Question 1

1. An individual experienced the death of a parent 2 years ago. This individual 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 this individual\'s problem?  a) Post-trauma syndrome R/T parent\'s death b) Anxiety (severe) R/T parent\'s death c) Coping, ineffective, R/T parent\'s death d) Grieving, complicated, R/T parent\'s death

Accepted Answer

D

Question 2

When teaching about the tricyclic group of antidepressant medications, which information should the nurse include? a) Strong or aged cheese should not be eaten   while taking this group of medications. b) The full therapeutic potential of tricyclics may not be reached for 4 weeks. c) Long-term use may result in physical   dependence. d) Tricyclics should not be given with anti-anxiety agents.

Accepted Answer

B

Question 3

A client has been diagnosed with major depression. The psychiatrist prescribes Paroxetine (Paxil). Which of the following medication information should the nurse include in discharge teaching?  a) Do not eat chocolate while taking this   medication. b) The medication may cause priapism. c) The medication should not be discontinued   abruptly. d) The medication may cause photosensitivity.

Accepted Answer

C

Question 4

Which is a misconception about suicide?   a) Eight out of ten individuals who commit suicide give warnings about their intentions.  b) Most suicidal individuals are very ambivalent about their feelings about suicide.  c) Most individuals commit suicide by taking an overdose of drugs.  d) Initial mood improvement can precipitate suicide.

Accepted Answer

C

Question 5

A client, with a history of a suicide attempt, has been discharged and is being followed in an outpatient clinic. At this time, which is the most appropriate nursing intervention for this client? a) Provide the client with a safe and structured environment. b) Isolate the client from all stressful situations that may precipitate a suicide attempt. c) Observe the client continuously to prevent self-harm. d) Assist the client to develop more effective coping mechanisms.

Accepted Answer

D

Question 6

The nurse is caring for an actively suicidal client on the psychiatric unit. What is the nurse\'s priority intervention?  a) Discuss strategies for the management of anxiety, anger, and frustration.  b) Provide opportunities for increasing the client\'s self-worth, morale, and control.  c) Place client on suicide precautions with one-to-one observation.  d) Explore experiences that affirm self-worth and self-efficacy.

Accepted Answer

C

Question 7

Risk factors for major depressive disorder

Accepted Answer

age, gender, social class, race, culture, marital status, seasonality

Question 8

what gender is major depressive disorder more common in

Accepted Answer

female

Question 9

which race is MDD more common in

Accepted Answer

whites but in the african american culture are less likely to treat

Question 10

what seasons effect seasonality MDD

Accepted Answer

spring and fall. also goes with amount of suicide.

Question 11

persistent depressive disorder

Accepted Answer

chronic mild depression

Question 12

premenstrual dsysphoric disorder

Accepted Answer

depressed mood, excessive anziety, mood swings and decreased interest in activities duing the week prior to menses. improving shortly after the onset of menstruation.

Question 13

substance/medication-induced depressive disorder

Accepted Answer

depression from substance or medication

Question 14

cause of depression

Accepted Answer

is unclear

Question 15

Is there a strong genetic link to depression

Accepted Answer

yes

Question 16

secondary depression

Accepted Answer

may be related to medication side effects, neurological disorders, electrolyte or hormonal imbalance, nutritional deficiencies and other physiological or psychological conditions

Question 17

melancholia

Accepted Answer

occurs after the loss of a loved object

Question 18

learned helplessness

Accepted Answer

numerous failures predispose patients to depression

Question 19

object loss theory

Accepted Answer

suggests that depressive illness occurs as a result of having been abandoned by or otherwise separated from a significant other during the first 6 months of life

Question 20

cognitive theory

Accepted Answer

negative defeated attitudes. negative exceptions of environment, self , and future

Question 21

developmental implications for depression up to 3 years of age

Accepted Answer

signs may include feeding problems, tantrums, lack of playfulness and emotional expressiveness, failure to thrive or delays in speech and gross motor development

Question 22

developmental implications for depression ages 3-5

Accepted Answer

common symptoms may include accident proneness, phobias, aggressiveness and excessive self reproach for minor infractions

