Nokea
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.
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Which meal would the nurse provide to best meet the nutritional needs of a client who is manic?
- A. Peanut butter sandwich, chips, cola
- B. Fried chicken, mashed potatoes, milk
- C. Ham sandwich, cheese slices, milk
- D. Spaghetti, garlic bread, salad, tea
Correct Answer: C
Rationale: Finger foods like a ham sandwich and cheese slices are high in calories and protein, suitable for a manic client's mobility.
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.
The nurse observes a client sitting alone at a table, looking sad and preoccupied. The nurse sits down and says, 'I saw you sitting alone and thought I might keep you company.' The client turns away from the nurse. Which would be the most therapeutic nursing intervention?
- A. Move to another chair closer to the client and say, 'The staff is here to help you.'
- B. Move to a chair a little further away and say, 'We can just sit together quietly.'
- C. Remain in place and say, 'How are you feeling today?'
- D. Say, 'I'll visit with you a little later,' and leave the client alone for a while.
Correct Answer: B
Rationale: Offering quiet companionship while respecting personal space conveys acceptance and supports the depressed client.
A client with mania is in the dining room at lunchtime and is observed taking food from other clients' trays. The nurse's intervention should be based on which rationale?
- A. As soon as lunch is over, the client will calm down.
- B. Other clients need to be protected from the intrusive behavior.
- C. The client's behavior is not an imminent threat to anyone's physical safety.
- D. The client needs food and fluids in any way possible.
Correct Answer: B
Rationale: Protecting other clients from intrusive behavior upholds their rights and maintains a safe environment.
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.