Nclex Review: Depression, Depression NCLEX, Bipolar Disorder
NCLEX, Schizophrenia NCLEX Questions, Schizophrenia NCLEX
questions, Schizophrenia NCLEX part 2, NCLEX Schizophrenia ||
Guaranteed Pass.
The nurse is planning care with a Mexican-American client who is diagnosed with depression.
The client believes in "mal ojo" (the evil eye), and uses treatment by a root healer. The nurse
should do which of the following? 1. Avoid talking to the client about the root healer.
2. Explain to the client that Western medicine has a scientific, not mystical, basis.
3. Explain that such beliefs are superstitious and should be forgotten.
4. Involve the root healer in a consultation with the client, physician and nurse. correct answers
4.
Including the root healer gives credibility and respect to the client's cultural beliefs. Avoiding
talking about the healer demonstrates either ignorance or disregard for the client's cultural values.
Negative comparison of root healing with Western medicine not only denigrate the client's
beliefs, but are likely to alienate him or her and cause them to end treatment.
After a period of unsuccessful treatment with Elavil (amitriptyline), a woman diagnosed with
depression is switched to Parnate (tranylcypromine). Which statement by the client indicates the
client understands the side effects of Parnate?
1. "I need to increase my intake of sodium."
2. "I must refrain from strenuous exercise."
3. "I must refrain from eating aged cheese or yeast products."
4. "I should decrease my intake of foods containing sugar." correct answers 3.
Cheese and yeast products contain tyramine which the client should avoid to prevent a negative
interaction with Parnate, a monoamine oxidase (MAO) inhibitor. Sodium will not interact with
Parnate and neither exercise nor sugar needs to be limited.
The client is receiving 6 mg of selegiline transdermal system (Emsam) every 24 hours for major
depression. The nurse should judge teaching about Emsam to be effective when the client makes
which statement?
,1. "I need to avoid using the sauna at the gym."
2. "I can cut the patch and use a smaller piece."
3. "I need to wait until the next day to put on a new patch if it falls off."
4. "I might gain at least 10 lb from Emsam." correct answers 1.
Selegiline transdermal system is the first transdermal monoamine oxidase inhibitor. The client on
Emsam needs to avoid exposing the application site to external sources of direct heat, such as
saunas, heating lamps, electric blankets, heating pads, heated water beds, and prolonged direct
sunlight because heat increases the amount of selegiline that is absorbed, resulting in elevated
serum levels of selegiline. Cutting the patch and using a smaller piece will result in a decreased
amount of medication absorption, most likely leading to a worsening of the symptoms of
depression. The client should apply a new patch as soon as possible if one falls off to ensure an
adequate amount of medication absorption. Emsam is not associated with significant weight
gain, although a weight gain of 1 to 2 lb (2.2 to 4.4 kg) is possible.
A client has been taking 30 mg of duloxetine hydrochloride (Cymbalta) twice daily for 2 months
because of depression and vague aches and pains. While interacting with the nurse, the client
discloses a pattern of drinking a 6-pack of beer daily for the past 10 years to help with sleep.
What should the nurse do first?
1. Refer the client to the dual diagnosis program at the clinic.
2. Share the information at the next interdisciplinary treatment conference.
3. Report the client's beer consumption to the physician. 4. Teach the client relaxation exercises
to perform before bedtime. correct answers 3.
The nurse should report the client's beer consumption to the physician. Duloxetine should not be
administered to a client with renal or hepatic insufficiency because the medication can elevate
liver enzymes and, together with substantial alcohol use, can cause liver injury. Referring the
client to the dual diagnosis program, sharing information at the next interdisciplinary treatment
conference, and teaching the client relaxation exercises are helpful interventions for the nurse to
implement. However, reporting the findings to the physician is most important.
