Chapters 14 and 25 P.Q.'s Flashcards Preview

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Flashcards in Chapters 14 and 25 P.Q.'s Deck (10):
1

The nurse is caring for a patient who exhibits disorganized thinking and delusions. The patient repeatedly states, “I hear voices of aliens trying to contact me.” The nurse should recognize this presentation as which type of major depressive disorder (major depression)?

a. Seasonal Affective Disorder

b. Dysthymic Disorder 

c.) Premenstrual Dysphoric Disorder

d.) Psychotic

d.) Psychotic

2

A nurse is educating a patient about the causes of depression. Which statement lets the nurse know the patient understands the neurobiological theory of depression?

a. “My depression is made worse because my marriage is stressful.” 

b.) “Sometimes I believe that I can’t help myself. That’s why I get so depressed.”

c.) “I’m depressed because my parents were depressed.”

d.) “If I take these medications as prescribed, I should start to think clearly and feel energized.” 

d.) “If I take these medications as prescribed, I should start to think clearly and feel energized.”

3

The nurse is planning care for a patient with depression who will be discharged to home soon. What aspect of teaching should be the priority on the nurse’s discharge plan of care?

a.) Pharmacological teaching

b.) Safety risk

c.) Awareness of symptoms that increase depression

d.) The need for interpersonal contact 

c.) Awareness of symptoms that increase depression

4

The nurse is reviewing orders given for a patient with depression. Which order should the nurse question?

a.) A low starting dose of a tricyclic antidepressant

b. An SSRI given initially with an MAOI 

c.) Electroconvulsive therapy to treat suicidal thoughts

d.) Elavil to address the patient’s agitation

b. An SSRI given initially with an MAOI

5

A female patient tells the nurse that she would like to begin taking St. John’s wort for depression. What teaching should the nurse provide?

a.) “St. John’s wort should be taken several hours after your other antidepressant.”

b.) “St. John’s wort has generally been shown to be effective in treating depression.”

c.) “This supplement is safe to take if you are pregnant.”

d.) “St. John’s wort is regulated by the FDA, so you can be assured of its safety.” 

b.) “St. John’s wort has generally been shown to be effective in treating depression.”

6

Griffin is a 19-year-old student who volunteers for a depression screening at his college. He identifies himself as gay. Which of the following is true based on current knowledge of the gay, lesbian, and bisexual community and suicide risk?

a.) Griffin’s sexual preference has no bearing on suicide risk.

b.) Griffin has a higher suicide risk than his heterosexual peers. 

c.) Griffin has a lower suicide risk than his heterosexual peers.

d.) Griffin may experience a threefold risk for a mood disorder in his lifetime because of his sexual preference. 

b.) Griffin has a higher suicide risk than his heterosexual peers.

7

You are admitting Joel, a 39-year-old patient with depression. Which assessment statement(s) would be appropriate to ask Joel to assess suicide risk? Select all that apply.

a.) Do you ever think about suicide?

b.) Are you thinking of hurting yourself?

c.) Do you sometimes wish you were dead?

d.) Has it ever seemed as if life is not worth living?

e.) If you were to kill yourself, how would you do it?

f.) Does it seem as if others might be better off if you were dead? 

all of them

a.) Do you ever think about suicide?

b.) Are you thinking of hurting yourself?

c.) Do you sometimes wish you were dead?

d.) Has it ever seemed as if life is not worth living?

e.) If you were to kill yourself, how would you do it?

f.) Does it seem as if others might be better off if you were dead? 

8

Which person is at the highest risk for suicide?

a.) A 50-year-old married white male with depression who has a plan to overdose if circumstances at work do not improve.

b.) A 45-year-old married white female who recently lost her parents, suffers from bipolar disorder, and attempted suicide once as a teenager.

c.) A young, single white male who is alcohol dependent, hopeless, impulsive, has just been rejected by his girlfriend, and has ready access to a gun he has hidden.

d.) An older Hispanic male who is Catholic, is living with a debilitating chronic illness, is recently widowed, and states: “I wish that God would take me too.” 

c.) A young, single white male who is alcohol dependent, hopeless, impulsive, has just been rejected by his girlfriend, and has ready access to a gun he has hidden.

9

Which intervention(s) maximize the safety of a patient who is actively suicidal on an inpatient mental health unit? Select all that apply.

a.) Place the patient on every-15-minute checks.

b.) Place the patient in a room near the nurses’ station. 

c.) Allow the patient periods of time alone for reflection to promote self-awareness.

d.) Install breakaway curtain rods, coat hooks, and shower rods.

e.) Allow the patient to keep personal objects such as a razor and hair dryer in his room to demonstrate trust.

f.) Assign the patient to a private room to facilitate monitoring. 

a, b, d

a.) Place the patient on every-15-minute checks.

b.) Place the patient in a room near the nurses’ station. 

d.) Install breakaway curtain rods, coat hooks, and shower rods.

10

Kara is a 23-year-old patient admitted with depression and suicidal ideation. Which intervention(s) would be therapeutic for Kara? Select all that apply.

a.) Focus primarily on developing solutions to the problems that are leading the patient to feel suicidal.

b.) Assess the patient thoroughly, and reassess the patient at regular intervals as levels of risk fluctuate.

c.) Avoid talking about the suicidal ideation as this may increase the patient’s risk for suicidal behavior.

d.) Meet regularly with the patient to provide opportunities for the patient to express and explore feelings.

e.) Administer antidepressant medications cautiously and conservatively because of their potential to increase the suicide risk in Kara's age group.

f.) Help the patient to identify positive self-attributes and to question negative self-perceptions that are unrealistic. 

b, d, e, f

b.) Assess the patient thoroughly, and reassess the patient at regular intervals as levels of risk fluctuate.

d.) Meet regularly with the patient to provide opportunities for the patient to express and explore feelings.

e.) Administer antidepressant medications cautiously and conservatively because of their potential to increase the suicide risk in Kara's age group.

f.) Help the patient to identify positive self-attributes and to question negative self-perceptions that are unrealistic.