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?
Bipolar disorder.
Dysthymia.
Substance-induced mood disorder.
Adjustment disorder.
The Correct Answer is B
Choice A rationale:
Bipolar disorder involves both depressive episodes and manic episodes. The client in question denies any history of manic episodes, making bipolar disorder less likely as a diagnosis. Manic episodes are characterized by elevated mood, increased energy, impulsivity, and risky behavior.
Choice B rationale:
Dysthymia, also known as persistent depressive disorder, involves chronic feelings of sadness and a lack of interest or pleasure in activities. It is a milder form of depression that persists for at least two years in adults. The client's persistent feelings of sadness align more closely with the criteria for dysthymia.
Choice C rationale:
Substance-induced mood disorder occurs when the client's mood disturbances are a direct result of substance use or withdrawal. Since there is no mention of substance use or withdrawal in the client's history, this choice is less relevant to the scenario.
Choice D rationale:
Adjustment disorder is characterized by the development of emotional or behavioral symptoms in response to an identifiable stressor, and these symptoms typically resolve within six months of the stressor's resolution. In the scenario, there is no indication of a recent stressor, and the client's symptoms seem to be chronic rather than time-limited, making adjustment disorder less likely.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Genetic theory suggests that a person's genetic makeup can predispose them to develop depression, but it does not specifically address the role of neurotransmitters in depression. While genetics can contribute to the risk of major depressive disorder (MDD), this choice doesn't focus on the neurotransmitter imbalances.
Choice B rationale:
Neuroendocrine theory pertains to the role of hormones in depression, particularly abnormalities in the hypothalamic-pituitary-adrenal (HPA) axis. While hormones play a role in mood regulation, this theory does not primarily revolve around neurotransmitter imbalances.
Choice C rationale:
Neurotransmitter theory proposes that an imbalance of neurotransmitters, such as serotonin, norepinephrine, and dopamine, contributes to the development of major depressive disorder. This theory aligns with the idea that these neurotransmitters are responsible for regulating mood, motivation, reward, cognition, and stress response.
Choice D rationale:
Environmental theory suggests that external factors, such as life events and stressors, contribute to the development of depression. While environment can indeed influence depression, it does not specifically address the neurotransmitter imbalances that are central to this question.
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.
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