Chapter 25: Depressive Disorders

Chapter 25: Depressive Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which account of history and symptoms is most consistent with dysthymia?

a.	Depressed mood for 2 weeks; anhedonia; feelings of worthlessness
b.	Delusions of guilt and poverty; weight loss; agitation beginning 3 weeks ago
c.	Depressed mood for 3 months; suicidal ruminations; hypersomnia; sullen affect
d.	Depressed for 3 years; poor concentration; anhedonia; low self-esteem; indecision

 

 

ANS:  D

Dysthymia is a depressive disorder marked by chronicity. The depression must have been present more than 50% of the time for at least 2 years. The other options describe major depression and psychotic depression.

 

DIF:    Cognitive level: Applying                REF:   p. 272

TOP:   Nursing process: Assessment           MSC:  NCLEX: Psychosocial Integrity

 

2. A 74-year-old patient is admitted diagnosed with anhedonia, weight loss of 20 lb in 6 weeks, and pervasive guilt over issues that occurred in early adulthood. The patient is diagnosed with melancholic depression. Which intervention has the highest priority for inclusion in the care plan?

a.	Assess history of seasonal variations of mood.
b.	Observe for increased sensitivity to rejection.
c.	Monitor and document sleep patterns.
d.	Assess for echolalia and posturing.

 

 

ANS:  C

Individuals with the depressive variant of melancholia often display anhedonia, depression worse in the morning, early-morning awakening, anorexia and/or weight loss, and inappropriate guilt. It is appropriate to monitor sleep patterns to ascertain if sleep disturbance is present. Homeostasis is contingent on adequate sleep. The distracters are seen in depression with catatonic features, atypical depression, and seasonal affective disorder.

 

DIF:    Cognitive level: Analyzing              REF:   p. 273             TOP:   Nursing process: Planning

MSC:  NCLEX: Physiologic Integrity

 

3. A patient diagnosed with seasonal affective disorder asks, “Will I ever feel better?” Based on an understanding of this psychopathology, the nurse’s best response is:

a.	“Your depressed mood will probably spontaneously improve in 6 months to a year.”
b.	“People with seasonal affective disorder usually feel better in spring and summer, when there are longer periods of light.”
c.	“It’s important to engage in community activities to improve your depressed mood. Activity stimulates important brain chemicals.”
d.	“Most people with seasonal affective disorder feel better during the fall and winter seasons as they experience the pleasure of the holidays.”

 

 

ANS:  B

Seasonal affective disorder is a depression occurring in conjunction with a seasonal change, most often beginning in fall and winter and remitting in spring in the Northern Hemisphere. The correct answer is the only option that reflects the information regarding the seasonal nature of the disorder.

 

DIF:    Cognitive level: Applying                REF:   pp. 273

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

 

4. Which adolescent would the nurse consider to have the highest priority for health promotion interventions aimed at reducing risk for depression, based on the person’s history?

a.	Parents killed in an auto accident
b.	Lived with adoptive parents since birth
c.	Allergies to dust, pollen, and mold
d.	Frequent conflicts with siblings

 

 

ANS:  A

The events that predispose children and adolescents to develop depression involve loss such as death or separation from parents, death of a close relative, death of a pet, a move to another neighborhood, academic problems, or illness or injury that requires hospitalization. This is the only answer that reflects the relationship of loss to the disorder.

 

DIF:    Cognitive level: Analyzing              REF:   p. 274

TOP:   Nursing process: Assessment           MSC:  NCLEX: Psychosocial Integrity