeling
A client prescribed a selective serotonin reuptake inhibitor mentions taking the medication along
with the St. John's wort daily. The nurse should provide the client with what information
regarding this practice?
A. Agreeing that this will help the client to remember the medications.
B. Caution the client to drink several glasses of water daily.
C. Suggest that the client also use a sun lamp daily.
D. Explain the high possibility of an adverse reaction. - ANSAnswer: D
Serotonin malignant syndrome is a possibility if St. John's wort is taken with other
antidepressants. None of the other options are relevant to the situation
A depressed client tells the nurse, "There is no sense in trying. I am never able to do anything
right!" The nurse should identify this cognitive distortion as what response?
A. Self-blame
B. Catatonia
C. Learned helplessness
D. Discounting positive attributes - ANSAnswer: C
Learned helplessness results in depression when the client feels no control over the outcome of
a situation. None of the other options demonstrate these feelings
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