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A client asks the nurse why he has to go to therapy and cannot just take his prescribed antidepressant medication. Which would be the most therapeutic nursing intervention?
- A. Stating, 'The effects of medications will not last forever. You will need to eventually learn to function without them.'
- B. Stating, 'Medications help your brain function better, but the therapy helps you achieve lasting behavior change.'
- C. Stating, 'Both are recommended. Since your insurance covers both, that is the best plan for you.'
- D. Asking, 'Do you have reservations about going to therapy?'
Correct Answer: B
Rationale: Therapy complements medication by fostering lasting behavioral changes, addressing underlying issues.
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A client has just been diagnosed as having major depression. At which time would the nurse expect the client to be at highest risk for self-harm?
- A. Immediately after a family visit
- B. On the anniversary of significant life events in the client's life
- C. During the first few days after admission
- D. Approximately 2 weeks after starting antidepressant medication
Correct Answer: D
Rationale: The risk of self-harm increases about 2 weeks after starting antidepressants, as energy improves before mood stabilizes.
Which client is at highest risk for carrying out a suicide plan?
- A. A client who plans to take a bottle of sleeping pills.
- B. A client who says, 'My life is over.'
- C. A client who has a private gun collection.
- D. A client who says, 'I'm going to jump off the next bridge I see.'
Correct Answer: C
Rationale: Access to a lethal means like a gun collection significantly increases the likelihood of completing a suicide plan.
Which variables represent the highest risk for developing major depressive disorder? Select all that apply.
- A. Male gender
- B. Mood disorder in first-degree relatives
- C. Substance abuse
- D. Divorced
- E. Older adult
Correct Answer: B,D
Rationale: Family history of mood disorders and being single or divorced increase the risk of major depressive disorder.
Which is a Freudian explanation of the etiology of depression?
- A. Depression is a reaction to a distressing life experience.
- B. Depression results from being raised by rejecting or unloving parents.
- C. Depression results from cognitive distortions.
- D. Depression is anger turned inward.
Correct Answer: D
Rationale: Freud's theory posits that depression arises from internalized anger due to real or perceived loss, leading to self-reproach.
Which may contribute to a staff person being less effective in dealing with a person who is at increased risk for suicide? Select all that apply.
- A. Negative societal view of suicide
- B. Feeling inadequate and anxious about suicide and/or his or her own mortality
- C. Having personally considered suicide but decided against it and not having dealt with the associated anxiety
- D. Being unaware of his or her own feelings and beliefs about suicide
- E. Implementing nursing interventions to decrease the risk of suicide
Correct Answer: A,B,C,D
Rationale: Negative societal views, personal anxiety, unresolved suicidal thoughts, and lack of self-awareness can impair effective care for suicidal clients.