Multiple Choice
Identify the choice that best completes the statement or answers the question.
The nurse is preparing a staff education session about depression in adolescents. Which statement
1. by a staff member indicates teaching has been effective?
1. “Adolescents are not likely to suffer from depression.”
2. “Depressed adolescents normally seek immediate treatment.”
3. “Many symptoms are attributed to normal adjustments of adolescents.”
4. “Suicide is not common among depressed adolescents.”
Which highest priority outcome would the nurse add to the plan of care for a depressed client?
1. The client will promise to remain safe.
2. 2. The client will discuss feelings with staff and family by day three.
3. The client will establish a trusting relationship with the nurse.
4. The client will not harm self during hospital stay.
The nurse is assisting with electroconvulsive therapy (ECT). What is the rationale for
administering 100% oxygen to a client during and after ECT?
1. To prevent brain damage from the electrical impulse of the procedure
3. 2. To prevent decreased blood pressure, pulse, and respiration owing to
electrical stimulation
3. To prevent anoxia EXAMINER-0in0d1uced paralysis of respiratory
res muscles
4. To prevent blocked airway, resulting from seizure activity
Which action should the nurse take when a depressed client refuses electroconvulsive therapy
4. (ECT)?
1. Accept the client’s decision
2. Inform the client that the procedure is mandatory
3. Tell the client that the signature verifies informed consent
4. Call the family to receive approval
The nurse is caring for a client with major depressive disorder who is withdrawn,
uncommunicative, and secludes self in room. Which nursing diagnosis should the nurse add to the
5. plan of care?
1. Spiritual distress
2. Social isolation
3. Low self-esteem
4. Powerlessness
The client with major depressive episode is experiencing command hallucination for self-harm.
Which intervention should be the nurse’s priority at this time?
1. Obtaining an order for locked seclusion until client is no longer suicidal
6. 2. Conducting 15-minute checks to ensure safety
3. Placing the client on one-to-one observation while continuing to monitor
suicidal ideations
, 4. Encouraging client to express feelings related to suicide
The nurse assesses a client with major depressive disorder. Which assessment finding would the
7. nurse observe?
1. Sadness subsides quickly
2. Promiscuous behaviors
3. Unable to feel any pleasure
4. Excessive spending sprees
Which statement by a client who is beginning tricyclic antidepressant therapy indicates successful
teaching?
8. 1. “I will continue to take this medication even if the symptoms have not subsided.”
2. “I will start to see results in about 2 weeks.”
3. “I will continue to smoke.”
4. “I will start to cut down on my alcohol intake and have only one glass of wine
at supper.”
9. The nurse is preparing a presentation about Beck’s cognitive theory. Which cognitive distortion
would the nurse include in the teaching session?
1. Negative expectation of the environment
2. Negative expectation of the present
3. Negative expectation of the career
4. Negative expectation of the family
10. The nurse discovers a clieNntUhRaSs aI hN iGst oTr By .o d OivM or c e, job loss,
family estrangement, and cocaine
E X A M IN E R 00 1
abuse. Which theory explains the etiology of this client’s depressive symptoms?
1. Psychoanalytic theory
2. Object loss theory
3. Learning theory
4. Cognitive theory
11. The nurse performs a full physical health assessment on an older adult client admitted with
a diagnosis of major depressive disorder. What is the rationale for the nurse’s assessment?
1. The attention during the assessment is beneficial in decreasing social isolation
in the elderly.
2. Depression can generate somatic symptoms that can mask actual
physical disorders.
3. Physical health complications are likely to arise from antidepressant therapy.
4. Depressed geriatric clients avoid addressing physical health and ignore
medical problems.
12. The nurse is preparing an antidepressant medication for a 13-year-old client who is experiencing
major depressive disorder. Which FDA-approved medication should the nurse administer?
1. Paroxetine (Paxil)
2. Sertraline (Zoloft)
3. Citalopram (Celexa)
4. Escitalopram (Lexapro)
,13. Which characteristic would help a nurse distinguish between dysthymia and major depressive
disorder (MDD)?
1. Dysthymia is associated with the menstrual cycle.
2. Dysthymia is a chronically depressed mood.
3. MDD lasts for at least 2 years.
4. MDD does not have delusions or hallucinations.
14. The nurse is teaching the depressed client about bupropion (Wellbutrin). Which statement by
the client indicates effective teaching?
