Question: A patient diagnosed with anorexia nervosa has a body mass index (BMI) of 14.8 kg/m². Which assessment finding is most likely to accompany this value?
Answer Choices: a. Cachexia b. Leukocytosis c. Hyperthermia d. Hypertension
Answer: a. Cachexia
Question: A patient referred to the eating disorders clinic has lost 35 pounds in 3 months and has developed amenorrhea. For which physical manifestations of anorexia nervosa should a nurse assess? (Select all that apply.)
Answer Choices: a. Hypothermia b. Parotid swelling c. Constipation d. Hypotension e. Dental caries f. Lanugo
Answer: a. Hypothermia c. Constipation d. Hypotension f. Lanugo
Question: A patient diagnosed with anorexia nervosa is hospitalized for treatment. What features should the milieu provide? (Select all that apply.)
Answer Choices: a. Flexible mealtimes b. Unscheduled weight checks c. Adherence to a selected menu d. Observation during and after meals e. Monitoring during bathroom trips f. Privileges correlated with emotional expression
Answer: c. Adherence to a selected menu d. Observation during and after meals e. Monitoring during bathroom trips
Question: 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?
Answer Choices: 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 negative things about yourself.” d. “I’ll sit with you for 10 minutes now and return for 10 minutes at lunchtime and again at 2:30 this afternoon.”
Answer: d. “I’ll sit with you for 10 minutes now and return for 10 minutes at lunchtime and again at 2:30 this afternoon.”
Question: 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.
Answer Choices: a. The patient will verbalize realistic positive characteristics about self by (date). b. The patient will consent to take antidepressant medication regularly by (date). c. The patient will initiate social interaction with another person daily by (date). d. The patient will identify two personal behaviors that alienate others by (date).
Answer: a. The patient will verbalize realistic positive characteristics about self by (date).
Question: A nurse wants to reinforce positive self-esteem for a patient diagnosed with major depressive disorder. Today, the patient is wearing a new shirt and has neat, clean hair. Which remark is most appropriate?
Answer Choices: a. “You look nice this morning.” b. “You are wearing a new shirt.” c. “I like the shirt you’re wearing.” d. “You must be feeling better today.”
Answer: b. “You are wearing a new shirt.”
Question: An adult diagnosed with major depressive disorder was treated with medication and cognitive behavioral therapy. The patient now recognizes how passivity contributed to the depression. Which intervention should the nurse suggest?
Answer Choices: a. Social skills training b. Relaxation training classes c. Use of complementary therapy d. Learning desensitization techniques
Answer: a. Social skills training
Question: What is a priority nursing intervention for a patient diagnosed with major depressive disorder?
Answer Choices: a. Distracting the patient from self-absorption b. Carefully and inconspicuously observing the patient around the clock c. Allowing the patient to spend long periods alone in self-reflection d. Offering opportunities for the patient to assume a leadership role in the therapeutic milieu
Answer: b. Carefully and inconspicuously observing the patient around the clock
Question: When counseling patients diagnosed with major depressive disorder, how will an advanced practice nurse likely address the negative thought patterns?
Answer Choices: Not provided.
Answer: a. Psychoanalytic therapy
Question: A patient says to the nurse, “My life does not have any happiness in it anymore. I once enjoyed holidays, but now they’re just another day.” How would the nurse document the patient’s statement?
Answer Choices: a. Vegetative b. Anhedonia c. Euphoria d. Anergia
Answer: b. Anhedonia
Question: A patient diagnosed with major depressive disorder is taking a tricyclic antidepressant. The patient says, “I don’t think I can keep taking these pills. They make me so dizzy, especially when I stand up.” The nurse should implement what intervention?
Answer Choices: a. Explain how to manage postural hypotension and educate the patient that side effects go away after several weeks. b. Tell the patient that the side effects are a minor inconvenience compared with the feelings of depression. c. Withhold the drug, force oral fluids, and notify the health care provider to examine the patient. d. Teach the patient how to use pursed-lip breathing.
Answer: a. Explain how to manage postural hypotension and educate the patient that side effects go away after several weeks.
Question: A patient diagnosed with major depressive disorder is receiving imipramine 200 mg every night at bedtime. Which assessment finding would prompt the nurse to collaborate with the health care provider regarding potentially hazardous side effects of this drug?
Answer Choices: a. Dry mouth b. Blurred vision c. Nasal congestion d. Urinary retention
Answer: d. Urinary retention
Question: A patient diagnosed with major depressive disorder tells the nurse, “Bad things that happen are always my fault.” To assist the patient in reframing this overgeneralization, how should the nurse respond?
Answer Choices: a. “I really doubt that one person can be blamed for all the bad things that happen.” b. “Let’s look at one bad thing that happened to see if another explanation exists.” c. “You are being exceptionally hard on yourself when you say those things.” d. “How does your belief in fate relate to your cultural heritage?”
Answer: b. “Let’s look at one bad thing that happened to see if another explanation exists.”
Question: A nurse worked with a patient diagnosed with major depressive disorder who was severely withdrawn and dependent on others. After 3 weeks, the patient did not improve. The nurse is at risk for what emotional response?
Answer Choices: a. Overinvolvement b. Guilt and despair c. Disinterest and apathy d. Ineffectiveness and frustration
Answer: d. Ineffectiveness and frustration
Question: Which psychotherapy modality is typically used for treating patients with major depressive disorder?
Answer Choices: a. Psychoanalytic therapy b. Desensitization therapy c. Cognitive behavioral therapy d. Alternative and complementary therapies
Answer: c. Cognitive behavioral therapy
Question: A patient diagnosed with major depressive disorder begins selective serotonin reuptake inhibitor (SSRI) antidepressant therapy. Priority information given to the patient and family should include a directive to do what?
Answer Choices: a. Avoid exposure to bright sunlight. b. Report increased suicidal thoughts. c. Restrict sodium intake to 1 g daily. d. Maintain a tyramine-free diet.
Answer: b. Report increased suicidal thoughts.
Question: A nurse teaching a patient about a tyramine-restricted diet would approve which meal?
Answer Choices: a. Mashed potatoes, ground beef patty, corn, green beans, apple pie b. Avocado salad, ham, creamed potatoes, asparagus, chocolate cake c. Macaroni and cheese, hot dogs, banana bread, caffeinated coffee d. Noodles with cheddar cheese sauce, smoked sausage, lettuce salad, yeast rolls
Answer: a. Mashed potatoes, ground beef patty, corn, green beans, apple pie
Question: What is the focus of priority nursing care for the period immediately after a patient has an electroconvulsive therapy (ECT) treatment?
Answer Choices: a. Supporting physiological stability b. Reducing disorientation and confusion c. Monitoring pupillary responses d. Assisting the patient to plan for the future
Answer: a. Supporting physiological stability
Question: A nurse provided medication education for a patient who is prescribed phenelzine for depression. Which patient behavior indicates effective learning?
Answer Choices: a. Monitors sodium intake and weight daily. b. Wears support stockings and elevates the legs when sitting. c. Consults the pharmacist when selecting over-the-counter medications. d. Can identify foods with high selenium content, which should be avoided.
Answer: c. Consults the pharmacist when selecting over-the-counter medications.
Question: A patient’s employment is terminated, and major depressive disorder develops shortly afterward. The patient says to the nurse, “I’m not worth the time you spend with me. I’m the most useless person in the world.” Which nursing diagnosis applies?
Answer Choices: a. Powerlessness b. Defensive coping c. Situational low self-esteem d. Disturbed personal identity
Answer: c. Situational low self-esteem