According to the Diagnostic and Statistical Manual, 5th Edition (DSM-5), how many symptoms should be present for at least two weeks before a diagnosis of adolescent depression is made?
- A. 2
- B. 3
- C. 4
- D. 5
Correct Answer: D
Rationale: DSM-5 requires 5 symptoms (including depressed mood or loss of interest) for at least 2 weeks for a Major Depressive Disorder diagnosis.
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The nurse at the clinic is interviewing a patient who offers a number of vague somatic complaints that might not ordinarily prompt a visit to a caregiver: fatigue, back pain, and seems tense. After having spoken of the symptoms, the nurse can best serve the patient by:
- A. Asking if the patient has ever had psychiatric counseling.
- B. Completing a structured abuse assessment protocol.
- C. Suggesting the patient take a break from work.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B: Completing a structured abuse assessment protocol. In this scenario, the patient presents with vague somatic complaints that could potentially be indicative of underlying abuse. By completing an abuse assessment protocol, the nurse can uncover any possible abuse the patient may be experiencing, which could be the root cause of their symptoms. This approach is crucial in ensuring the patient's safety and well-being.
Choice A is incorrect because assuming the symptoms are solely related to psychiatric issues without exploring other potential causes can lead to overlooking important factors. Choice C is incorrect as suggesting a break from work may not address the underlying issue and could potentially worsen the patient's situation. Choice D is incorrect as taking no action could result in the patient's condition worsening without proper intervention.
Which assessment data suggests a person who appears to have dementia instead has depression and pseudodementia?
- A. Demonstrates impaired judgment.
- B. Demonstrates impaired concentration.
- C. Has a history of significant losses or crises.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B because impaired concentration is a key indicator of depression and pseudodementia rather than dementia. In depression, individuals may experience difficulties focusing and maintaining attention, leading to impaired concentration. Pseudodementia, which mimics dementia but is caused by depression, also presents with similar cognitive symptoms like impaired concentration. Choices A and C are incorrect because impaired judgment and significant losses or crises can be present in both dementia and depression, making them less specific to differentiating between the two conditions. Choice D is incorrect as choice B clearly distinguishes the cognitive symptomatology between dementia and depression/pseudodementia.
Which information should the nurse include when teaching a client with a personality disorder?
- A. Journal writing will help you recognize feeling states.'
- B. Try problem solving independently to help with difficult relationships.'
- C. Identify people and circumstances that create conflict; then avoid them.'
- D. Try to alleviate behaviors that cause problems relating with others.'
Correct Answer: A
Rationale: The correct answer is A because journal writing can help individuals with personality disorders recognize and better understand their emotions, leading to improved self-awareness and emotional regulation. This can be a useful tool in therapy and self-management.
Choice B is incorrect because individuals with personality disorders often struggle with interpersonal relationships and might benefit from seeking support or guidance rather than attempting to solve problems independently.
Choice C is incorrect because avoidance does not address the underlying issues and can lead to isolation and maladaptive coping mechanisms.
Choice D is incorrect because simply trying to alleviate problematic behaviors without addressing the underlying emotional issues may not lead to long-term improvement in relationships.
A nurse would attempt to reduce nighttime agitation for a patient with either delirium or dementia by:
- A. giving warm milk as a snack at bedtime.
- B. keeping a soft light on in the patient's room.
- C. placing a large-faced lighted alarm clock opposite the bed.
- D. hanging family pictures near enough to the bed to be easily seen.
Correct Answer: B
Rationale: The correct answer is B: keeping a soft light on in the patient's room. This helps to reduce nighttime agitation by providing a soothing environment without complete darkness, which can cause confusion and disorientation in patients with delirium or dementia. Warm milk (A) may not address the underlying cause of agitation. A large-faced lighted alarm clock (C) may be distracting and increase confusion. Family pictures (D) may not directly impact nighttime agitation and could potentially overstimulate the patient.
A nurse would assess for which feature in a patient diagnosed with anorexia nervosa without bingeing or purging?
- A. Extroverted personality traits
- B. Abuse of diuretics and laxatives
- C. Claims of sexual activity
- D. Denial of hunger at all times
Correct Answer: D
Rationale: The correct answer is D: Denial of hunger at all times. In anorexia nervosa without bingeing or purging, patients typically deny hunger despite severe weight loss. This is due to their distorted body image and fear of gaining weight. Assessing for denial of hunger helps in understanding their mindset and severity of the disorder.
Explanation of why other choices are incorrect:
A: Extroverted personality traits - Anorexia nervosa is often associated with introverted personality traits, not extroverted.
B: Abuse of diuretics and laxatives - This behavior is more characteristic of bulimia nervosa, not anorexia nervosa without bingeing or purging.
C: Claims of sexual activity - This choice is unrelated to the typical features of anorexia nervosa without bingeing or purging.