Depressive Disorders
An acutely depressed client isolates herself in her room and just sits and stares into space. Which of these is the best example of an active communication approach with this client?
A) âDo you like to exercise?â
B) âCome with me. I will go with you to group therapy.â
C) âWould you like to go to group therapy, stay in bed, or come out to the day lounge for some activities?â
D) âWhy do you stay in your room all the time?â
B) âCome with me. I will go with you to group therapy.â
Select all that apply. What are characteristics of a manic episode ?
A) Flat affect
B) Distractibility
C) Increased self esteem
D) Decreased need for sleep
E) Lack of energy
B, C, D
A patient shows no facial expression when engaging in a game with peers during an outing at a park. The nurse uses which of the following terms when documenting the patient's affect?
A) Blunt affect
B) Restricted affect
C) Broad affect
D) Flat affect
D) Flat affect
A 19yr old patient with MDD has been prescribed an SARI, the nurse should be most cautious of what which side effect?
A) nausea
B) altered sleep
C) increased suicidal ideation
D) weight gain
C) increased suicidal ideation
What is lithium's therapeutic range for acute mania?
a. 0.6-1.2 mEq/L
b. 1.0-1.5 mEq/ L
c. 1.2-3.1 mEq/ L
d. 0.3-1.6 mEq/ L
b. 1.0-1.5 mEq/ L
Which of the following is not a suicide warning sign?
A) Substance abuse
B) Aggressiveness and irritability
C) Increased social interactions
D) Giving things away
C) Increased social interactions
A client is exhibiting behavioral symptoms of depression. Which charting entry would appropriately document these symptoms?
A) âRates mood as 4/10
B) âExpresses thoughts of poor self-esteem during groupâ
C) âBecame irritable and agitated on waking.â
D) âRates anxiety as 2/10 after receiving lorazepam(Ativan).â
C) âBecame irritable and agitated on waking.â
A highly agitated client paces the unit & states, "I could buy & sell this place." The clients mood fluctuates from fits of laughter to outbursts of anger. Which is the most accurate documentation of this clients behavior?
A) Rates mood 8/10. Exhibiting looseness of association. Euphoric.
B) Mood euthymic. Exhibiting magical thinking. Restless.
C) Mood labile. Exhibiting delusions of reference. Hyperactive.
D) Agitated & pacing. Exhibiting grandiosity. Mood labile.
D) Agitated & pacing. Exhibiting grandiosity. Mood labile.
You are giving your patient a suicidal assessment after they expressed suicidal ideation, which are important considerations for this assessment? Select all that apply:
a. collaborating with the patient
b. establish trust and open communication with the patient
c. asking specific questions about how strong their intention to die is
d. ask minimal questions and keep it casual to avoid hurting their feelings
e. identify if the patient has made a plan to kill themself
A, B, C, E
A client has been admitted to the psychiatric unit with a diagnosis of major depressive disorder. Which of the following behavioral manifestations might the nurse expect to assess? (Select all that apply)
A) Slumped Posture
B) Hallucinations
C) Feelings of despair
D) Appears to have boundless energy
E) Anorexia
A, C, E
Select all that apply. What is recommended to keep the medication lithium within the therapeutic range?
A) Avoid NSAIDs
B) Monitor blood levels closely
C) Limit water intake
D) Avoid if pregnant or breastfeeding (teratogenic effects on fetus)
E) Eliminate sodium from diet
A, B, D
C is not right, because decreased body fluids can cause an increase in lithium levels. E is not right, because changes sodium consumption in diet can affect lithium blood levels.
What is the paradoxical calm?
A) As antidepressants take effect, the individual has a sudden lift in mood. May now have increased energy to implement a suicide plan
B) Negative view of self
C) Disturbance in mood and change in functioning observable to others
A) As antidepressants take effect, the individual has a sudden lift in mood. May now have increased energy to implement a suicide plan