Nokea
A nurse worked with a patient diagnosed with major depressive disorder who was severely withdrawn and dependent on others. After 3 weeks, the patient did not improve. The nurse is at risk for what emotional response?
- A. Overinvolvement
- B. Guilt and despair
- C. Disinterest and apathy
- D. Ineffectiveness and frustration
Correct Answer: D
Rationale: Nurses may have expectations for self and patients that are not wholly realistic, especially regarding the patient's progress toward health. Unmet expectations result in feelings of ineffectiveness, anger, or frustration. Guilt and despair might be observed when the nurse experiences feelings about patients because of sympathy. Disinterest and apathy are possible but not the most likely result. The correct response is more global than over-involvement.
You may also like to solve these questions
A student nurse caring for a patient diagnosed with major depressive disorder reads in the patient's medical record, 'This patient shows vegetative signs of depression.' Which nursing diagnoses most clearly relate to the vegetative signs?
- A. Imbalanced nutrition: less than body requirements
- B. Chronic low self-esteem
- C. Sexual dysfunction
- D. Self-care deficit
- E. Powerlessness
- F. Insomnia
Correct Answer: A,C,D,F
Rationale: Vegetative signs of depression are alterations in the body processes necessary to support life and growth, such as eating, sleeping, elimination, and sexual activity. These diagnoses are more closely related to vegetative signs than to diagnoses associated with feelings about self.
A patient diagnosed with major depressive disorder shows vegetative signs of depression. Which nursing actions should be implemented?
- A. Offer laxatives, if needed.
- B. Monitor food and fluid intake.
- C. Provide a quiet sleep environment.
- D. Eliminate all daily caffeine intake.
- E. Restrict the intake of processed foods.
Correct Answer: A,B,C
Rationale: The correct options promote a normal elimination pattern. Although excessive intake of stimulants such as caffeine may make the patient feel jittery and anxious, small amounts may provide useful stimulation. No indication exists that processed foods should be restricted.
A patient's employment is terminated, and major depressive disorder develops shortly afterward. The patient says to the nurse, 'I'm not worth the time you spend with me. I'm the most useless person in the world.' Which nursing diagnosis applies?
- A. Powerlessness
- B. Defensive coping
- C. Situational low self-esteem
- D. Disturbed personal identity
Correct Answer: C
Rationale: The patient's statements express feelings of worthlessness and most clearly relate to the nursing diagnosis of situational low self-esteem. Insufficient information exists to justify the other diagnoses.
The admission note indicates a patient diagnosed with major depressive disorder has displayed symptomology of both anergia and anhedonia. For which measures should the nurse plan?
- A. Channeling excessive energy
- B. Reducing guilty ruminations
- C. Instilling a sense of hopefulness
- D. Assisting with self-care activities
- E. Accommodating psychomotor retardation
Correct Answer: C,D,E
Rationale: Anhedonia refers to the inability to find pleasure or meaning in life; thus, planning should include measures to accommodate psychomotor retardation, assist with activities of daily living, and instill hopefulness. Anergia is the lack of energy, not excessive energy. Anhedonia does not necessarily imply the presence of guilty ruminations.
An adult diagnosed with major depressive disorder was treated with medication and cognitive behavioral therapy. The patient now recognizes how passivity contributed to the depression. Which intervention should the nurse suggest?
- A. Social skills training
- B. Relaxation training classes
- C. Use of complementary therapy
- D. Learning desensitization techniques
Correct Answer: A
Rationale: Social skills training is helpful in treating and preventing the recurrence of depression. Training focuses on assertiveness and coping skills that lead to positive reinforcement from others and the development of a patient's support system. The use of complementary therapy refers to adjunctive therapies such as herbals. Assertiveness would be of greater value than relaxation training because passivity is a concern. Desensitization is used in the treatment of phobias.