Chapter 14 Varcolis
10. A patient diagnosed with major depressive disorder tells the nurse, "Bad things that happen
are always my fault." Which response by the nurse will best assist the patient to reframe this
overgeneralization?
a. "I really doubt that one person can be blamed for all the bad things that happen."
b. "Let's look at one bad thing that happened to see if another explanation exists."
c. "You are being extremely hard on yourself. Try to have a positive focus."
d. "Are you saying that you don't have any good things happen?" - -ANS: B
By questioning a faulty assumption, the nurse can help the patient look at the premise more
objectively and reframe it as a more accurate representation of fact. The incorrect responses
cast doubt but do not require the patient to evaluate the statement.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 14-27, 57 (Table 14-4) TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
- 12. A patient diagnosed with depressive disorder begins selective serotonin reuptake inhibitor
(SSRI) antidepressant therapy. The nurse should provide information to the patient and family
about
a. restricting sodium intake to 1 gram daily.
b. minimizing exposure to bright sunlight.
c. reporting increased suicidal thoughts.
d. maintaining a tyramine-free diet. - -ANS: C
Some evidence indicates that suicidal ideation may worsen at the beginning of antidepressant
therapy; thus, close monitoring is necessary. Avoiding exposure to bright sunlight and
restricting sodium intake are unnecessary. Tyramine restriction is associated with monoamine
oxidase inhibitor (MAOI) therapy.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 14-25, 32, 72 (Box 14-4) TOP: Nursing Process: Implementation
MSC: Client Needs: Physiological Integrity
- 13. A nurse taught a patient about a tyramine-restricted diet. Which menu selection would the
nurse approve?
a. Macaroni and cheese, hot dogs, banana bread, caffeinated coffee
b. Mashed potatoes, ground beef patty, corn, green beans, apple pie
c. Avocado salad, ham, creamed potatoes, asparagus, chocolate cake
d. Noodles with cheddar cheese sauce, smoked sausage, lettuce salad, yeast rolls - -ANS: B
TestBankWorld.org
The correct answer describes a meal that contains little tyramine. Vegetables and fruits
contain little or no tyramine. Fresh ground beef and apple pie are safe. The other meals
contain various amounts of tyramine-rich foods or foods that contain vasopressors: avocados,
ripe bananas (banana bread), sausages/hot dogs, smoked meat (ham), cheddar cheese, yeast,
caffeine drinks, and chocolate.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 14-37, 60 (Table 14-6), 66 (Table 14-7) TOP: Nursing Process: Evaluation
MSC: Client Needs: Physiological Integrity
- 14. What is the focus of priority nursing interventions for the period immediately after
, electroconvulsive therapy (ECT) treatment?
a. Nutrition and hydration
b. Supporting physiological stability
c. Reducing disorientation and confusion
d. Assisting the patient to identify and test negative thoughts - -ANS: B
During the immediate posttreatment period, the patient is recovering from general anesthesia;
hence, the priority need is to establish and support physiological stability. Reducing
disorientation and confusion is an acceptable intervention but not the priority. Assisting the
patient in identifying and testing negative thoughts is inappropriate in the immediate
posttreatment period because the patient may be confused.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Page 14-36 TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity
- 15. A nurse provided medication education for a patient diagnosed with major depressive
disorder
who began a new prescription for phenelzine (Nardil). Which behavior indicates effective
learning? The patient
a. monitors sodium intake and weight daily.
b. wears support stockings and elevates the legs when sitting.
c. can identify foods with high selenium content that should be avoided.
d. confers with a pharmacist when selecting over-the-counter medications. - -ANS: D
Over-the-counter medicines may contain vasopressor agents or tyramine, a substance that
must be avoided when the patient takes MAOI antidepressants. Medications for colds,
allergies, or congestion or any preparation that contains ephedrine or phenylpropanolamine
may precipitate a hypertensive crisis. MAOI antidepressant therapy is unrelated to the need
for sodium limitation, support stockings, or leg elevation. MAOIs interact with
tyramine-containing foods, not selenium, to produce dangerously high blood pressure.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 14-36, 60 (Table 14-6), 66 (Table 14-7) TOP: Nursing Process: Evaluation
MSC: Client Needs: Physiological Integrity
- 17. A patient diagnosed with major depressive disorder does not interact with others except when
addressed, and then only in monosyllables. The nurse wants to show nonjudgmental
acceptance and support for the patient. Which communication technique will be effective?
a. Make observations.
b. Ask the patient direct questions.
c. Phrase questions to require yes or no answers.
d. Frequently reassure the patient to reduce guilt feelings. - -ANS: A
Making observations about neutral topics draws the patient into the reality around him or her
but places no burdensome expectations for answers on the patient. Acceptance and support are
shown by the nurse's presence. Direct questions may make the patient feel that the encounter
is an interrogation. Open-ended questions are preferable if the patient is able to participate in
dialogue. Platitudes are never acceptable. They minimize patient feelings and can increase
feelings of worthlessness.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Page 14-56 (Table 14-3) TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
- 18. A patient being treated for depression has taken sertraline daily for a year. The patient calls
the clinic nurse and says, "I stopped taking my antidepressant 2 days ago. Now I am having
10. A patient diagnosed with major depressive disorder tells the nurse, "Bad things that happen
are always my fault." Which response by the nurse will best assist the patient to reframe this
overgeneralization?
