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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.
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Which best explains the neurochemical processes responsible for depression?
- A. Increased activity of dopamine
- B. Decreased glucocorticoid activity
- C. Decreased serotonin and norepinephrine
- D. Potentiation of GABA
Correct Answer: C
Rationale: Decreased levels of serotonin and norepinephrine in the brain are associated with depression, contributing to mood dysregulation.
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.
A client with bipolar disorder is admitted to the psychiatric unit. The client is talking loudly, walking back and forth rapidly, and exhibiting a short attention span. Which nursing intervention should occur first?
- A. Decrease the client's environmental stimuli.
- B. Give the client feedback about his behavior.
- C. Introduce the client to other staff on the unit.
- D. Tell the client about hospital rules and policies.
Correct Answer: A
Rationale: Reducing environmental stimuli is the priority to help calm an agitated client with bipolar disorder.
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.
A client who is manic threatens others on the unit. Which would be the initial nursing action in response to this behavior?
- A. Administering a sedative that has been prescribed to be used PRN.
- B. Insisting the client take a time-out in his room.
- C. Clearing the area of all other clients.
- D. Setting limits on aggressive and intimidating behavior.
Correct Answer: D
Rationale: Setting limits on aggressive behavior is the initial action to ensure safety while allowing the client to exercise self-control.