A client is curious about the impact of chronic stress on the development of depression. Which statement accurately reflects the relationship between chronic stress and depression according to the text?

"Chronic stress can lead to hyperactivity of the HPA axis, resulting in elevated levels of cortisol that can support neuronal growth and survival.".

"Chronic stress can lead to hypoactivity of the HPA axis, resulting in reduced levels of cortisol that enhance neurogenesis and synaptic plasticity.".

"Chronic stress can lead to hyperactivity of the HPA axis, resulting in elevated levels of cortisol that can impair neurogenesis and synaptic plasticity.".

"Chronic stress can lead to hypoactivity of the HPA axis, resulting in reduced levels of cortisol that improve neurotrophic factors and cognitive function.".

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Chronic stress is known to activate the Hypothalamic-Pituitary-Adrenal (HPA) axis, which leads to increased cortisol production. While cortisol is important for various physiological functions, chronic elevation of cortisol due to stress can actually have detrimental effects on the brain. Elevated cortisol levels have been associated with impaired neurogenesis (the formation of new neurons) and synaptic plasticity (the ability of synapses to change and adapt), both of which play crucial roles in maintaining cognitive function and mental health.

Choice B rationale:

This statement is not accurate. Chronic stress typically leads to hyperactivity, not hypoactivity, of the HPA axis, resulting in increased levels of cortisol. The increased cortisol levels can negatively impact neurogenesis and synaptic plasticity, which are key factors in depression and cognitive function.

Choice C rationale:

This is the correct statement. Chronic stress triggers hyperactivity of the HPA axis, causing elevated levels of cortisol. While cortisol is meant to help the body cope with stress in the short term, chronic elevation can lead to adverse effects on the brain. High cortisol levels have been linked to impaired neurogenesis and synaptic plasticity, contributing to the development of depression and cognitive deficits.

Choice D rationale:

This statement is not accurate. Chronic stress tends to lead to hyperactivity of the HPA axis and elevated cortisol levels. Reduced cortisol levels, as suggested in this choice, are not commonly associated with chronic stress and its impact on depression.

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Correct Answer is ["C","D"]

Explanation

Choice A rationale:

Increased interest in activities is not consistent with the clinical presentation of MDD. In fact, a hallmark symptom of MDD is anhedonia, which involves a reduced interest or pleasure in most activities.

Choice B rationale:

Weight gain is not typically associated with MDD. In contrast, significant changes in appetite and weight loss are more common symptoms, often accompanied by feelings of worthlessness or guilt related to body image.

Choice C rationale:

Excessive guilt and self-blame are common cognitive and emotional symptoms of MDD. Individuals with MDD tend to have a negative self-perception and may blame themselves for their difficulties.

Choice D rationale:

Insomnia, or difficulty falling asleep or staying asleep, is a common sleep disturbance associated with MDD. Sleep problems can exacerbate the symptoms of depression and impact overall well-being.

Choice E rationale:

Elevated mood and increased energy are actually more indicative of conditions like bipolar disorder or manic episodes, where there are distinct periods of abnormally elevated mood, known as mania or hypomania.

A. Bipolar disorder. B. An adjustment disorder. C. Major depressive disorder (MDD). D. A normal response to stress.

Correct Answer is C

Explanation

Choice A rationale:

Bipolar disorder involves distinct periods of both elevated mood (mania or hypomania) and depressive episodes. The scenario describes persistent feelings of sadness, guilt, worthlessness, weight loss, and insomnia, which are characteristic symptoms of major depressive disorder (MDD) but not necessarily indicative of bipolar disorder.

Choice B rationale:

An adjustment disorder is characterized by emotional or behavioral symptoms that arise within three months of experiencing a stressor (e.g., a major life change or event). The persistent feelings of sadness, guilt, worthlessness, weight loss, and insomnia described in the scenario are beyond the typical time frame for an adjustment disorder.

Choice C rationale:

The correct answer. Major depressive disorder (MDD) is characterized by persistent feelings of sadness, loss of interest or pleasure, changes in weight or appetite, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue, feelings of worthlessness or excessive guilt, difficulty concentrating, and recurrent thoughts of death or suicide. The client's symptoms align closely with the diagnostic criteria for MDD.

Choice D rationale:

A normal response to stress usually involves transient feelings of sadness or anxiety in response to a stressor. However, the client's symptoms of persistent feelings of sadness, guilt, worthlessness, weight loss, and insomnia are indicative of a more serious and prolonged condition like major depressive disorder (MDD).

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A client is curious about the impact of chronic stress on the development of depression. Which statement accurately reflects the relationship between chronic stress and depression according to the text?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

(Select All That Apply): A nurse is assessing a client for major depressive disorder (MDD). Which of the following signs and symptoms are consistent with the clinical presentation of MDD? Select all that apply.

Correct Answer is ["C","D"]

Explanation

A client is experiencing persistent feelings of sadness, guilt, and worthlessness. They also report significant weight loss and insomnia. The nurse suspects the client may have:

Correct Answer is C

Explanation

A client is sharing their experiences with a nurse. The client states, "I just can't seem to enjoy anything anymore. Even activities I used to love don't bring me pleasure." This statement by the client is indicative of:

A nurse is assessing a client who has been experiencing persistent feelings of sadness, fatigue, and difficulty concentrating. The client denies any history of manic episodes. Which of the following conditions should the nurse consider as a possible differential diagnosis for this client?

A nurse is administering a depression assessment tool to a client. The tool evaluates mood, anxiety, insomnia, somatic symptoms, and other aspects of depression. Which assessment tool is the nurse most likely using?

(Select All That Apply): A nurse is discussing the psychosocial factors that can affect or be affected by depression with a client. Which of the following factors are considered psychosocial factors related to depression? Select all that apply.

(Select All That Apply): A nurse is teaching a group of nursing students about the diagnostic criteria for major depressive disorder (MDD) according to DSM-5. Which of the following are part of the diagnostic criteria? Select all that apply.

A client asks a nurse about the differences between major depressive disorder (MDD) and dysthymia. Which of the following responses by the nurse is accurate?

(Select All That Apply): A nurse is providing care for a client with suspected major depressive disorder (MDD). Which of the following are risk factors for developing MDD? Select all that apply.

A client is concerned about the potential side effects of antidepressant medications. Which of the following side effects is commonly associated with antidepressant use?