Question 23

developmental implications for depression ages 6-8

Accepted Answer

there may be vauge physical compliants and aggresive behavior. they may cling to parents and avoid new people and challenges. they may lag behind their classmates in social skills and academic competence

Question 24

developmental implications for depression ages 9-12

Accepted Answer

common symptoms include morbid thoughts and excessive worrying. they may reason that they are depressed because they have disappointed their parents in some way. there may be lack of interest in playing with friends

Question 25

Depression in adolescence

Accepted Answer

common symptoms may be compared to normal adjustments

Question 26

best clue for a mood disorder in a teenager

Accepted Answer

2 weeks or more noticed changes

Question 27

Prozac

Accepted Answer

has been approved in treating depression in children

Question 28

lexapro

Accepted Answer

has been approved in treating MDD in adolescence

Question 29

What predisposes the elderly to depressive disorders

Accepted Answer

bereavement overload

Question 30

Transient depression

Accepted Answer

lifes everyday disappointment

Question 31

Mild depression

Accepted Answer

normal grief response

Question 32

moderate depression

Accepted Answer

dysthymia

Question 33

severe depression

Accepted Answer

MDD

Question 34

Sertraline (zolof)

Accepted Answer

medication for depression

Question 35

What is ect

Accepted Answer

grand mal seizure through application of electrical current of the brain (induction). Therapy and medication is tried first

Question 36

side effects of ect

Accepted Answer

memory loss

Question 37

would you oxygenate a patient during ect

Accepted Answer

yes always

Question 38

light therapy

Accepted Answer

helps with seasonal depression

Question 39

action of depressive medication

Accepted Answer

these drugs ultimately work to increase the concentration of norepinephrine, serotonin and or dopamine in the body

Question 40

is a person with depression who has been on medication for a couple of weeks at risk for suicide

Accepted Answer

yes they get a burst of energy and carry out suicide plans

Question 41

MAOIs (marplan, nardil, parnate, emsam)

Accepted Answer

avoid products high in tyramine (wine, deli meat, soy sauce, raisins, fava beans). could result in hypertensive crisis

Question 42

what medication causes a long penile erections

Accepted Answer

trazadone

Question 43

What percent of all perople who commit or attempt suicide have a diagnosed mental disorder

Accepted Answer

95

Question 44

depressive disorders account for what percent of this

Accepted Answer

80

Question 45

what is the leading cause of death is suicide victims

Accepted Answer

gunshot wounds

Question 46

main suicide risk factor

Accepted Answer

previous trys

Question 47

risk factors

Accepted Answer

single, divorced, widowed, highest and lowest social economic class, healthcare and business executives, firearms higher risk then overdose, family history

Question 48

non verbal clues

Accepted Answer

giving away items, getting financial orders in order, writting suicide notes,

Question 49

verbal clues

Accepted Answer

saying i want to die, i want to kill myself, i wont be around much longer

Question 50

Margaret age 68 is a widow of 6 months. since her husband died her sister reports that margaret has become socially withdrawn, has lost weight, and does little more each day than visit the cemetery where her husband was buried. she told her sister today that she didnt have anything more to live for. she has been hospitalized with MDD. the priority nursing diagnosis for Margaret would be  a, imbalanced nutrition b. complicated grieving c. risk for suicide d. social isolation

Accepted Answer

C

Question 51

The physician orders zoloft 50mg PO bid for margaret a 68 year old woman with MDD. after 3 days of raking the medication, margaret says to the nurse, I dont think this medicine is doing any good. I dont feel a bit better. What is the most appropriate response by the nurse a. cheer up margaret you have so much to be happy about b.sometimes it takes a few weeks for the medicine to bring about an improvement in symptoms c. ill report that to the physician margaret. maybe he will order something different d. try not to dewll on your symptoms margaret. why dont you join the others down in the dayroom

Accepted Answer

B

Question 52

the goal of cognitive therapy with depressed clients is to  a. identify and change ydfunctional patterns of thinking b. resolve the symptoms and initiate or restore adaptive family function c. alter the neurotransmitters that are creating the depressed mood d. provide feedback from peers who are having similar experiences

