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NCLEX RN Exam Bank: Mood Disorders,
Therapeutic Communication & Nursing Care
Table of Contents
Subtopic 1: Assessment and Identification of Mood Disorders ......................................... 2
Subtopic 2: Therapeutic Communication Strategies in Mood Disorders........................... 10
Subtopic 3: Nursing Interventions for Acute Depressive Episodes ................................... 19
Subtopic 4: Nursing Interventions for Acute Manic Episodes .......................................... 27
Subtopic 5: Nursing Management of Bipolar Disorder (Mania and Depression Phases) ..... 36
Subtopic 6: Family Education and Support in Mood Disorders (Questions 101–120) ......... 44
Subtopic 7: Therapeutic Boundaries and Ethical Considerations in Mood Disorder Care .. 52
Subtopic 8: Mood Disorders in Adolescents and Young Adults—Therapeutic Interventions &
Education ................................................................................................................... 61
Subtopic 9: Patient-Centered Education and Empowerment in Mood Disorders .............. 69
Subtopic 10: Pharmacologic and Non-Pharmacologic Interventions for Treatment-
Resistant Mood Disorders............................................................................................ 79
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Subtopic 1: Assessment and Identification of Mood
Disorders
(Questions 1–20)
Question 1:
A patient diagnosed with major depressive disorder states, “Nothing matters anymore.”
What is the nurse’s best initial response?
A. “Try not to think that way.”
B. “Can you tell me more about what you mean?”
C. “You have people who care about you.”
D. “Have you tried journaling your thoughts?”
Correct Answer: B. “Can you tell me more about what you mean?”
Rationale: Open-ended, nonjudgmental questions facilitate further discussion and
assessment of suicidal ideation or hopelessness. It promotes therapeutic communication.
Question 2:
Which clinical finding would most likely indicate melancholic depression?
A. Grandiosity
B. Early morning awakening with lack of interest in pleasure
C. Auditory hallucinations
D. Inflated self-esteem
Correct Answer: B. Early morning awakening with lack of interest in pleasure
Rationale: Melancholic depression is characterized by early waking, anhedonia,
psychomotor changes, and profound guilt.
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Question 3:
A patient with bipolar I disorder is experiencing a manic episode. Which is the most
appropriate nursing intervention during the assessment phase?
A. Encourage the patient to make major decisions
B. Assess sleep patterns, impulsivity, and psychotic features
C. Explore childhood trauma
D. Discuss potential medication side effects
Correct Answer: B. Assess sleep patterns, impulsivity, and psychotic features
Rationale: During mania, critical assessment elements include sleep, impulsivity, and
presence of delusions or hallucinations.
Question 4:
Which tool is most appropriate for initial depression screening in primary care?
A. Mini-Mental State Exam
B. Columbia Suicide Severity Rating Scale
C. PHQ-9 (Patient Health Questionnaire-9)
D. Hamilton Anxiety Scale
Correct Answer: C. PHQ-9 (Patient Health Questionnaire-9)
Rationale: The PHQ-9 is a validated screening tool for depressive symptoms and their
severity in primary care settings.
Question 5:
A patient describes feeling “tired all the time” and has stopped engaging in hobbies. Which
mood disorder symptom is this most likely reflecting?
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A. Psychosis
B. Mania
C. Anhedonia
D. Euphoric affect
Correct Answer: C. Anhedonia
Rationale: Anhedonia is the inability to experience pleasure, a key symptom of depression.
Question 6:
Which finding requires priority intervention in a depressed adolescent?
A. Isolation from peers
B. Sudden cheerful mood after prolonged sadness
C. Sleep disturbances
D. Poor appetite
Correct Answer: B. Sudden cheerful mood after prolonged sadness
Rationale: A sudden mood lift may indicate a decision to carry out suicide and is a red flag
in suicidal risk assessment.
Question 7:
A nurse assesses a patient with major depressive disorder. Which cognitive symptom is
most likely present?
