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Question 1
Free
Multiple Choice

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?

Choose correct answer/s
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."

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Question 2
Free
Multiple Choice

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. The patient will:

Choose correct answer/s
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).

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Question 3
Free
Multiple Choice

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?

Choose correct answer/s
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."

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Question 4
Free
Multiple Choice

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?

Choose correct answer/s
A

Social skills training

B

Relaxation training classes

C

Use of complementary therapy

D

Learning desensitization techniques

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Question 5
Free
Multiple Choice

A priority nursing intervention for a patient diagnosed with major depressive disorder is:

Choose correct answer/s
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.

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Question 6
Multiple Choice

When counseling patients diagnosed with major depressive disorder, an advanced practice nurse will address the negative thought patterns by using:

Choose correct answer/s
A
psychoanalytic therapy.
B
desensitization therapy.
C
cognitive behavioral therapy.
D
alternative and complementary therapies.
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Question 7
Multiple Choice

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 complaint?

Choose correct answer/s
A
Vegetative
B
Anhedonia
C
Euphoria
D
Anergia
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Question 8
Multiple Choice

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:

Choose correct answer/s
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.
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Question 9
Multiple Choice

A patient diagnosed with major depressive disorder is receiving imipramine (Tofranil) 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?

Choose correct answer/s
A
Dry mouth
B
Blurred vision
C
Nasal congestion
D
Urinary retention
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Question 10
Multiple Choice

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, the nurse should respond:

Choose correct answer/s
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?"
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Question 11
Multiple Choice

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 feelings of:

Choose correct answer/s
A
overinvolvement.
B
guilt and despair.
C
interest and pleasure.
D
ineffectiveness and frustration.
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Question 12
Multiple Choice

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:

Choose correct answer/s
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.
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Question 13
Multiple Choice

A nurse teaching a patient about a tyramine-restricted diet would approve which meal?

Choose correct answer/s
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
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Question 14
Multiple Choice

What is the focus of priority nursing care for the period immediately after a patient has an electroconvulsive therapy (ECT) treatment?

Choose correct answer/s
A
Supporting physiologic stability
B
Reducing disorientation and confusion
C
Monitoring pupillary responses
D
Assisting the patient to plan for the future
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Question 15
Multiple Choice

A nurse provided medication education for a patient who takes phenelzine (Nardil) for depression. Which behavior indicates effective learning? The patient:

Choose correct answer/s
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.
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Question 16
Multiple Choice

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?

Choose correct answer/s
A
Powerlessness
B
Defensive coping
C
Situational low self-esteem
D
Disturbed personal identity
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Question 17
Multiple Choice

A patient diagnosed with major depressive disorder does not interact with others except when addressed and then only in monosyllables. The nurse wants to show nonjudgmental acceptance and support for the patient. Select the nurse's most effective approach to communication.

Choose correct answer/s
A
Make observations.
B
Ask the patient direct questions.
C
Phrase questions to require "yes" or "no" answers.
D
Frequently reassure the patient to reduce guilt feelings.
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Question 18
Multiple Choice

A patient being treated for major depressive disorder has taken 300 mg amitriptyline (Elavil) daily for a year. The patient calls the case manager at the clinic and says, "I stopped taking my antidepressant 2 days ago. Now I am having cold sweats, nausea, a rapid heartbeat, and nightmares." The nurse should advise the patient:

Choose correct answer/s
A
"Go to the nearest emergency department immediately."
B
"Do not to be alarmed. Take two aspirin and drink plenty of fluids."
C
"Take one dose of the antidepressant. Come to the clinic to see the health care provider."
D
"Resume taking the antidepressant for 2 more weeks, and then discontinue it again."
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Question 19
Multiple Choice

Which documentation indicates the treatment plan of a patient diagnosed with major depressive disorder was effective?

Choose correct answer/s
A
Slept 6 hours uninterrupted. Sang with activity group. Anticipates seeing grandchild.
B
Slept 10 hours uninterrupted. Attended craft group; stated "project was a failure, just like me."
C
Slept 5 hours with brief interruptions. Personal hygiene adequate with assistance. Weight loss of 1 pound.
D
Slept 7 hours uninterrupted. Preoccupied with perceived inadequacies. States, "I feel tired all the time."
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Question 20
Multiple Choice

A woman gave birth to a healthy newborn 1 month ago. The patient now reports she cannot cope and is unable to sleep or eat. She says, "I feel like a failure. This baby is the root of my problems." The priority nursing diagnosis is:

Choose correct answer/s
A
insomnia.
B
ineffective coping.
C
situational low self-esteem.
D
risk for other-directed violence.
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