Accepted Answer

A

Question 53

education for the client who is taking monamine oxidase inhibitors should include which of the following a. fluid and sodium replacement when appropriate, frequent blood drug levels, signs and symptoms of toxicity b. lifetime of continuous use, posible tardive dyskinesia, advantages of an injections every 2-4 weeks c. short term use, possible tolerance to beneficial effects, careful tapering of the drug at end of treatment d. tyramine- restricted diet, prohibitive concurrent use of OTC medictions without physician notification

Accepted Answer

D

Question 54

In teaching a client about his antidepressant medication, fluoxetine, which of the following would the nurse include. Select all that apply a. dont eat chocolate while taking this medication b. keep taking this medication, even if you dont feel it is helping. it sometimes takes a while to take effect c. dont take this mediction with the migraine drugs \"triptans\" d. go to the lab each week to have your blood drawn for therapeutic level of this drug e. this drug causes a high degree of sedation, so take it just before bedtime

Accepted Answer

B, C,

Question 55

a client has just been admitted to the osychiatric unit with a diagnosis of MDD. which of the follow behavioral manifestations might the nurse expect to assess. select all that apply a. slumped posture b. delusional thinking c. feelings of depair d. feels best early in the morning and worse as the day progresses e. anorexia

Accepted Answer

A, B, C, E

Question 56

a client with depression has just been prescribed the antidepressant nardil. she says to the nurse, the doctor says i will need to watch my diet while i am on this medication. what foods should i avoid. which of the following is the correct response by the nurse a. blue cheese, red wine, raisins b. black beans, garlic, pears c. pork, shellfish, egg yolk d. milk, peanuts, tomatoes

Accepted Answer

A

Question 57

John is a client at the mental health clinic. he is depressed, has been expressing suicidal ideations and has been seeing the psychiatric nurse every three days. He has been taking 100mg of sertraline daily for about a month, receiving small amounts of the medication from his nurse at each visit. today he comes to the clinic in a cheerful mood, much different than he seemed just 3 days ago. how might the nurse assess this behavioral change? a. the sertraline is finally taking effect b. he is no longer in need of antidepressant medication c. he has complete the frief response over the loss of his wife d. he may have decided to carry out his suicide plan

Accepted Answer

D

Question 58

The nurse is preparing a patient for electroconvulsive therapy treatment. About 20 minutes propr to the treatment the nurse administers atropine 0.4 mg IM. Rational for this order is  a. to decrease secreations and increase heart rate b. to relax muscles c. to produce a calming effect d. induce anesthesia

Accepted Answer

A

Question 59

a depressed client is receiving an ECT treatment., In the treatment room, the anesthesiologist administers methodhexital sodium followed by IV succinylcholine. The purpose of these medication are to a. decrease secretions and increase heart rate b. prevent nausea and induce a calming effect c. minimize memory loss and stabilize mood d. induce anesthesia and relax muscles

Accepted Answer

D

Question 60

after receiving three ECT treatments, a clent says to the nurse. I feel so much better, but im having trouble remembering some things that happened this last week. the nurses best response would be a. dont worry about that. nothing important happened b. memory loss is just something you have to put up with in order to feel better c. memory loss is a side effect of ECT but it is only temporary. your memory should return in a few weeks d. forget about last week mr. C. you need to worry about the future

Accepted Answer

C

Question 61

a nurse is preparing a client who is a potential candidate for ECT and providing information about the treatments. the nurse may do which of the following. select all that apply a. encourage the client to express fears about getting ECT b. discuss with the client and family the possibility of short term memory loss c. remind the client and family that injury from the induced seizure is common d. monitor for any cardiac alterations (current and past) to avoid possible negative outcomes e. ensure the client he will be awake during the entire process

Accepted Answer

A, B, D

Question 62

ECT is thought to effect a therapeutic response by a. stimulation of the CNS b. decreasing the leels of acetylcholing and monoamine oxidase c. increasing the levels of serotonin, norepinephrine and dopamine d. altering sodium metabolism within nerve and muscle cells

Accepted Answer

C

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