a. "I really doubt that one person can be blamed for all the bad things that happen."
b. "Let's look at one bad thing that happened to see if another explanation exists."
c. "You are being extremely hard on yourself. Try to have a positive focus."
d. "Are you saying that you don't have any good things happen?" - -ANS: B
By questioning a faulty assumption, the nurse can help the patient look at the premise more
objectively and reframe it as a more accurate representation of fact. The incorrect responses
cast doubt but do not require the patient to evaluate the statement.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 14-27, 57 (Table 14-4) TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
- 12. A patient diagnosed with depressive disorder begins selective serotonin reuptake inhibitor
(SSRI) antidepressant therapy. The nurse should provide information to the patient and family
about
a. restricting sodium intake to 1 gram daily.
b. minimizing exposure to bright sunlight.
c. reporting increased suicidal thoughts.
d. maintaining a tyramine-free diet. - -ANS: C
Some evidence indicates that suicidal ideation may worsen at the beginning of antidepressant
therapy; thus, close monitoring is necessary. Avoiding exposure to bright sunlight and
restricting sodium intake are unnecessary. Tyramine restriction is associated with monoamine
oxidase inhibitor (MAOI) therapy.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 14-25, 32, 72 (Box 14-4) TOP: Nursing Process: Implementation
MSC: Client Needs: Physiological Integrity
- 13. A nurse taught a patient about a tyramine-restricted diet. Which menu selection would the
nurse approve?
a. Macaroni and cheese, hot dogs, banana bread, caffeinated coffee
b. Mashed potatoes, ground beef patty, corn, green beans, apple pie
c. Avocado salad, ham, creamed potatoes, asparagus, chocolate cake
d. Noodles with cheddar cheese sauce, smoked sausage, lettuce salad, yeast rolls - -ANS: B
TestBankWorld.org
The correct answer describes a meal that contains little tyramine. Vegetables and fruits
contain little or no tyramine. Fresh ground beef and apple pie are safe. The other meals
contain various amounts of tyramine-rich foods or foods that contain vasopressors: avocados,
ripe bananas (banana bread), sausages/hot dogs, smoked meat (ham), cheddar cheese, yeast,
caffeine drinks, and chocolate.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 14-37, 60 (Table 14-6), 66 (Table 14-7) TOP: Nursing Process: Evaluation
MSC: Client Needs: Physiological Integrity
- 14. What is the focus of priority nursing interventions for the period immediately after
, electroconvulsive therapy (ECT) treatment?
a. Nutrition and hydration
b. Supporting physiological stability
c. Reducing disorientation and confusion
d. Assisting the patient to identify and test negative thoughts - -ANS: B
During the immediate posttreatment period, the patient is recovering from general anesthesia;
hence, the priority need is to establish and support physiological stability. Reducing
disorientation and confusion is an acceptable intervention but not the priority. Assisting the
patient in identifying and testing negative thoughts is inappropriate in the immediate
posttreatment period because the patient may be confused.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Page 14-36 TOP: Nursing Process: Planning
MSC: Client Needs: Physiological Integrity
- 15. A nurse provided medication education for a patient diagnosed with major depressive
disorder
who began a new prescription for phenelzine (Nardil). Which behavior indicates effective
learning? The patient
a. monitors sodium intake and weight daily.
b. wears support stockings and elevates the legs when sitting.
c. can identify foods with high selenium content that should be avoided.
d. confers with a pharmacist when selecting over-the-counter medications. - -ANS: D
Over-the-counter medicines may contain vasopressor agents or tyramine, a substance that
must be avoided when the patient takes MAOI antidepressants. Medications for colds,
allergies, or congestion or any preparation that contains ephedrine or phenylpropanolamine
may precipitate a hypertensive crisis. MAOI antidepressant therapy is unrelated to the need
for sodium limitation, support stockings, or leg elevation. MAOIs interact with
tyramine-containing foods, not selenium, to produce dangerously high blood pressure.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Pages 14-36, 60 (Table 14-6), 66 (Table 14-7) TOP: Nursing Process: Evaluation
MSC: Client Needs: Physiological Integrity
- 17. A patient diagnosed with major depressive disorder does not interact with others except when
addressed, and then only in monosyllables. The nurse wants to show nonjudgmental
acceptance and support for the patient. Which communication technique will be effective?
a. Make observations.
b. Ask the patient direct questions.
c. Phrase questions to require yes or no answers.
d. Frequently reassure the patient to reduce guilt feelings. - -ANS: A
Making observations about neutral topics draws the patient into the reality around him or her
but places no burdensome expectations for answers on the patient. Acceptance and support are
shown by the nurse's presence. Direct questions may make the patient feel that the encounter
is an interrogation. Open-ended questions are preferable if the patient is able to participate in
dialogue. Platitudes are never acceptable. They minimize patient feelings and can increase
feelings of worthlessness.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Page 14-56 (Table 14-3) TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
- 18. A patient being treated for depression has taken sertraline daily for a year. The patient calls
the clinic nurse and says, "I stopped taking my antidepressant 2 days ago. Now I am having