A client was admitted to the inpatient unit 3 days ago with a flat affect, psychomotor retardation,
anorexia, hopelessness, and suicidal ideation. The physician prescribed 75 mg of venlafaxine
extended release (Effexor XR) to be given every morning. The client interacted minimally with
the staff and spent most of the day in his room. As the nurse enters the unit at the beginning of
the evening shift, the client is smiling and cheerfully greets the nurse. He appears to be relaxed
,and joins the group for community meeting before supper. What should the nurse interpret as the
most likely cause of the client's behavior?
1. The Effexor is helping the client's symptoms of depression significantly.
2. The client's sudden improvement calls for close observation by the staff.
3. The staff can decrease their observation of the client. 4. The client is nearing discharge due to
the improvement of his symptoms. correct answers 2.
The client's sudden improvement and decrease in anxiety most likely indicates that the client is
relieved because he has made the decision to kill himself and may now have the energy to
complete the suicide. Symptoms of severe depression do not suddenly abate because most
antidepressants work slowly and take 2 to 4 weeks to provide a maximum benefit. The client will
improve slowly due to the medication. The sudden improvement in symptoms does not mean the
client is nearing discharge and decreasing observation of the client compromises the client's
safety.
The nurse is conducting an intake interview with an Asian American female who reports sadness,
physical and mental fatigue, anxiety, and sleep disturbance. Prior to the client's time with the
physician, it is important for the nurse to obtain information about the client's use of which of the
following? Select all that apply.
1. Tea.
2. Herbal medicine.
3. Breathing exercise.
4. Massage.
5. Folk healer. correct answers 1, 2, 5.
It is important for the nurse to obtain information about the client's use of tea, herbal medicine,
and a folk healer because the information is critical to the safe prescription of psychotropic
medication. Breathing exercises, massage, and acupuncture are also traditional therapies used by
the Asian American population, but do not interfere with the use of medications.
The client is taking 50 mg of lamotrigine (Lamictal) daily for bipolar depression. The client
shows the nurse a rash on his arm. What should the nurse do?
1. Report the rash to the physician.
2. Explain that the rash is a temporary adverse effect.
, 3. Give the client an ice pack for his arm.
4. Question the client about recent sun exposure. correct answers 1.
The nurse should immediately report the rash to the physician because lamotrigine can cause
Stevens-Johnson syndrome, a toxic epidermal necrolysis. The rash is not a temporary adverse
effect. Giving the client an ice pack and questioning the client about recent sun exposure are
irresponsible nursing actions because of the possible seriousness of the rash.
A nurse is conducting a psychoeducational group for family members of clients hospitalized with
depression. Which family member's statement indicates a need for additional teaching?
1. "My husband will slowly feel better as his medicine takes effect over the next 2 to 4 weeks."
2. "My wife will need to take her antidepressant medicine and go to group to stay well."
3. "My son will only need to attend outpatient appointments when he starts to feel depressed
again."
4. "My mother might need help with grocery shopping, cooking, and cleaning for a while."
correct answers 3.
Additional teaching is needed for the family member who states her son will only need to attend
outpatient appointments when he starts to feel depressed again. Compliance with medication and
outpatient follow-up are key in preventing relapse and rehospitalization. The statements
expressing expectations of feeling better as medication takes effect, needing medicine and group
therapy to stay well, and needing help with grocery shopping, cooking, and cleaning for a while
indicate the families' understanding of depression, medication, and follow-up care.
The nurse is distinguishing between delusions experienced by a client diagnosed with major
depression with psychotic features and the delusions of a client diagnosed with schizophrenia.
The essential difference is: 1. Major depression delusions are more likely to be negative than
schizophrenic delusions.
2. Major depression delusions clear up less quickly than schizophrenic delusions.
3. Major depression delusions are more likely than schizophrenic delusions to require long-
acting depot antipsychotic medication given intramuscularly.
4. Major depression delusions are more mood congruent than schizophrenic delusions. correct
answers 4.