A. Increased alertness
B. Negative self-image and guilt
C. Euphoria
D. Disorganized speech
NCLEX RN Exam Bank: Mood Disorders,
Therapeutic Communication & Nursing Care
Table of Contents
Subtopic 1: Assessment and Identification of Mood Disorders ......................................... 2
Subtopic 2: Therapeutic Communication Strategies in Mood Disorders........................... 10
Subtopic 3: Nursing Interventions for Acute Depressive Episodes ................................... 19
Subtopic 4: Nursing Interventions for Acute Manic Episodes .......................................... 27
Subtopic 5: Nursing Management of Bipolar Disorder (Mania and Depression Phases) ..... 36
Subtopic 6: Family Education and Support in Mood Disorders (Questions 101–120) ......... 44
Subtopic 7: Therapeutic Boundaries and Ethical Considerations in Mood Disorder Care .. 52
Subtopic 8: Mood Disorders in Adolescents and Young Adults—Therapeutic Interventions &
Education ................................................................................................................... 61
Subtopic 9: Patient-Centered Education and Empowerment in Mood Disorders .............. 69
Subtopic 10: Pharmacologic and Non-Pharmacologic Interventions for Treatment-
Resistant Mood Disorders............................................................................................ 79
, 2
Subtopic 1: Assessment and Identification of Mood
Disorders
(Questions 1–20)
Question 1:
A patient diagnosed with major depressive disorder states, “Nothing matters anymore.”
What is the nurse’s best initial response?
A. “Try not to think that way.”
B. “Can you tell me more about what you mean?”
C. “You have people who care about you.”
D. “Have you tried journaling your thoughts?”
Correct Answer: B. “Can you tell me more about what you mean?”
Rationale: Open-ended, nonjudgmental questions facilitate further discussion and
assessment of suicidal ideation or hopelessness. It promotes therapeutic communication.
Question 2:
Which clinical finding would most likely indicate melancholic depression?
A. Grandiosity
B. Early morning awakening with lack of interest in pleasure
C. Auditory hallucinations
D. Inflated self-esteem
Correct Answer: B. Early morning awakening with lack of interest in pleasure
Rationale: Melancholic depression is characterized by early waking, anhedonia,
psychomotor changes, and profound guilt.
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Question 3:
A patient with bipolar I disorder is experiencing a manic episode. Which is the most
appropriate nursing intervention during the assessment phase?
A. Encourage the patient to make major decisions
B. Assess sleep patterns, impulsivity, and psychotic features
C. Explore childhood trauma
D. Discuss potential medication side effects
Correct Answer: B. Assess sleep patterns, impulsivity, and psychotic features
Rationale: During mania, critical assessment elements include sleep, impulsivity, and
presence of delusions or hallucinations.
Question 4:
Which tool is most appropriate for initial depression screening in primary care?
A. Mini-Mental State Exam
B. Columbia Suicide Severity Rating Scale
C. PHQ-9 (Patient Health Questionnaire-9)
D. Hamilton Anxiety Scale
Correct Answer: C. PHQ-9 (Patient Health Questionnaire-9)
Rationale: The PHQ-9 is a validated screening tool for depressive symptoms and their
severity in primary care settings.
Question 5:
A patient describes feeling “tired all the time” and has stopped engaging in hobbies. Which
mood disorder symptom is this most likely reflecting?
, 4
A. Psychosis
B. Mania
C. Anhedonia
D. Euphoric affect
Correct Answer: C. Anhedonia
Rationale: Anhedonia is the inability to experience pleasure, a key symptom of depression.
Question 6:
Which finding requires priority intervention in a depressed adolescent?
A. Isolation from peers
B. Sudden cheerful mood after prolonged sadness
C. Sleep disturbances
D. Poor appetite
Correct Answer: B. Sudden cheerful mood after prolonged sadness
Rationale: A sudden mood lift may indicate a decision to carry out suicide and is a red flag
in suicidal risk assessment.
Question 7:
A nurse assesses a patient with major depressive disorder. Which cognitive symptom is
most likely present?
A. Increased alertness
B. Negative self-image and guilt
C. Euphoria
D. Disorganized speech
