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 B

Explanation

Choice A rationale:

Pharmacological interventions involve the use of medications to treat conditions like Major Depressive Disorder (MDD). This does not involve stimulating the brain electrically or magnetically. While antidepressant medications can have an impact on neuronal activity and neuroplasticity, they are not classified as brain stimulation therapies.

Choice B rationale:

This is the correct answer. Electroconvulsive therapy (ECT) is a treatment modality that involves passing an electrical current through the brain to induce a controlled seizure. This has been found to be effective in cases of severe depression where other treatments have not worked. Other somatic therapies might include repetitive transcranial magnetic stimulation (rTMS) and vagus nerve stimulation (VNS), both of which involve modulating brain activity through electrical or magnetic means.

Choice C rationale:

Psychotherapeutic interventions involve talking therapies aimed at addressing psychological and emotional issues. These therapies do not directly involve electrical or magnetic stimulation of the brain. While they can certainly lead to changes in neuronal activity and neuroplasticity, they are not the primary modalities for brain stimulation.

Choice D rationale:

Cognitive-behavioral therapy (CBT) is a specific type of psychotherapeutic intervention that focuses on changing thought patterns and behaviors. While CBT can lead to changes in brain activity and neuroplasticity, it does not involve direct brain stimulation through electrical or magnetic means like ECT or rTMS.

A. Bipolar disorder. B. An adjustment disorder. C. Major depressive disorder (MDD). D. A normal response to stress.

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).

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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 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?

Correct Answer is B

Explanation

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

A nurse is conducting a mental health assessment on a client. The client reports feeling extremely fatigued, having difficulty concentrating, and having thoughts of worthlessness. The nurse recognizes these as:

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:

A client is curious about the impact of chronic stress on the development of depression. Which statement accurately reflects the relationship between chronic stress and depression according to the text?

(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.

(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 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 nurse is administering a depression assessment tool to a client. The tool evaluates mood, anxiety, insomnia, somatic symptoms, and other aspects of depression. Which assessment tool is the nurse most likely using?