Depression
, Depression
1. A nurse is caring for depressed older adults. What precipitating factors for depression
are most common in the older adult without cognitive problems? Select all that apply.
1 Dementia
2 Multiple losses
3 Declines in health
4 A milestone birthday
5 An injury requiring hospitalization: 2 & 3
Depression in the older adult is most often associated with the loss of family members and
friends (e.g., death, relocation) and declines in mobility, health, and income.
2. A client is admitted with a bipolar disorder, depressed episode. The nursing history
indicates a progressive increase in depression over the past month. What should the
nurse expect the client to display?
1 Elated affect related to reaction formation
2 Loose associations related to a thought disorder
3 Physical exhaustion related to decreased physical activity
4 Decrease of verbal expression related to slowed thought processes: 4
As depression increases, thought processes become slower and verbal expression
decreases due to lack of emotional energy. Elation is associated with bipolar disorder,
manic episode; the affect of a depressed person is usually one of sadness, or it may be
blank. Loose associations are related to schizophrenia, not depression. Physical
exhaustion is associated with bipolar disorder, manic episode; decreased physical activity
does not produce physical exhaustion.
3. A client diagnosed with depression is prescribed phenelzine. Which foods consumed
along with this drug would cause a hypertensive crisis?
1 Yogurt
2 Soy sauce
3 Cream cheese
4 Soybean paste
, Depression
5 Over-ripened bananas: 2, 4, 5
Monoamine oxidase inhibitors (MAOIs) may cause hypertensive crisis if the client
consumes foods rich in tyramine. Soy sauce, soybean, and over-ripened bananas contain
high amounts of tyramine
4. A registered nurse provides dietary instructions to a client who is prescribed
isocarboxazid for depression. Which statements made by the client indicates a need for
further education?
1 "I will limit my intake of fish."
2 "I will limit my intake of yogurt."
3 "I will limit my intake of bananas."
4 "I will limit my intake of beer."
5 "I will limit my intake of chocolate.": 3 & 4
If a client is unresponsive to other antipsychotic drugs, isocarboxazid (a monoamine
oxidase inhibitor) is used to treat depression. Clients taking isocarboxazid should avoid
foods high in tyramine and should limit the intake of foods (banana or chocolate) that
contain a moderate amount of tyramine content because these foods may cause a
hypertensive crisis
5. A male client with the dual diagnosis of major depression and polysubstance abuse has
been attending group therapy. One day the client tells the nurse, "The things they talk about
in group don't really pertain to me." What is the most therapeutic response by the nurse?
A) Confronting the client with realistic feedback
B) Identifying the client's stress-coping tolerance
C) Informing the client that he needs to get more involved
D)Asking the client what therapy he thinks would be more helpful: A
6. The primary healthcare provider notices that a client exhibits a period of mania followed
by hypomania and depression and prescribes lithium carbonate. What is the mode of
administration of the prescribed drug?
1 Oral route
, Depression
2 Sublingual route
3 Intravenous route
4 Transdermal route: 1
Episodes of mania followed by hypomania and depression are indicative of bipolar disease.
Lithium carbonate is the drug of choice to treat this condition and should be administered
only by the oral route
7. The nurse suspects serotonin syndrome in a client prescribed second-generation
antidepressants for depression. Which assessment findings observed by the nurse would
be beneficial in diagnosing the severity of the syndrome? Select all that apply.
1
Delirium
2
Hyperreflexia
3
Hyperthermia
4
Muscle spasms
5
Rhabdomyolysis: 3, 5
Serotonin syndrome is a potentially hazardous adverse effect of second-generation
antidepressants that are used to treat depression. Hyperthermia and rhabdomyolysis are
symptoms observed in severe cases of serotonin syndrome.
Delirium, hyperreflexia, and muscle spasms are common symptoms of this syndrome.
8. A client with depression is to be given fluoxetine. What precaution will the nurse
consider when initiating treatment with this drug?
1 It must be given with milk and crackers to prevent hyperacidity and discomfort.
2 Eating cheese or pickled herring or drinking wine may cause a hypertensive crisis.
3 The blood level may not be sufficient to cause noticeable improvement for 2 to 4
weeks.
