Chapter 17 - Mood Disorders and Suicide:
Test Bank for Psychiatric-Mental Health Nursing, 8th Edition
1. Which best explains the neurochemical processes responsible for depression?
A) Increased activity of dopamine
B) Decreased glucocorticoid activity
C) Decreased serotonin and norepinephrine activity
D) Potentiating of the kindling process
Answer: C
Explanation: The monoamine hypothesis of depression suggests that decreased activity of
neurotransmitters, particularly serotonin and norepinephrine, plays a key role in the
pathophysiology of depression.
2. Which is a Freudian explanation of the etiology of depression?
A) Depression is a reaction to a distressing life experience.
B) Depression results from being raised by rejecting or unloving parents.
C) Depression results from cognitive distortions.
D) Depression is anger turned inward.
Answer: D
Explanation: Freud's psychoanalytic theory proposed that depression results from internalized
anger, often related to a real or perceived loss, which is then directed inward as self-reproach.
3. Which statements about the etiology of bipolar disorder do most
psychoanalytical theories subscribe to? Select all that apply.
A) Norepinephrine levels may be increased in mania.
B) Manic episodes are a defense against underlying depression.
C) Acetylcholine seems to be implicated in mania.
D) The id takes over the ego and acts as an undisciplined hedonistic being (child).
Answer: B, D
Explanation: Psychoanalytic theories often view manic episodes as a psychological defense
against underlying depression, characterized by the id overpowering the ego, leading to
impulsive, pleasure-seeking behavior.
4. 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
Answer: B, D
Explanation: Major depression has a strong genetic component and is more common in first-
degree relatives of affected individuals. Marital status is a significant risk factor, with
divorced individuals having higher rates of depression than married or single individuals.
5. A concerned family member tells the nurse, "I am concerned about my brother.
He has been acting very different lately." Knowing the family has a history of
bipolar disorder, the nurse inquires further about this. Which behavior during
the past week might indicate that the brother has bipolar disorder?
A) Taking unnecessary risks
B) Sleeping more
C) Intense focus
D) Showing low self-esteem
Answer: A
Explanation: During manic episodes, individuals often engage in high-risk activities with
poor judgment, such as reckless spending, impulsive investments, or dangerous behaviors,
which are hallmark symptoms of bipolar disorder.
6. A client is admitted for major depression. What should the nurse expect to find
during assessment?
A) Anhedonia, feelings of worthlessness, and difficulty focusing
B) Depressed mood, guilt, and pressured speech
C) Changes in sleep pattern, tired, and grandiose mood
D) Difficulty focusing, feelings of helplessness, and flight of ideas
Answer: A
Explanation: Key symptoms of major depressive disorder include anhedonia (loss of
interest/pleasure), feelings of worthlessness, and cognitive difficulties such as impaired
concentration. Pressured speech, grandiosity, and flight of ideas are associated with mania.
7. A client has just been diagnosed as having major depression. At which time
would the nurse expect the client to be at highest risk for self-harm?
A) Immediately after a family visit
, B) On the anniversary of significant life events in the client's life
C) During the first few days after admission
D) Approximately 2 weeks after starting antidepressant medication
Answer: D
Explanation: As antidepressant medication begins to improve energy and motivation before
mood lifts, clients may have increased capacity to act on pre-existing suicidal thoughts,
making this a high-risk period.
8. The nurse is planning care for a client with major depression. Which is an
appropriate expected outcome?
A) The client will avoid causing harm to others.
B) The client will be free from stress.
C) The client will independently carry out activities of daily living.
D) The client will not experience agitation.
Answer: C
Explanation: A primary goal in depression treatment is restoring functional capacity,
including the ability to perform self-care and activities of daily living independently.
9. A client who is depressed begins to cry and states, "I'm just really sick of feeling
this way. Nothing ever seems to go right in my life." Which would be the most
appropriate response by the nurse?
A) "Don't cry. Try to look at the positive side of things."
B) "You are feeling really sad right now. It's a hard time."
C) "Hang in there. Your medication will start helping in a few days."
D) "Nothing ever goes right?"
Answer: B
Explanation: This response validates the client's feelings and provides empathetic support,
which is therapeutic. Minimizing feelings ("don't cry") or offering false reassurance is less
helpful.
10. 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
Answer: D
, Explanation: The initial approach should involve clear, firm limit-setting to help the client
control their behavior. More restrictive measures are used only if the client cannot respond to
verbal intervention.
11. 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
Answer: C
Explanation: Finger foods that are high in protein and calories are most appropriate for clients
with mania, as they can eat while active and may have difficulty sitting for full meals.
12. A client who is manic states, "What time is it? I have to see the doctor. Is
breakfast here yet? I've got to see the doctor first. Can I get my cereal out of the
kitchen?" Which would be the most appropriate response by the nurse?
A) "Please slow down. I'm not sure what you need first."
B) "You will have to be quiet and have breakfast after the doctor comes."
C) "Are you hungry?"
D) "Your thoughts seem to be racing this morning."
Answer: A
Explanation: This response acknowledges the client's pressured speech and racing thoughts
while gently encouraging them to slow down, facilitating more effective communication.
13. A client with mania is demonstrating hypersexual behavior by blowing kisses to
other clients, making suggestive remarks, and removing some articles of
clothing. Which nursing intervention would be most appropriate at this time?
A) Accompany the client to his or her room to get dressed.
B) Put the client in seclusion for his or her own protection.
C) Tell other clients to ignore the behavior because it is harmless.
D) Tell the client that the behaviors have to stop right now.
Answer: A
Explanation: Redirection to a private area allows for addressing the behavior without
confrontation or embarrassment, while maintaining the client's dignity and safety.
