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A client with depression appears lethargic and apathetic but agrees to participate in a leisure activity group. Which nursing intervention is most likely to help the client successfully participate?
- A. Allowing the client to direct her participation at her own pace.
- B. Giving the client several choices of projects, so she can choose her favorite.
- C. Staying away from the client during the session to encourage free expression.
- D. Structuring the activity to facilitate completion of one specific task.
Correct Answer: D
Rationale: Structuring the activity ensures success for a lethargic client, supporting engagement and achievement.
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A client is being discharged on lithium. The nurse encourages the client to follow which health maintenance recommendations? Select all that apply.
- A. Weigh self weekly at the same time of day.
- B. Drink a 2-L bottle of decaffeinated fluid daily.
- C. Do not alter dietary salt intake.
- D. See the doctor if you get the flu.
- E. Restrict involvement in intense exercise.
Correct Answer: B,C,D
Rationale: Maintaining fluid intake, stable salt levels, and monitoring for illness prevent lithium toxicity and ensure therapeutic levels.
A client is admitted for major depression. What should the nurse expect to find during assessment?
- A. Anhedonia, feelings of worthlessness, and difficulty focusing
- B. Depressed mood, guilt, and pressured speech
- C. Changes in sleep pattern, tired, and grandiose mood
- D. Difficulty focusing, feelings of helplessness, and flight of ideas
Correct Answer: A
Rationale: Major depression typically presents with anhedonia, worthlessness, and difficulty focusing, unlike symptoms of mania.
A concerned family member tells the nurse, 'I am concerned about my brother. He has been acting very different lately.' Knowing the family has a history of bipolar disorder, the nurse inquiries further about this. Which behavior during the past week might indicate that the brother has bipolar disorder?
- A. Taking unnecessary risks
- B. Sleeping more
- C. Intense focus
- D. Showing low self-esteem
Correct Answer: A
Rationale: Taking unnecessary risks is a symptom of mania, characteristic of bipolar disorder, unlike the other options.
Which is a possible explanation for the increased risk of suicide in persons who have had a relative who committed suicide?
- A. The relative's suicide offers a sense of permission or acceptance of suicide as a method of escaping a difficult situation.
- B. Many people with depression who have suicidal ideation lack the energy to implement suicide plans, but antidepressant treatment can actually give clients with depression the energy to act on suicidal ideation.
- C. Suicide is more likely to occur in April when natural energy from increased sunlight may give the client the energy to act on suicidal ideation.
- D. The relative's suicide caused the family members to realize that suicide is emotionally harmful to the ones left behind and vow not to consider suicide.
Correct Answer: A
Rationale: A relative's suicide may normalize the act, increasing risk by providing a sense of acceptability.
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.