NSG 4067 FINAL EXAM QUESTIONS BANK/: Chapter 15- Impaired Affective Function- Depression/(ANSWERS VERIFIED 100% CORRECT)

Origin: Chapter 15- Impaired Affective Function- Depression, 1 1.A nurse monitors older adults in a long-term care facility. Which of the following symptoms would require follow-up by the nurse to assess for depression in the older adult? A) Anorexia B) Weakness C) Labile affect D) Impaired perceptions Ans: A Feedback: Appetite disturbances, particularly anorexia, are among the most common physical complaints of depressed older adults. Individuals with dementia have the following symptoms: vague fatigue, labile affect, and physical complaints that are easily forgotten. Origin: Chapter 15- Impaired Affective Function- Depression, 2 2.A nurse is reviewing the side effects of antidepressants with a group of older adults. Which of the following statements by a member of the group indicates that the nurse's teaching has been effective? A) "I will start on the dose that I will take for life." B) "Fluoxetine should be given in the evening because it may help me sleep." C) "I need to maintain my fluid intake while on antidepressant medication." D) "The length of antidepressant treatment is usually 3 months for a first-time depression." Ans: C Feedback: An increase in fluid intake helps prevent the risk of postural hypotension. Dosages can be increased gradually until maximal therapeutic levels are reached, while observing for adverse effects. Fluoxetine should be given in the afternoon because of agitation. The length of treatment is usually 6 months for a first-time depression. Origin: Chapter 15- Impaired Affective Function- Depression, 3 3.A nurse monitors for depression in the older adult population. Which of the following are a risk factor and a functional consequence of depression in the older adult? (Select all that apply.) A) Chronic pain B) Functional impairment C) Hypernatremia D) Nutritional deficiencies E) Renal impairment Ans: A, B, D Feedback: Chronic pain, functional impairment, and nutritional deficiencies are both contributing factors and consequences of depression in the older adult. Renal impairment and hypernatremia are not specifically related to depression. Page 1 This study source was downloaded by from CourseH on 04-09-2022 23:33:39 GMT -05:00 Your text here 1 Origin: Chapter 15- Impaired Affective Function- Depression, 4 4.A nurse educator teaches about theories of late-life depression. Which of the following statements by a student shows that the material is understood? A) "Adverse events impair your ability to evaluate yourself." B) "Depression is caused by decreased activity in the hypothalamic–pituitary–adrenal axis." C) "Older adults with depression and chronic illness have more serious negative functional consequences." D) "Researchers have identified a cause-and-effect relationship between depression and dementia." Ans: C Feedback: Studies consistently find that the co-occurrence of depression with chronic conditions in older adults is associated with more serious negative functional consequences. Cognitive theory says that distorted perceptions, not adverse (unfavorable) events, impair one's ability to appraise oneself and the event constructively. Increased plasma cortisol levels and increased activity of the hypothalamic–pituitary–adrenal axis can lead to depression. Researchers have identified neuropathologic changes but have not identified a specific cause-and-effect relationship between dementia and depression. Origin: Chapter 15- Impaired Affective Function- Depression, 5 5.When risk factors to potential suicide have been identified, a nurse must further assess the actual risk for a suicide attempt. Which of the following questions would be appropriate for initial assessment to determine the presence or absence of suicidal thoughts in an older adult with risk factors? A) "Under what circumstances would you take your life? Have you ever started to act on a plan to harm yourself?" B) "Do you have a plan for taking your life? What action would you take if you were to harm yourself?" C) "Does your life feel worthless? Do you ever think about escaping from your problems?" D) "Do you think about harming yourself? Do you ever think about committing suicide?" Ans: C Feedback: Suicide assessment is multilevel, and each level of questions depends on the response the client gives to the previous level's questions. Level 1 questions determine the presence or absence of suicidal thoughts. Level 1 questions are indirect; at level 2, they become more direct. Level 2 determines the presence or absence of thoughts about self-harm. Level 3 questions determine whether the client has a realistic suicide plan. Origin: Chapter 15- Impaired Affective Function- Depression, 6 Page 2 This study source was downloaded by from CourseH on 04-09-2022 23:33:39 GMT -05:00 6.A gerontological nurse conducts an assessment of an older adult who has a history of depression. Assessment reveals that the client has been drinking up to two bottles of wine each day for the last several months. What should the nurse teach the client about alcohol use and depression? A) "If you choose to use alcohol to address your depression, it's best to limit it to four to five drinks each day." B) "We recommend that everyone over the age of 70 abstain from drinking alcohol." C) "Alcohol has been shown to contribute to depression and vice versa." D) "If you quit drinking, your depression will likely improve." Ans: C Feedback: Alcohol and depression have a synergistic relationship: alcohol causes depression, depression leads to alcohol abuse, which, in turn, exacerbates the depression. Four or five drinks daily is excessive, but abstinence is not necessary for all older adults. Abstinence is not guaranteed to improve symptoms of depression. Origin: Chapter 15- Impaired Affective Function- Depression, 7 7.An older adult has been accompanied by an adult child to visit a primary care provider. The child has expressed concern about the client's increasing apathy, isolation, and apparent sadness over the past several months; and the client acknowledges many of the symptoms of depression. Which of the following assessments should the nurse prioritize? A) Functional assessment B) Medication assessment C) Musculoskeletal assessment D) Cardiovascular assessment Ans: B Feedback: Medications may be risk factors for depression in numerous ways. A functional assessment is necessary, but this is more likely to ascertain the effects, rather than causes, of her depression. Musculoskeletal and cardiovascular assessments are secondary. Origin: Chapter 15- Impaired Affective Function- Depression, 8 8.Which of the following statements by residents of a nursing home should prompt a nurse to assess for depression? A) "Lately I wake up for the day at 4:00 or 5:00 in the morning and can't fall asleep again." B) "I've got these cravings for sugary and salty snacks more than I used to." C) "I've never been too prone to headaches, but these days I always seem to have one." D) "I don't know why this sore on my ankle just won't heal this time." Ans: A Feedback: Early morning waking is a sleep disturbance that is characteristic of depression. Headaches and impaired healing may also be linked with depression, but sleep disturbances are more highly associated with the problem. Food cravings are not typical