Chapter 15: Mood Disorders: Depression

Chapter 15: Mood Disorders: Depression

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient became severely depressed when the last of six children moved out of the home 4 months ago. The patient repeatedly says, “No one cares about me. I’m not worth anything.” Which response by the nurse would be the most helpful?

a.	“Things will look brighter soon. Everyone feels down once in a while.”
b.	“The staff here cares about you and wants to try to help you get better.”
c.	“It is difficult for others to care about you when you repeatedly say the same negative things.”
d.	“I’ll sit with you for 10 minutes now and return for 10 minutes at lunchtime and again at 2:30 this afternoon.”

 

 

ANS:  D

Spending time with the patient at intervals throughout the day shows acceptance by the nurse and helps the patient establish a relationship with the nurse. The therapeutic technique is called offering self. Setting definite times for the therapeutic contacts and keeping the appointments show predictability on the part of the nurse, an element that fosters the building of trust. The incorrect responses would be difficult for a person with profound depression to believe, provide trite reassurance, and are counterproductive. The patient is unable to say positive things at this point.

 

DIF:    Cognitive Level: Application           REF:   Pages: 258-260

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Psychosocial Integrity

 

2. A patient became depressed after the last of six children moved out of the home 4 months ago. The patient has been self-neglectful, slept poorly, lost weight, and repeatedly says, “No one cares about me anymore. I’m not worth anything.” Select an appropriate initial outcome for the nursing diagnosis Situational low self-esteem, related to feelings of abandonment. The patient will:

a.	verbalize realistic positive characteristics about self by  (date)  .
b.	consent to take antidepressant medication regularly by  (date)  .
c.	initiate social interaction with another person daily by  (date)  .
d.	identify two personal behaviors that alienate others by  (date)  .

 

 

ANS:  A

Low self-esteem is reflected by making consistently negative statements about self and self-worth. Replacing negative cognitions with more realistic appraisals of self is an appropriate intermediate outcome. The incorrect options are not as clearly related to the nursing diagnosis. Outcomes are best when framed positively; identifying two personal behaviors that might alienate others is a negative concept.

 

DIF:    Cognitive Level: Application           REF:   Pages: 245-246

TOP:   Nursing Process: Outcomes Identification

MSC:  NCLEX: Psychosocial Integrity

 

3. A patient with major depression says, “No one cares about me anymore. I’m not worth anything.” The nurse wants to reinforce positive self-esteem. Today, the patient is wearing a new shirt and has neat, clean hair. Which remark is most appropriate?

a.	“You look nice this morning.”
b.	“You’re wearing a new shirt.”
c.	“I like the shirt you’re wearing.”
d.	“You must be feeling better today.”

 

 

ANS:  B

Patients with depression usually see the negative side of things. The meaning of compliments may be altered to “I didn’t look nice yesterday” or “They didn’t like my other shirt.” Neutral comments such as an observation avoid negative interpretations. Saying “You look nice” or “I like your shirt” gives approval (nontherapeutic techniques). Saying “You must be feeling better today” is an assumption, which is nontherapeutic.

 

DIF:    Cognitive Level: Application           REF:   Pages: 258-260

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Psychosocial Integrity

 

4. An adult with depression was treated with medication and cognitive behavioral therapy. The patient now recognizes how passivity contributed to the depression. Which intervention should the nurse suggest?

a.	Social skills training
b.	Relaxation training classes
c.	Use of complementary therapy
d.	Learning desensitization techniques

 

 

ANS:  A

Social skills training is helpful in treating and preventing the recurrence of depression. Training focuses on assertiveness and coping skills that lead to positive reinforcement from others and the development of a patient’s support system. The use of complementary therapy refers to adjunctive therapies such as herbals. Assertiveness would be of greater value than relaxation training because passivity is a concern. Desensitization is used in the treatment of phobias.

 

DIF:    Cognitive Level: Analysis                REF:   Page: 250|Page: 272

TOP:   Nursing Process: Planning               MSC:  NCLEX: Psychosocial Integrity