VARCAROLIS FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH EDITION HALTER TEST BANK
Chapter 14: Depressive Disorders
Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical
Approach, 8th Edition
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)
NURSINGTB.COM
REF: Pages 14-27, 57 (Table 14-4) | Page 14-16 (Case Study and Nursing Care Plan)
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: Pages 14-27, 53 (Table 14-2) | Page 14-16 (Case Study and Nursing Care Plan) | Page 274
TOP: Nursing Process: Outcomes Identification
MSC: Client Needs: Psychosocial Integrity
NURSINGTB.COM
, VARCAROLIS FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH EDITION HALTER TEST BANK
3. A patient diagnosed with major depressive disorder 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.”
b. “You’re wearing a new shirt.”
c. “I like the shirt you are wearing.”
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 (nontherapeutic techniques). Saying “You must be
feeling better today” is an assumption, which is nontherapeutic.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Page 14-53 (Table 14-2) | Page 14-16 (Case Study and Nursing Care Plan)
TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
4. 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?
a. Social skills training
b. Relaxation training classes
c. Desensitization techniques
d. Use of complementary therapy
ANS: A NURSINGTB.COM
Social skills 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 skills 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: Pages 14-16 (Case Study and Nursing Care Plan), 43 TOP: Nursing Process: Planning
MSC: Client Needs: Psychosocial Integrity
5. Priority interventions for a patient diagnosed with major depressive disorder and feelings of
worthlessness should include
a. distracting the patient from self-absorption.
b. careful unobtrusive observation around the clock.
c. allowing the patient to spend long periods alone in meditation.
d. opportunities to assume a leadership role in the therapeutic milieu.
ANS: B
Approximately two-thirds of people with depression contemplate suicide. Patients with
depressive disorder who exhibit feelings of worthlessness are at higher risk. Regular planned
observations of the patient diagnosed with depression may prevent a suicide attempt on the
unit.
NURSINGTB.COM
Chapter 14: Depressive Disorders
Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical
Approach, 8th Edition
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)
NURSINGTB.COM
REF: Pages 14-27, 57 (Table 14-4) | Page 14-16 (Case Study and Nursing Care Plan)
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: Pages 14-27, 53 (Table 14-2) | Page 14-16 (Case Study and Nursing Care Plan) | Page 274
TOP: Nursing Process: Outcomes Identification
MSC: Client Needs: Psychosocial Integrity
NURSINGTB.COM
, VARCAROLIS FOUNDATIONS OF PSYCHIATRIC MENTAL HEALTH NURSING 8TH EDITION HALTER TEST BANK
3. A patient diagnosed with major depressive disorder 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.”
b. “You’re wearing a new shirt.”
c. “I like the shirt you are wearing.”
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 (nontherapeutic techniques). Saying “You must be
feeling better today” is an assumption, which is nontherapeutic.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Page 14-53 (Table 14-2) | Page 14-16 (Case Study and Nursing Care Plan)
TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
4. 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?
a. Social skills training
b. Relaxation training classes
c. Desensitization techniques
d. Use of complementary therapy
ANS: A NURSINGTB.COM
Social skills 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 skills 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: Pages 14-16 (Case Study and Nursing Care Plan), 43 TOP: Nursing Process: Planning
MSC: Client Needs: Psychosocial Integrity
5. Priority interventions for a patient diagnosed with major depressive disorder and feelings of
worthlessness should include
a. distracting the patient from self-absorption.
b. careful unobtrusive observation around the clock.
c. allowing the patient to spend long periods alone in meditation.
d. opportunities to assume a leadership role in the therapeutic milieu.
ANS: B
Approximately two-thirds of people with depression contemplate suicide. Patients with
depressive disorder who exhibit feelings of worthlessness are at higher risk. Regular planned
observations of the patient diagnosed with depression may prevent a suicide attempt on the
unit.
NURSINGTB.COM
