C HAPTER 14: D EPRESSIVE D ISORDERS
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. Major depression resulted after a patients employment was terminated.
The patient now says t o the nurse, Im not worth the time you spend with
me. I am the most useless person in the world. Which nursing diagnosis
applies?
a. Powerlessness
b. Defensive coping
c. Situational low self -esteem
d. Disturbed personal identit y
ANS: C
The patients statements ex press feelings of worthlessness and most
clearl y relate to the nursing diagnosis of situational low self -esteem.
Insufficient information exists to lead to other diagnoses.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 243 TOP: Nursing Process: Diagnosis/Anal ysis
MSC: Client Needs: Psychosocial Integrity
2. A patient diagnosed with major depression does not interact with others
except when addressed, and then onl y in monosyllables. The nurse wants
to show nonjudgmental acceptance and support for the patient. Which
communication technique will be effective?
, a. Make observations.
b. Ask the patient direct questions.
c. Phrase questions to require yes or no answers.
d. Frequentl y reassure the patient to reduce guilt feelings.
ANS: A
Making observations about n eutral topics such as the environment
draws the patient into the realit y around him or her but places no
burdensome expectations for answers on the patient. Acceptance and
support are shown by the nurses presence. Direct questions may make
the patient feel that the encounter is an interrogation. Open - ended
questions are preferable if the patient is able to participate in dialogue.
Platitudes are never acceptable. They minimize patient feelings and can
increase feelings of worthlessness.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 254 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
3. A patient being treated for depression has taken 300 mg amitript yline
(Elavil) dail y for a year. The patient calls the case manager at the clinic
and says, I stopped taking m y antidepressant 2 days ago. Now I am having
cold sweats, nausea, a rapid heartbeat, and nightmares. The nurse will
advise the patient to:
a. Go to the nearest emergency department immediatel y.
b. Do not to be alarmed. T ake two aspirin and drink plent y of fluids.
c. Take a dose of your antidepressant now and come to the clinic to
see the health care provider.
d. Resume taking your antidepressants for 2 more weeks and then
discontinue them again.
, ANS: C
The patient has symptom s associated with abrupt withdrawal of the
tricyclic antidepressant. Taking a dose of the drug will ameliorate the
s ymptoms. Seeing the health care provider will allow the patient to
discuss the advisabilit y of going off the medication and to be given a
gradual withdrawal schedule if discontinuation is the decision. This
situation is not a medical emergency, although it calls for medical
advice. Resuming taking the antidepressant for 2 more weeks and then
discontinuing again would produce the same symptoms the patient is
experiencing.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 256 TOP: Nursing Process: Implementation
MSC: Client Needs: Physiological Integrity
4. Which documentation for a patient diagnosed with major depression
indicates the tre atment plan was effective?
a. Slept 6 hours uninterrupted. Sang with activit y group. Anticipates
seeing grandchild.
b. Slept 10 hours uninterrupted. Attended craft group; stated project
was a failure, just like me.
c. Slept 5 hours with brief interruptions. Persona l hygiene adequate
with assistance. Weight loss of 1 pound.
d. Slept 7 hours uninterrupted. Preoccupied with perceived
inadequacies. States, I feel tired all the time.
ANS: A
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. Major depression resulted after a patients employment was terminated.
The patient now says t o the nurse, Im not worth the time you spend with
me. I am the most useless person in the world. Which nursing diagnosis
applies?
a. Powerlessness
b. Defensive coping
c. Situational low self -esteem
d. Disturbed personal identit y
ANS: C
The patients statements ex press feelings of worthlessness and most
clearl y relate to the nursing diagnosis of situational low self -esteem.
Insufficient information exists to lead to other diagnoses.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 243 TOP: Nursing Process: Diagnosis/Anal ysis
MSC: Client Needs: Psychosocial Integrity
2. A patient diagnosed with major depression does not interact with others
except when addressed, and then onl y in monosyllables. The nurse wants
to show nonjudgmental acceptance and support for the patient. Which
communication technique will be effective?
, a. Make observations.
b. Ask the patient direct questions.
c. Phrase questions to require yes or no answers.
d. Frequentl y reassure the patient to reduce guilt feelings.
ANS: A
Making observations about n eutral topics such as the environment
draws the patient into the realit y around him or her but places no
burdensome expectations for answers on the patient. Acceptance and
support are shown by the nurses presence. Direct questions may make
the patient feel that the encounter is an interrogation. Open - ended
questions are preferable if the patient is able to participate in dialogue.
Platitudes are never acceptable. They minimize patient feelings and can
increase feelings of worthlessness.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 254 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
3. A patient being treated for depression has taken 300 mg amitript yline
(Elavil) dail y for a year. The patient calls the case manager at the clinic
and says, I stopped taking m y antidepressant 2 days ago. Now I am having
cold sweats, nausea, a rapid heartbeat, and nightmares. The nurse will
advise the patient to:
a. Go to the nearest emergency department immediatel y.
b. Do not to be alarmed. T ake two aspirin and drink plent y of fluids.
c. Take a dose of your antidepressant now and come to the clinic to
see the health care provider.
d. Resume taking your antidepressants for 2 more weeks and then
discontinue them again.
, ANS: C
The patient has symptom s associated with abrupt withdrawal of the
tricyclic antidepressant. Taking a dose of the drug will ameliorate the
s ymptoms. Seeing the health care provider will allow the patient to
discuss the advisabilit y of going off the medication and to be given a
gradual withdrawal schedule if discontinuation is the decision. This
situation is not a medical emergency, although it calls for medical
advice. Resuming taking the antidepressant for 2 more weeks and then
discontinuing again would produce the same symptoms the patient is
experiencing.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 256 TOP: Nursing Process: Implementation
MSC: Client Needs: Physiological Integrity
4. Which documentation for a patient diagnosed with major depression
indicates the tre atment plan was effective?
a. Slept 6 hours uninterrupted. Sang with activit y group. Anticipates
seeing grandchild.
b. Slept 10 hours uninterrupted. Attended craft group; stated project
was a failure, just like me.
c. Slept 5 hours with brief interruptions. Persona l hygiene adequate
with assistance. Weight loss of 1 pound.
d. Slept 7 hours uninterrupted. Preoccupied with perceived
inadequacies. States, I feel tired all the time.
ANS: A