Delusions occurring in schizophrenia tend to be more mood incongruent and more bizarre than
delusions experienced with depression. Schizophrenic delusions clear up less quickly and are
NCLEX, Schizophrenia NCLEX Questions, Schizophrenia NCLEX
questions, Schizophrenia NCLEX part 2, NCLEX Schizophrenia ||
Guaranteed Pass.
The nurse is planning care with a Mexican-American client who is diagnosed with depression.
The client believes in "mal ojo" (the evil eye), and uses treatment by a root healer. The nurse
should do which of the following? 1. Avoid talking to the client about the root healer.
2. Explain to the client that Western medicine has a scientific, not mystical, basis.
3. Explain that such beliefs are superstitious and should be forgotten.
4. Involve the root healer in a consultation with the client, physician and nurse. correct answers
4.
Including the root healer gives credibility and respect to the client's cultural beliefs. Avoiding
talking about the healer demonstrates either ignorance or disregard for the client's cultural values.
Negative comparison of root healing with Western medicine not only denigrate the client's
beliefs, but are likely to alienate him or her and cause them to end treatment.
After a period of unsuccessful treatment with Elavil (amitriptyline), a woman diagnosed with
depression is switched to Parnate (tranylcypromine). Which statement by the client indicates the
client understands the side effects of Parnate?
1. "I need to increase my intake of sodium."
2. "I must refrain from strenuous exercise."
3. "I must refrain from eating aged cheese or yeast products."
4. "I should decrease my intake of foods containing sugar." correct answers 3.
Cheese and yeast products contain tyramine which the client should avoid to prevent a negative
interaction with Parnate, a monoamine oxidase (MAO) inhibitor. Sodium will not interact with
Parnate and neither exercise nor sugar needs to be limited.
The client is receiving 6 mg of selegiline transdermal system (Emsam) every 24 hours for major
depression. The nurse should judge teaching about Emsam to be effective when the client makes
which statement?
,1. "I need to avoid using the sauna at the gym."
2. "I can cut the patch and use a smaller piece."
3. "I need to wait until the next day to put on a new patch if it falls off."
4. "I might gain at least 10 lb from Emsam." correct answers 1.
Selegiline transdermal system is the first transdermal monoamine oxidase inhibitor. The client on
Emsam needs to avoid exposing the application site to external sources of direct heat, such as
saunas, heating lamps, electric blankets, heating pads, heated water beds, and prolonged direct
sunlight because heat increases the amount of selegiline that is absorbed, resulting in elevated
serum levels of selegiline. Cutting the patch and using a smaller piece will result in a decreased
amount of medication absorption, most likely leading to a worsening of the symptoms of
depression. The client should apply a new patch as soon as possible if one falls off to ensure an
adequate amount of medication absorption. Emsam is not associated with significant weight
gain, although a weight gain of 1 to 2 lb (2.2 to 4.4 kg) is possible.
A client has been taking 30 mg of duloxetine hydrochloride (Cymbalta) twice daily for 2 months
because of depression and vague aches and pains. While interacting with the nurse, the client
discloses a pattern of drinking a 6-pack of beer daily for the past 10 years to help with sleep.
What should the nurse do first?
1. Refer the client to the dual diagnosis program at the clinic.
2. Share the information at the next interdisciplinary treatment conference.
3. Report the client's beer consumption to the physician. 4. Teach the client relaxation exercises
to perform before bedtime. correct answers 3.
The nurse should report the client's beer consumption to the physician. Duloxetine should not be
administered to a client with renal or hepatic insufficiency because the medication can elevate
liver enzymes and, together with substantial alcohol use, can cause liver injury. Referring the
client to the dual diagnosis program, sharing information at the next interdisciplinary treatment
conference, and teaching the client relaxation exercises are helpful interventions for the nurse to
implement. However, reporting the findings to the physician is most important.
