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.

Answer and Explanation

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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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).

A. Increased interest in activities. B. Weight gain of 3% in a month. C. Excessive guilt and self-blame. D. Insomnia. E. Elevated mood and increased energy.

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.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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

(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

(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 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:

(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.

(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 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?

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?

A client is wondering about the genetic factors that contribute to depression. What is the relationship between genetic factors and depression according to the text?

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?