Nursing Elites

1. What intervention is likely to be most effective in returning a middle-aged adult with major depressive disorder who suffers from psychomotor retardation, hypersomnia, and amotivation to a normal level of functioning?

• A. Encourage the client to exercise.
• B. Suggest that the client develop a list of pleasurable activities.
• C. Provide education on methods to enhance sleep.
• D. Teach the client to develop a plan for daily structured activities.

Correct answer: D

Rationale: The most effective intervention for a middle-aged adult with major depressive disorder experiencing psychomotor retardation, hypersomnia, and amotivation is to teach the client to develop a plan for daily structured activities. This intervention helps combat the symptoms by providing a routine and purpose to the client's day, addressing the issues of psychomotor retardation and amotivation. Structured activities can help establish a sense of normalcy, improve motivation, and regulate sleep patterns. Encouraging exercise (Choice A) can be beneficial but may be challenging for a client experiencing psychomotor retardation. Developing a list of pleasurable activities (Choice B) may not address the need for structure and routine in the client's daily life. Providing education on sleep enhancement methods (Choice C) is important but may not be sufficient to address the overall functional impairment in this case.

2. A client who is known to abuse drugs is admitted to the psychiatric unit. Which medication should the nurse anticipate administering to a client who is exhibiting benzodiazepine withdrawal symptoms?

• A. Diphenhydramine (Benadryl)
• B. Perphenazine (Trilafon)
• C. Isocarboxazid (Marplan)
• D. Chlordiazepoxide (Librium)

Correct answer: D

Rationale: Chlordiazepoxide (Librium) is the correct choice for managing benzodiazepine withdrawal symptoms. Benzodiazepines are drugs that can lead to physical dependence, and abrupt discontinuation can result in withdrawal symptoms. Chlordiazepoxide, a benzodiazepine itself, is often used in a controlled manner to taper off the drug gradually and manage withdrawal symptoms effectively. Choices A, Diphenhydramine, and B, Perphenazine, are not typically used to manage benzodiazepine withdrawal. Choice C, Isocarboxazid, is a monoamine oxidase inhibitor (MAOI) used in the treatment of depression and not indicated for benzodiazepine withdrawal.

3. A client with a recent diagnosis of bipolar disorder is attending a support group for the first time. Which statement made by the client indicates a need for further education about the disorder?

• A. “I will make sure to take my medications every day.”
• B. “I will avoid high-stress situations whenever possible.”
• C. “I know I can stop my medications when I am feeling better.”
• D. “I should monitor my mood changes closely.”

Correct answer: C

Rationale: The correct answer is C because it shows a misconception about bipolar disorder treatment. Stopping medications when feeling better can lead to a relapse or worsening of symptoms. Choice A is correct because medication adherence is crucial in managing bipolar disorder. Choice B is also a good strategy as stress management is important in symptom control. Choice D is a proactive approach to self-awareness and can help in recognizing early signs of mood changes.

4. Which actions are likely to help promote the self-esteem of a male client with major depression?

• A. Ask the client about his long-term goals.
• B. Discuss the challenges of his medical condition.
• C. Include the client in determining treatment protocol.
• D. Encourage the client to engage in recreational therapy.

Correct answer: C

Rationale: Including the client in determining the treatment protocol is the most suitable action to promote the self-esteem of a male client with major depression. This approach empowers the client, involves him in decision-making regarding his care, and fosters a sense of control and self-worth. Option A, asking about his long-term goals, may not directly address his immediate self-esteem needs related to his current condition. Option B, discussing the challenges of his medical condition, may inadvertently focus on negative aspects and potentially lower self-esteem. Option D, encouraging engagement in recreational therapy, is beneficial but may not directly address the client's sense of control and self-worth in decision-making related to his treatment.

5. A female client with a history of major depressive disorder is experiencing a worsening of symptoms. Which statement by the client indicates a potential risk for suicide?

• A. “I’ve been feeling more tired than usual.”
• B. “I’ve been thinking about how much better everyone would be without me.”
• C. “I’ve been having trouble sleeping lately.”
• D. “I feel like I can’t handle everything.”

Correct answer: B

Rationale: The client’s statement about thinking that everyone would be better off without her indicates suicidal ideation. This statement is a significant warning sign for suicide risk and requires immediate intervention. Choices A, C, and D reflect common symptoms of depression but do not directly indicate suicidal thoughts or intentions. Feeling tired, having trouble sleeping, and feeling overwhelmed are typical symptoms of major depressive disorder but do not necessarily suggest an imminent risk of suicide like the statement in option B does.

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