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The nurse is assessing a client's affect while discussing common issues such as the weather and family. The client appears sad with a slow speech pattern. The nurse considers that this may be a sign of depression but understands that the physician will want to rule out which medical condition first?
- A. Mania
- B. Hypothyroidism
- C. A pituitary deficiency
- D. A cerebral vascular accident
Correct Answer: B
Rationale: When a nurse identifies that a client is experiencing symptoms of depression, it is essential that other conditions, which may produce similar symptoms, be ruled out. One condition that mimics depression is hypothyroidism. Mania increases and exaggerates actions and speech patterns. Common symptoms of a pituitary deficiency include a deficiency in hormones such as luteinizing hormone (LH) and follicle-stimulating hormone (FSH) and growth hormones. A cerebrovascular accident exhibits physical and mental changes.
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The nurse is employed in a pediatric mental health clinic. Which statement made by the client is an indication of a clinical effect of selective serotonin reuptake inhibitors (SSRI)?
- A. I have gained 25 lb in the last year.
- B. I feel that I am so sleepy all of the time.
- C. No one cares about me. I just want to die.
- D. I have a difficult time concentrating.
Correct Answer: C
Rationale: In the pediatric client, clinical evidence has stated an ominous link between SSRI use and an increased risk of suicidal thoughts and behavior. Some side effects of medication use include nausea, weight loss, insomnia, nervousness, tremor, and headache.
What mood disorder has alternating sad and elated mood, resembling bipolar disorder, but less extreme mood shifts?
- A. Euthymia
- B. Dysthymia
- C. Cyclothymia
- D. Psychotic depression
Correct Answer: C
Rationale: Cyclothymia, alternating sad and elated moods, resembling bipolar disorder, but the extremes of mood are less pronounced. People with normal moods are referred to as euthymic. Dysthymia is a feeling of unremitting sadness and is similar to but less severe than major depression. Psychotic depression encompasses an extreme form of depressive disorder and some persons experience hallucinations and delusions.
The nurse is caring for an older adult client diagnosed with bipolar disorder. Which manifestation of the disease can the nurse anticipate?
- A. The disease remits as the client ages.
- B. The disease increases as the client ages.
- C. The depression increases as the client ages.
- D. The manic phase increases as the client ages.
Correct Answer: C
Rationale: Older adult clients with bipolar disorder typically experience depressive episodes that increase in frequency and last longer. The increase for functional decline occurs, which may necessitate further care.
The nurse is caring for a client who reports 'not feeling very well.' When asking the client for specific symptoms, the client is vague with details but does state feeling better when the sun is shining. With this information, the nurse would document which disorder as a possibility?
- A. Major depression
- B. Seasonal affective disorder
- C. Bipolar disorder
- D. Reactive depression
Correct Answer: B
Rationale: The nurse would document seasonal affective disorder as a possibility based on the comments of feeling better when there is sunlight. The other options do not relate to sunlight or time of the year.
The nurse is providing instruction to a community class regarding seasonal affective disorder (SAD). Which gland and hormone would the nurse stress is responsible?
- A. Thyroid gland and thyroxin
- B. Pineal gland and melatonin
- C. Pancreas and insulin
- D. Pituitary gland and oxytocin
Correct Answer: B
Rationale: The hypothalamus relays the light-sensing data from the sun to the pineal gland. The pineal gland regulates the hormone melatonin. Melatonin also affects the regulation of serotonin, which affects mood.