1. “I will begin to wear short sleeves when outdoors.”
2. “I will not take two pills if I miss a dose.”
3. “I will discontinue the medication when my depression is gone.”
4. “I will stand up smoothly and quickly to keep my balance.”
15. A client is taking phenelzine (Nardil). Which statement by the client should cause the nurse
to intervene?
1. “I cannot use over-the-counter medications for my colds.”
2. “I have to cut out eating my raisin bran every morning.”
3. “I will have to avoid pepperoni pizza when eating with my friends.”
4. “I am taking diet pills to lose weight for my friend’s wedding.”
16. The depressed client is receiving light therapy. Which instruction would the nurse share with the
client?
1. “White LED lights will be used with protective glasses to block ultraviolet rays.”
2. “You will sit in front oNfUthReSlIigENhXtGbAToMBx .wINCithOEMyRo0ur0e1yes
open.”
3. “The light sessions will start out at 5 minutes and work up to 30 minute intervals.”
4. “Vagal stimulation from the light waves will help release melatonin in the brain.”
17. Which scale would a nurse practitioner use to assess a depressed client?
1. Zung Depression Scale
2. Hamilton Depression Rating Scale
3. Beck Depression Inventory
4. AIMS Depression Rating Scale
18. The nurse is caring for a client with a postpartum emotional disorder. Which postpartum disorder
is correctly matched with its presenting symptoms?
1. Baby blues (lack of concentration, agitation, guilt, and an abnormal attitude
toward bodily functions)
2. Moderate postpartum depression (irritability, loss of libido, sleep
disturbances, expresses concern about inability to care for baby)
3. Maternity blues (overprotection of infant, severe guilt, depressed mood, lack
of concentration)
4. Postpartum depression with psychotic features (transient depressed
mood, decisive, abnormal fear of child abduction, suicidal ideations)
19. The nurse determines that a depressed client is using the cognitive distortion of “automatic
thoughts.” Which client statement is evidence of the “automatic thought” of discounting
positives?
1. “It’s all my fault for trusting him.”
, 2. “I don’t play games. I never win.”
3. “She never visits, because she thinks I don’t care.”
4. “Growing plants is so easy. Any old fool can grow a rose.”
20. A client is prescribed transdermal selegiline (Emsam) for depressive symptoms. Which action
would the nurse take to administer this medication?
1. Apply new patch to the lower abdomen.
2. Apply new patch to inner surface of upper arm.
3. Place new patch on dry, intact skin.
4. Place direct heat to new patch for a tight seal.
21. After 5 months of taking nortriptyline (Aventyl) for depressive symptoms, a client reports that the
medication doesn’t seem as effective as before. Which question should the nurse ask to determine
the cause of this problem?
1. “Are you consuming foods high in tyramine?”
2. “How many packs of cigarettes do you smoke daily?”
3. “Do you drink any alcohol?”
4. “When did you last eat yogurt?”
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
22. An older adult client has a diagnosis of dysthymic disorder. Which signs and symptoms should the
nurse expect the client to xUhibRSit I?E(NSXGelATecMBt .aINlCl OtEhMaRt 0ap0p1ly.)
1. Sad mood on most days
2. Mood rating of 2 out of 10 for the past 6 months
3. Labile mood
4. Sad mood for the past 3 years after spouse’s death
5. Pressured speech when communicating
23. The client experiences sadness and melancholia in September continuing through November.
Which factors should a nurse identify as most likely to contribute to the etiology of these
symptoms? (Select all that apply.)
1. Gender differences in social opportunities
2. Increased production of melatonin
3. Hyposecretion of cortisol
4. Less exposure to natural sunlight
5. Blockade of histamine reuptake
24. The depressed client is prescribed a monoamine oxidase inhibitor (MAOI). Which statements by
the client should indicate to a nurse that the discharge teaching about this medication has been
successful? (Select all that apply.)
1. “I’ll have to let my surgeon know about this medication before I have
my cholecystectomy.”
2. “I guess I will have to give up my glass of red wine with dinner.”
3. “I’ll have to be very careful about reading food labels.”
4. “I’m going to drink my caffeinated coffee in the morning.”
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