C HAPTER 14: D EPRESSIVE D ISORDERS
Halter: Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: A
Clinical Approach, 9th Edition
MULTIPLE CHOICE
1. Major depressive disorder resulted after a client’s employment was
terminated. The client now says to the nurse, “I’m not worth the time you
spend with me. I am the most useless person in the world.” Which n ursing
diagnosis applies?
a. Powerlessness
b. Defensive coping
c. Situational low self -esteem
d. Disturbed personal identit y
ANS: C
The client’s statements express feelings of worthlessness and most
clearl y relate to the nursing diagnosis of situational low self -esteem.
Insufficient information exists to lead to other diagnoses.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Diagnosis | Nursing Process:
Anal ysis MSC: Client Needs: Psychosocial Integrity
2. A client diagnosed with major dep ressive disorder does not interact with
others except when addressed, and then onl y in monosyllables. The nurse
, wants to show nonjudgmental acceptance and support for the client. Which
communication technique will be effective?
a. Make observations.
b. Ask the client direct questions.
c. Phrase questions to require yes or no answers.
d. Frequentl y reassure the client to reduce guilt feelings.
ANS: A
Making observations about neutral topics draws the client into the
realit y around him or her but places no burdensome expectations for
answers on the client. Acceptance and support are shown by the nurse’s
presence. Direct questions may make the client feel that the encounter
is an interrogation. Open -ended questions are preferable if the client is
able to participate in dialogue. Platitudes are never acceptable. They
minimize client feelings and can increase feelings of worthlessness.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Implementation MSC: Client
Needs: Psychosocial Integrit y
3. A client being treated for depression has taken sertraline dail y for a year.
The client calls the clinic nurse and says, “I stopped taking m y
antidepressant 2 days ago. Now I am having nausea, nervous feelings, and
I can’t sleep.” The nurse will advise the cli ent to:
a. “Go to the nearest emergency department immediatel y.”
b. “Do not to be alarmed. Take two aspirin and drink plent y of fluids.”
c. “Take a dose of your antidepressant now and come to the clinic to
see the health care provider.”
d. “Resume taking your antidepr essants for 2 more weeks and then
discontinue them again.”
, ANS: C
The client has symptoms associated with abrupt withdrawal of the
antidepressant. Taking a dose of the drug will ameliorate the
s ymptoms. Seeing the health care provider will allow the clie nt to
discuss the advisabilit y of going off the medication and to be given a
gradual withdrawal schedule if discontinuation is the decision. This
situation is not a medical emergency, although it calls for medical
advice. Resuming taking the antidepressant for 2 more weeks and then
discontinuing again would produce the same symptoms the client is
experiencing.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Implementation MSC: Client
Needs: Physiological Integrit y
4. Which documen tation for a client diagnosed with major depressive
disorder indicates the treatment plan was effective?
a. Slept 6 hours uninterrupted. Sang with activit y group. Anticipates
seeing grandchild.
b. Slept 10 hours uninterrupted. Attended craft group; stated “proje ct
was a failure, just like me.”
c. Slept 5 hours with brief interruptions. Personal hygiene adequate
with assistance. Weight loss of 1 pound.
d. Slept 7 hours uninterrupted. Preoccupied with perceived
inadequacies. States, “I feel tired all the time.”
ANS: A
Halter: Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: A
Clinical Approach, 9th Edition
MULTIPLE CHOICE
1. Major depressive disorder resulted after a client’s employment was
terminated. The client now says to the nurse, “I’m not worth the time you
spend with me. I am the most useless person in the world.” Which n ursing
diagnosis applies?
a. Powerlessness
b. Defensive coping
c. Situational low self -esteem
d. Disturbed personal identit y
ANS: C
The client’s statements express feelings of worthlessness and most
clearl y relate to the nursing diagnosis of situational low self -esteem.
Insufficient information exists to lead to other diagnoses.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Diagnosis | Nursing Process:
Anal ysis MSC: Client Needs: Psychosocial Integrity
2. A client diagnosed with major dep ressive disorder does not interact with
others except when addressed, and then onl y in monosyllables. The nurse
, wants to show nonjudgmental acceptance and support for the client. Which
communication technique will be effective?
a. Make observations.
b. Ask the client direct questions.
c. Phrase questions to require yes or no answers.
d. Frequentl y reassure the client to reduce guilt feelings.
ANS: A
Making observations about neutral topics draws the client into the
realit y around him or her but places no burdensome expectations for
answers on the client. Acceptance and support are shown by the nurse’s
presence. Direct questions may make the client feel that the encounter
is an interrogation. Open -ended questions are preferable if the client is
able to participate in dialogue. Platitudes are never acceptable. They
minimize client feelings and can increase feelings of worthlessness.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Implementation MSC: Client
Needs: Psychosocial Integrit y
3. A client being treated for depression has taken sertraline dail y for a year.
The client calls the clinic nurse and says, “I stopped taking m y
antidepressant 2 days ago. Now I am having nausea, nervous feelings, and
I can’t sleep.” The nurse will advise the cli ent to:
a. “Go to the nearest emergency department immediatel y.”
b. “Do not to be alarmed. Take two aspirin and drink plent y of fluids.”
c. “Take a dose of your antidepressant now and come to the clinic to
see the health care provider.”
d. “Resume taking your antidepr essants for 2 more weeks and then
discontinue them again.”
, ANS: C
The client has symptoms associated with abrupt withdrawal of the
antidepressant. Taking a dose of the drug will ameliorate the
s ymptoms. Seeing the health care provider will allow the clie nt to
discuss the advisabilit y of going off the medication and to be given a
gradual withdrawal schedule if discontinuation is the decision. This
situation is not a medical emergency, although it calls for medical
advice. Resuming taking the antidepressant for 2 more weeks and then
discontinuing again would produce the same symptoms the client is
experiencing.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Implementation MSC: Client
Needs: Physiological Integrit y
4. Which documen tation for a client diagnosed with major depressive
disorder indicates the treatment plan was effective?
a. Slept 6 hours uninterrupted. Sang with activit y group. Anticipates
seeing grandchild.
b. Slept 10 hours uninterrupted. Attended craft group; stated “proje ct
was a failure, just like me.”
c. Slept 5 hours with brief interruptions. Personal hygiene adequate
with assistance. Weight loss of 1 pound.
d. Slept 7 hours uninterrupted. Preoccupied with perceived
inadequacies. States, “I feel tired all the time.”
ANS: A