, Depression
1. A nurse is caring for depressed older adults. What precipitating factors for depression
are most common in the older adult without cognitive problems? Select all that apply.
1 Dementia
2 Multiple losses
3 Declines in health
4 A milestone birthday
5 An injury requiring hospitalization: 2 & 3
Depression in the older adult is most often associated with the loss of family members and
friends (e.g., death, relocation) and declines in mobility, health, and income.
2. A client is admitted with a bipolar disorder, depressed episode. The nursing history
indicates a progressive increase in depression over the past month. What should the
nurse expect the client to display?
1 Elated affect related to reaction formation
2 Loose associations related to a thought disorder
3 Physical exhaustion related to decreased physical activity
4 Decrease of verbal expression related to slowed thought processes: 4
As depression increases, thought processes become slower and verbal expression
decreases due to lack of emotional energy. Elation is associated with bipolar disorder,
manic episode; the affect of a depressed person is usually one of sadness, or it may be
blank. Loose associations are related to schizophrenia, not depression. Physical
exhaustion is associated with bipolar disorder, manic episode; decreased physical activity
does not produce physical exhaustion.
3. A client diagnosed with depression is prescribed phenelzine. Which foods consumed
along with this drug would cause a hypertensive crisis?
1 Yogurt
2 Soy sauce
3 Cream cheese
4 Soybean paste
, Depression
5 Over-ripened bananas: 2, 4, 5
Monoamine oxidase inhibitors (MAOIs) may cause hypertensive crisis if the client
consumes foods rich in tyramine. Soy sauce, soybean, and over-ripened bananas contain
high amounts of tyramine
4. A registered nurse provides dietary instructions to a client who is prescribed
isocarboxazid for depression. Which statements made by the client indicates a need for
further education?
1 "I will limit my intake of fish."
2 "I will limit my intake of yogurt."
3 "I will limit my intake of bananas."
4 "I will limit my intake of beer."
5 "I will limit my intake of chocolate.": 3 & 4
If a client is unresponsive to other antipsychotic drugs, isocarboxazid (a monoamine
oxidase inhibitor) is used to treat depression. Clients taking isocarboxazid should avoid
foods high in tyramine and should limit the intake of foods (banana or chocolate) that
contain a moderate amount of tyramine content because these foods may cause a
hypertensive crisis
5. A male client with the dual diagnosis of major depression and polysubstance abuse has
been attending group therapy. One day the client tells the nurse, "The things they talk about
in group don't really pertain to me." What is the most therapeutic response by the nurse?
A) Confronting the client with realistic feedback
B) Identifying the client's stress-coping tolerance
C) Informing the client that he needs to get more involved
D)Asking the client what therapy he thinks would be more helpful: A
6. The primary healthcare provider notices that a client exhibits a period of mania followed
by hypomania and depression and prescribes lithium carbonate. What is the mode of
administration of the prescribed drug?
1 Oral route
, Depression
2 Sublingual route
3 Intravenous route
4 Transdermal route: 1
Episodes of mania followed by hypomania and depression are indicative of bipolar disease.
Lithium carbonate is the drug of choice to treat this condition and should be administered
only by the oral route
7. The nurse suspects serotonin syndrome in a client prescribed second-generation
antidepressants for depression. Which assessment findings observed by the nurse would
be beneficial in diagnosing the severity of the syndrome? Select all that apply.
1
Delirium
2
Hyperreflexia
3
Hyperthermia
4
Muscle spasms
5
Rhabdomyolysis: 3, 5
Serotonin syndrome is a potentially hazardous adverse effect of second-generation
antidepressants that are used to treat depression. Hyperthermia and rhabdomyolysis are
symptoms observed in severe cases of serotonin syndrome.
Delirium, hyperreflexia, and muscle spasms are common symptoms of this syndrome.
8. A client with depression is to be given fluoxetine. What precaution will the nurse
consider when initiating treatment with this drug?
1 It must be given with milk and crackers to prevent hyperacidity and discomfort.
2 Eating cheese or pickled herring or drinking wine may cause a hypertensive crisis.
3 The blood level may not be sufficient to cause noticeable improvement for 2 to 4
weeks.
