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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","E"]
Explanation
Choice A rationale:
Social support refers to the network of family, friends, and community that provide emotional and practical assistance. Depression can be influenced by inadequate social support, as having a strong support system can buffer against the development and exacerbation of depressive symptoms.
Choice B rationale:
Personalization involves attributing external events to oneself, often in a negative manner. While this cognitive distortion is relevant to depression, it is not mentioned in the question stem and does not directly relate to cognitive processes influenced by depression.
Choice C rationale:
Cognitive distortions are irrational and negative thought patterns that are common in depression. These distortions contribute to the maintenance of depressive symptoms. Examples include all-or-nothing thinking, overgeneralization, and catastrophizing.
Choice D rationale:
Catastrophizing involves magnifying the negative significance of events. While it can contribute to depressive thought patterns, it is not as central to cognitive processes influenced by depression as cognitive distortions are.
Choice E rationale:
Interpersonal relationships are affected by depression and can also contribute to its development. The question does not focus on the effects of depression on relationships, but rather on the factors that can influence or be influenced by depression.
Correct Answer is C
Explanation
Choice A rationale:
A manic episode is characterized by a distinct period of abnormally elevated, expansive, or irritable mood, often accompanied by increased energy, decreased need for sleep, and impulsive behavior. The client's description does not align with a manic episode.
Choice B rationale:
Bipolar disorder involves cycling between periods of mania or hypomania and depression. The client's statement does not provide evidence of mood cycling, which is characteristic of bipolar disorder.
Choice C rationale:
The client's statement directly describes anhedonia, which is a key characteristic of major depressive disorder (MDD). Anhedonia involves the inability to derive pleasure from activities that were previously enjoyable, and it is a central diagnostic criterion for MDD.
Choice D rationale:
Adjustment disorder is a condition characterized by emotional or behavioral symptoms that develop in response to a specific stressor. The client's statement is more indicative of a pervasive and ongoing lack of enjoyment, which aligns with the concept of anhedonia in MDD rather than the time-limited nature of adjustment disorder.
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