Chapter 25. Depressive Disorders
Multiple Choice
1. A client is diagnosed with persistent depressive (dysthymia) disorder. Which should
a nurse classify as an affective symptom of this disorder?
A. Social isolation with a focus on self
B. Low energy level
C. Difficulty concentrating
D. Gloomy and pessimistic outlook on life
ANS: D
The nurse should classify a gloomy and pessimistic outlook on life as an affective
symptom of dysthymia. Symptoms of depression can be described as alterations in
four areas of human functions: affective, behavioral, cognitive, and physiological.
Affective symptoms are those that relate to the mood.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process:
Assessment | Client Need:
Psychosocial Integrity
2. A client is diagnosed with major depressive disorder. Which nursing diagnosis
should a nurse assign to this client to address a behavioral symptom of this disorder?
,A. Altered communication R/T feelings of worthlessness AEB anhedonia
B. Social isolation R/T poor self-esteem AEB secluding self in room
C. Altered thought processes R/T hopelessness AEB persecutory delusions
D. Altered nutrition: less than body requirements R/T high anxiety AEB anorexia
ANS: B
A nursing diagnosis of social isolation R/T poor self-esteem AEB secluding self in
room addresses a behavioral symptom of major depressive disorder. Other behavioral
symptoms include psychomotor retardation, virtually nonexistent communication,
maintaining a fetal position, and no personal hygiene and/or grooming.
KEY: Cognitive Level: Analysis | Integrated Processes: Nursing Process: Analysis |
Client Need:
Psychosocial Integrity
3. A nurse assesses a client suspected of having major depressive disorder. Which
client symptom would eliminate this diagnosis?
A. The client is disheveled and malodorous. B. The client refuses to interact with
others. C. The client is unable to feel any pleasure.
D. The client has maxed-out charge cards and exhibits promiscuous behaviors.
ANS: D
, The nurse should assess that a client who has maxed-out credit cards and exhibits
promiscuous behavior would be exhibiting manic symptoms. According to the DSM-5,
these symptoms would rule out the diagnosis of
major depressive disorder.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process:
Assessment | Client Need:
Psychosocial Integrity
4. A nurse reviews the laboratory data of a 29-year-old client suspected of having
major depressive disorder. Which laboratory value would potentially rule out this
diagnosis?
A. Thyroid-stimulating hormone (TSH) level of 6.2 U/mL B. Potassium (K+) level of 4.2
mEq/L
C. Sodium (Na+) level of 140 mEq/L
D. Calcium (Ca2+) level of 9.5 mg/dL
ANS: A
According to the DSM-5, symptoms of major depressive disorder cannot be due to the
direct physiological effects of a general medical condition (e.g., hypothyroidism). The
diagnosis of major depressive disorder may be ruled out if the clients laboratory
results indicate a high TSH level (normal range for this age group is 0.4 to
4.2 U/mL), which results from a low thyroid function, or hypothyroidism. In
hypothyroidism metabolic processes are slowed, leading to depressive symptoms.
Multiple Choice
1. A client is diagnosed with persistent depressive (dysthymia) disorder. Which should
a nurse classify as an affective symptom of this disorder?
A. Social isolation with a focus on self
B. Low energy level
C. Difficulty concentrating
D. Gloomy and pessimistic outlook on life
ANS: D
The nurse should classify a gloomy and pessimistic outlook on life as an affective
symptom of dysthymia. Symptoms of depression can be described as alterations in
four areas of human functions: affective, behavioral, cognitive, and physiological.
Affective symptoms are those that relate to the mood.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process:
Assessment | Client Need:
Psychosocial Integrity
2. A client is diagnosed with major depressive disorder. Which nursing diagnosis
should a nurse assign to this client to address a behavioral symptom of this disorder?
,A. Altered communication R/T feelings of worthlessness AEB anhedonia
B. Social isolation R/T poor self-esteem AEB secluding self in room
C. Altered thought processes R/T hopelessness AEB persecutory delusions
D. Altered nutrition: less than body requirements R/T high anxiety AEB anorexia
ANS: B
A nursing diagnosis of social isolation R/T poor self-esteem AEB secluding self in
room addresses a behavioral symptom of major depressive disorder. Other behavioral
symptoms include psychomotor retardation, virtually nonexistent communication,
maintaining a fetal position, and no personal hygiene and/or grooming.
KEY: Cognitive Level: Analysis | Integrated Processes: Nursing Process: Analysis |
Client Need:
Psychosocial Integrity
3. A nurse assesses a client suspected of having major depressive disorder. Which
client symptom would eliminate this diagnosis?
A. The client is disheveled and malodorous. B. The client refuses to interact with
others. C. The client is unable to feel any pleasure.
D. The client has maxed-out charge cards and exhibits promiscuous behaviors.
ANS: D
, The nurse should assess that a client who has maxed-out credit cards and exhibits
promiscuous behavior would be exhibiting manic symptoms. According to the DSM-5,
these symptoms would rule out the diagnosis of
major depressive disorder.
KEY: Cognitive Level: Application | Integrated Processes: Nursing Process:
Assessment | Client Need:
Psychosocial Integrity
4. A nurse reviews the laboratory data of a 29-year-old client suspected of having
major depressive disorder. Which laboratory value would potentially rule out this
diagnosis?
A. Thyroid-stimulating hormone (TSH) level of 6.2 U/mL B. Potassium (K+) level of 4.2
mEq/L
C. Sodium (Na+) level of 140 mEq/L
D. Calcium (Ca2+) level of 9.5 mg/dL
ANS: A
According to the DSM-5, symptoms of major depressive disorder cannot be due to the
direct physiological effects of a general medical condition (e.g., hypothyroidism). The
diagnosis of major depressive disorder may be ruled out if the clients laboratory
results indicate a high TSH level (normal range for this age group is 0.4 to
4.2 U/mL), which results from a low thyroid function, or hypothyroidism. In
hypothyroidism metabolic processes are slowed, leading to depressive symptoms.
