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.
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).
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
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.
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.
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