Chapter 25: Depressive Disorders
Steele: Keltner’s Psychiatric Nursing,
MULTIPLE CHOICE
1. Which account of a patient‘s history and symptoms is most consistent with the diagnosis of
dysthymia?
a. Depressed mood for 2 weeks; anhedonia; feelings of worthlessness
b. Delusions of guilt and poverty; weight loss; agitation beginning 3 weeks ago
c. Depressed mood for 3 months; suicidal ruminations; hypersomnia; sullen affect
d. Depressed for 3 years; poor concentration; anhedonia; low self-esteem; indecision
ANS: D
Dysthymia is a depressive disorder marked by chronicity. The depression must have been present
most of the time for at least 2 years. The other options describe major depression and psychotic
depression.
DIF: Cognitive level: Applying TOP: Nursing process: Assessment
MSC: Client Needs: Psychosocial Integrity
2. Which intervention has the highest priority for inclusion in the care plan of a client diagnosed
with anhedonia?
a. Assess history of seasonal variations of mood.
b. Observe for increased sensitivity to rejection.
c. Monitor and document sleep patterns.
d. Assess for echolalia and posturing.
ANS: C
, Individuals with the depressive variant of melancholia often display anhedonia, depression worse
in the morning, early-morning awakening, anorexia and/or weight loss, and inappropriate guilt. It
is appropriate to monitor sleep patterns to ascertain if sleep disturbance is present. Homeostasis
is contingent on adequate sleep. The distracters are seen in depression with catatonic features,
atypical depression, and seasonal affective disorder.
DIF: Cognitive level: Analyzing TOP: Nursing process: Planning
MSC: Client Needs: Physiologic Integrity
3. A patient diagnosed with seasonal affective disorder asks, ―Will I ever feel better?‖ Based on an
understanding of this psychopathology, what is the nurse‘s best response?
a. ―Your depressed mood will probably spontaneously improve in 6 months to a
year.‖
b. ―People with seasonal affective disorder usually feel better in spring and summer,
when there are longer periods of light.‖
c. ―It‘s important to engage in community activities to improve your depressed
mood. Activity stimulates important brain chemicals.‖
d. ―Most people with seasonal affective disorder feel better during the fall and winter
seasons as they experience the pleasure of the holidays.‖
ANS: B
Seasonal affective disorder is a depression occurring in conjunction with a seasonal change, most
often beginning in fall and winter and remitting in spring in the Northern Hemisphere. The
correct answer is the only option that reflects the information regarding the seasonal
nature of the disorder.
DIF: Cognitive level: Applying TOP: Nursing process: Implementation
MSC: Client Needs: Psychosocial Integrity
4. Which adolescent would the nurse consider having the highest priority for health promotion
interventions aimed at reducing risk for depression, based on the person‘s history?
a. Parents killed in an auto accident
Steele: Keltner’s Psychiatric Nursing,
MULTIPLE CHOICE
1. Which account of a patient‘s history and symptoms is most consistent with the diagnosis of
dysthymia?
a. Depressed mood for 2 weeks; anhedonia; feelings of worthlessness
b. Delusions of guilt and poverty; weight loss; agitation beginning 3 weeks ago
c. Depressed mood for 3 months; suicidal ruminations; hypersomnia; sullen affect
d. Depressed for 3 years; poor concentration; anhedonia; low self-esteem; indecision
ANS: D
Dysthymia is a depressive disorder marked by chronicity. The depression must have been present
most of the time for at least 2 years. The other options describe major depression and psychotic
depression.
DIF: Cognitive level: Applying TOP: Nursing process: Assessment
MSC: Client Needs: Psychosocial Integrity
2. Which intervention has the highest priority for inclusion in the care plan of a client diagnosed
with anhedonia?
a. Assess history of seasonal variations of mood.
b. Observe for increased sensitivity to rejection.
c. Monitor and document sleep patterns.
d. Assess for echolalia and posturing.
ANS: C
, Individuals with the depressive variant of melancholia often display anhedonia, depression worse
in the morning, early-morning awakening, anorexia and/or weight loss, and inappropriate guilt. It
is appropriate to monitor sleep patterns to ascertain if sleep disturbance is present. Homeostasis
is contingent on adequate sleep. The distracters are seen in depression with catatonic features,
atypical depression, and seasonal affective disorder.
DIF: Cognitive level: Analyzing TOP: Nursing process: Planning
MSC: Client Needs: Physiologic Integrity
3. A patient diagnosed with seasonal affective disorder asks, ―Will I ever feel better?‖ Based on an
understanding of this psychopathology, what is the nurse‘s best response?
a. ―Your depressed mood will probably spontaneously improve in 6 months to a
year.‖
b. ―People with seasonal affective disorder usually feel better in spring and summer,
when there are longer periods of light.‖
c. ―It‘s important to engage in community activities to improve your depressed
mood. Activity stimulates important brain chemicals.‖
d. ―Most people with seasonal affective disorder feel better during the fall and winter
seasons as they experience the pleasure of the holidays.‖
ANS: B
Seasonal affective disorder is a depression occurring in conjunction with a seasonal change, most
often beginning in fall and winter and remitting in spring in the Northern Hemisphere. The
correct answer is the only option that reflects the information regarding the seasonal
nature of the disorder.
DIF: Cognitive level: Applying TOP: Nursing process: Implementation
MSC: Client Needs: Psychosocial Integrity
4. Which adolescent would the nurse consider having the highest priority for health promotion
interventions aimed at reducing risk for depression, based on the person‘s history?
a. Parents killed in an auto accident
