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:

Bipolar disorder.

An adjustment disorder.

Major depressive disorder (MDD).

A normal response to stress.

Answer and Explanation

The Correct Answer is C

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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Correct Answer is A

Explanation

The correct answer is choicea. MDD is more prevalent in older adults.

Choice A rationale:

Major depressive disorder (MDD) is indeed more prevalent in older adults.This demographic often faces unique stressors such as chronic illness, loss of loved ones, and social isolation, which can contribute to higher rates of depression.

Choice B rationale:

MDD is not primarily caused by a single factor.It is a complex disorder with multiple contributing factors, including genetics, brain chemistry, environmental influences, and psychological factors.

Choice C rationale:

Anhedonia refers to the loss of interest or pleasure in activities that were once enjoyable, not excessive sleeping.Excessive sleeping is known as hypersomnia.

Choice D rationale:

MDD cannot be diagnosed if only one symptom is present.The diagnosis requires the presence of multiple symptoms, including depressed mood or anhedonia, for at least two weeks.

A. Symptoms must cause mild distress. B. At least one symptom must be insomnia. C. Symptoms must not be due to a medical condition. D. Presence of a manic or hypomanic episode. E. Five or more symptoms present during a 2-week period.

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

Explanation

Choice A rationale:

Symptoms of major depressive disorder (MDD) are characterized by causing significant distress, not mild distress. The distress associated with MDD is usually severe and impairs daily functioning.

Choice B rationale:

While insomnia is a common symptom of major depressive disorder (MDD), it is not necessary for the diagnosis. Other symptoms, such as changes in appetite, psychomotor agitation or retardation, fatigue, and diminished interest or pleasure, can also contribute to the diagnosis.

Choice C rationale:

The correct answer. Symptoms of major depressive disorder (MDD) must not be due to a medical condition. It's crucial to rule out medical conditions that can mimic depressive symptoms, such as hypothyroidism or certain neurological disorders.

Choice D rationale:

The presence of a manic or hypomanic episode would indicate a diagnosis of bipolar disorder, not major depressive disorder (MDD). Bipolar disorder involves distinct periods of both elevated mood and depressive episodes.

Choice E rationale:

The correct answer. To meet the diagnostic criteria for major depressive disorder (MDD) according to DSM-5, an individual must experience five or more symptoms of depression during a continuous two-week period. These symptoms must include either depressed mood or loss of interest/pleasure. The scenario did not specify all the symptoms, but the persistent feelings of sadness, guilt, worthlessness, weight loss, and insomnia described align with the criteria.

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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:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing education to a group of nursing students about major depressive disorder (MDD). Which of the following statements accurately describes a characteristic of MDD?

Correct Answer is A

Explanation

(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.

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

Explanation

A nurse is explaining the role of neurotransmitters in the pathophysiology of MDD to a group of nursing students. Which neurotransmitters are mentioned in the text as being involved in regulating mood, motivation, reward, cognition, and stress response?

(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.

A nurse is discussing the various treatment approaches for Major Depressive Disorder (MDD) with a client. Which treatment modality involves stimulating the brain electrically or magnetically to induce changes in neuronal activity and neuroplasticity?

(Select All That Apply): A nurse is educating a group of clients about the treatment approaches for MDD. Which of the following modalities are considered main treatment options for MDD according to the text? 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 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.

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