A client was admitted to the inpatient unit 3 days ago with a flat affect, psychomotor retardation,
anorexia, hopelessness, and suicidal ideation. The physician prescribed 75 mg of venlafaxine
extended release (Effexor XR) to be given every morning. The client interacted minimally with
the staff and spent most of the day in his room. As the nurse enters the unit at the beginning of
the evening shift, the client is smiling and cheerfully greets the nurse. He appears to be relaxed
,and joins the group for community meeting before supper. What should the nurse interpret as the
most likely cause of the client's behavior?
1. The Effexor is helping the client's symptoms of depression significantly.
2. The client's sudden improvement calls for close observation by the staff.
3. The staff can decrease their observation of the client. 4. The client is nearing discharge due to
the improvement of his symptoms. correct answers 2.
The client's sudden improvement and decrease in anxiety most likely indicates that the client is
relieved because he has made the decision to kill himself and may now have the energy to
complete the suicide. Symptoms of severe depression do not suddenly abate because most
antidepressants work slowly and take 2 to 4 weeks to provide a maximum benefit. The client will
improve slowly due to the medication. The sudden improvement in symptoms does not mean the
client is nearing discharge and decreasing observation of the client compromises the client's
safety.
The nurse is conducting an intake interview with an Asian American female who reports sadness,
physical and mental fatigue, anxiety, and sleep disturbance. Prior to the client's time with the
physician, it is important for the nurse to obtain information about the client's use of which of the
following? Select all that apply.
1. Tea.
2. Herbal medicine.
3. Breathing exercise.
4. Massage.
5. Folk healer. correct answers 1, 2, 5.
It is important for the nurse to obtain information about the client's use of tea, herbal medicine,
and a folk healer because the information is critical to the safe prescription of psychotropic
medication. Breathing exercises, massage, and acupuncture are also traditional therapies used by
the Asian American population, but do not interfere with the use of medications.
The client is taking 50 mg of lamotrigine (Lamictal) daily for bipolar depression. The client
shows the nurse a rash on his arm. What should the nurse do?
1. Report the rash to the physician.
2. Explain that the rash is a temporary adverse effect.
, 3. Give the client an ice pack for his arm.
4. Question the client about recent sun exposure. correct answers 1.
The nurse should immediately report the rash to the physician because lamotrigine can cause
Stevens-Johnson syndrome, a toxic epidermal necrolysis. The rash is not a temporary adverse
effect. Giving the client an ice pack and questioning the client about recent sun exposure are
irresponsible nursing actions because of the possible seriousness of the rash.
A nurse is conducting a psychoeducational group for family members of clients hospitalized with
depression. Which family member's statement indicates a need for additional teaching?
1. "My husband will slowly feel better as his medicine takes effect over the next 2 to 4 weeks."
2. "My wife will need to take her antidepressant medicine and go to group to stay well."
3. "My son will only need to attend outpatient appointments when he starts to feel depressed
again."
4. "My mother might need help with grocery shopping, cooking, and cleaning for a while."
correct answers 3.
Additional teaching is needed for the family member who states her son will only need to attend
outpatient appointments when he starts to feel depressed again. Compliance with medication and
outpatient follow-up are key in preventing relapse and rehospitalization. The statements
expressing expectations of feeling better as medication takes effect, needing medicine and group
therapy to stay well, and needing help with grocery shopping, cooking, and cleaning for a while
indicate the families' understanding of depression, medication, and follow-up care.
The nurse is distinguishing between delusions experienced by a client diagnosed with major
depression with psychotic features and the delusions of a client diagnosed with schizophrenia.
The essential difference is: 1. Major depression delusions are more likely to be negative than
schizophrenic delusions.
2. Major depression delusions clear up less quickly than schizophrenic delusions.
3. Major depression delusions are more likely than schizophrenic delusions to require long-
acting depot antipsychotic medication given intramuscularly.
4. Major depression delusions are more mood congruent than schizophrenic delusions. correct
answers 4.
Delusions occurring in schizophrenia tend to be more mood incongruent and more bizarre than
delusions experienced with depression. Schizophrenic delusions clear up less quickly and are
