Chapter 14: Depressive Disorders

Chapter 14: Depressive Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient became severely depressed when the last of the family’s 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.	“Our staff members care about you and want 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 10 minutes after lunch to help you feel that I care about you.”

 

 

ANS:  D

Spending time with the patient at intervals throughout the day shows acceptance by the nurse and will help the patient establish a relationship with the nurse. The therapeutic technique is “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 trust building. The incorrect responses would be difficult for a person with profound depression to believe, provide false reassurance, and are counterproductive. The patient is unable to say positive things at this point.

 

PTS:   1                    DIF:    Cognitive Level: Apply (Application)

REF:   Page 263 (Table 14-4) | Page 256 (Case Study and Nursing Care Plan 14-1)

TOP:   Nursing Process: Implementation     MSC:  Client Needs: Psychosocial Integrity

 

2. A patient became depressed after the last of the family’s six children moved out of the home 4 months ago. Select the best 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.	agree to take an 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.

 

PTS:   1                    DIF:    Cognitive Level: Apply (Application)

REF:   Page 259 | Page 261 (Table 14-2) | Page 256 (Case Study and Nursing Care Plan 14-1) | Page 274  TOP:           Nursing Process: Outcomes Identification

MSC:  Client Needs: Psychosocial Integrity

 

3. A patient diagnosed with major depression says, “No one cares about me anymore. I’m not worth anything.” Today the patient is wearing a new shirt and has neat, clean hair. Which remark by the nurse supports building a positive self-esteem for this patient?

a.	“You look nice this morning.”	c.	“I like the shirt you are wearing.”
b.	“You’re wearing a new shirt.”	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 making an observation avoid negative interpretations. Saying, “You look nice” or “I like your shirt” gives approval (non-therapeutic techniques). Saying “You must be feeling better today” is an assumption, which is non-therapeutic.

 

PTS:   1                    DIF:    Cognitive Level: Apply (Application)

REF:   Page 259 | Page 261 (Table 14-2) | Page 256 (Case Study and Nursing Care Plan 14-1) | Page 274  TOP:           Nursing Process: Implementation

MSC:  Client Needs: Psychosocial Integrity

 

4. An adult diagnosed with major 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	c.	Desensitization techniques
b.	Relaxation training classes	d.	Use of complementary therapy

 

 

ANS:  A

Social skill 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 development of a patient’s support system. Use of complementary therapy refers to adjunctive therapies such as herbals, which would be less helpful than social skill training. Assertiveness would be of greater value than relaxation training because passivity was a concern. Desensitization is used in treatment of phobias.

 

PTS:   1                    DIF:    Cognitive Level: Analyze (Analysis)

REF:   Page 256 (Case Study and Nursing Care Plan 14-1) | Page 259

TOP:   Nursing Process: Planning               MSC:  Client Needs: Psychosocial Integrity