Test Bank for Psychiatric-Mental Health Nursing, 8th Edition
1. Which best explains the neurochemical processes responsible for depression?
A) Increased activity of dopamine
B) Decreased glucocorticoid activity
C) Decreased serotonin and norepinephrine activity
D) Potentiating of the kindling process
Answer: C
Explanation: The monoamine hypothesis of depression suggests that decreased activity of
neurotransmitters, particularly serotonin and norepinephrine, plays a key role in the
pathophysiology of depression.
2. Which is a Freudian explanation of the etiology of depression?
A) Depression is a reaction to a distressing life experience.
B) Depression results from being raised by rejecting or unloving parents.
C) Depression results from cognitive distortions.
D) Depression is anger turned inward.
Answer: D
Explanation: Freud's psychoanalytic theory proposed that depression results from internalized
anger, often related to a real or perceived loss, which is then directed inward as self-reproach.
3. Which statements about the etiology of bipolar disorder do most
psychoanalytical theories subscribe to? Select all that apply.
A) Norepinephrine levels may be increased in mania.
B) Manic episodes are a defense against underlying depression.
C) Acetylcholine seems to be implicated in mania.
D) The id takes over the ego and acts as an undisciplined hedonistic being (child).
Answer: B, D
Explanation: Psychoanalytic theories often view manic episodes as a psychological defense
against underlying depression, characterized by the id overpowering the ego, leading to
impulsive, pleasure-seeking behavior.
4. 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
Answer: B, D
Explanation: Major depression has a strong genetic component and is more common in first-
degree relatives of affected individuals. Marital status is a significant risk factor, with
divorced individuals having higher rates of depression than married or single individuals.
5. A concerned family member tells the nurse, "I am concerned about my brother.
He has been acting very different lately." Knowing the family has a history of
bipolar disorder, the nurse inquires further about this. Which behavior during
the past week might indicate that the brother has bipolar disorder?
A) Taking unnecessary risks
B) Sleeping more
C) Intense focus
D) Showing low self-esteem
Answer: A
Explanation: During manic episodes, individuals often engage in high-risk activities with
poor judgment, such as reckless spending, impulsive investments, or dangerous behaviors,
which are hallmark symptoms of bipolar disorder.
6. A client is admitted for major depression. What should the nurse expect to find
during assessment?
A) Anhedonia, feelings of worthlessness, and difficulty focusing
B) Depressed mood, guilt, and pressured speech
C) Changes in sleep pattern, tired, and grandiose mood
D) Difficulty focusing, feelings of helplessness, and flight of ideas
Answer: A
Explanation: Key symptoms of major depressive disorder include anhedonia (loss of
interest/pleasure), feelings of worthlessness, and cognitive difficulties such as impaired
concentration. Pressured speech, grandiosity, and flight of ideas are associated with mania.
7. A client has just been diagnosed as having major depression. At which time
would the nurse expect the client to be at highest risk for self-harm?
A) Immediately after a family visit
, B) On the anniversary of significant life events in the client's life
C) During the first few days after admission
D) Approximately 2 weeks after starting antidepressant medication
Answer: D
Explanation: As antidepressant medication begins to improve energy and motivation before
mood lifts, clients may have increased capacity to act on pre-existing suicidal thoughts,
making this a high-risk period.
8. The nurse is planning care for a client with major depression. Which is an
appropriate expected outcome?
A) The client will avoid causing harm to others.
B) The client will be free from stress.
C) The client will independently carry out activities of daily living.
D) The client will not experience agitation.
Answer: C
Explanation: A primary goal in depression treatment is restoring functional capacity,
including the ability to perform self-care and activities of daily living independently.
9. A client who is depressed begins to cry and states, "I'm just really sick of feeling
this way. Nothing ever seems to go right in my life." Which would be the most
appropriate response by the nurse?
A) "Don't cry. Try to look at the positive side of things."
B) "You are feeling really sad right now. It's a hard time."
C) "Hang in there. Your medication will start helping in a few days."
D) "Nothing ever goes right?"
Answer: B
Explanation: This response validates the client's feelings and provides empathetic support,
which is therapeutic. Minimizing feelings ("don't cry") or offering false reassurance is less
helpful.
10. 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
Answer: D
, Explanation: The initial approach should involve clear, firm limit-setting to help the client
control their behavior. More restrictive measures are used only if the client cannot respond to
verbal intervention.
11. 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
Answer: C
Explanation: Finger foods that are high in protein and calories are most appropriate for clients
with mania, as they can eat while active and may have difficulty sitting for full meals.
12. A client who is manic states, "What time is it? I have to see the doctor. Is
breakfast here yet? I've got to see the doctor first. Can I get my cereal out of the
kitchen?" Which would be the most appropriate response by the nurse?
A) "Please slow down. I'm not sure what you need first."
B) "You will have to be quiet and have breakfast after the doctor comes."
C) "Are you hungry?"
D) "Your thoughts seem to be racing this morning."
Answer: A
Explanation: This response acknowledges the client's pressured speech and racing thoughts
while gently encouraging them to slow down, facilitating more effective communication.
13. A client with mania is demonstrating hypersexual behavior by blowing kisses to
other clients, making suggestive remarks, and removing some articles of
clothing. Which nursing intervention would be most appropriate at this time?
A) Accompany the client to his or her room to get dressed.
B) Put the client in seclusion for his or her own protection.
C) Tell other clients to ignore the behavior because it is harmless.
D) Tell the client that the behaviors have to stop right now.
Answer: A
Explanation: Redirection to a private area allows for addressing the behavior without
confrontation or embarrassment, while maintaining the client's dignity and safety.
