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:

Signs of normal bereavement.

Symptoms of bipolar disorder.

Indicators of substance-induced mood disorder.

Criteria for diagnosing MDD according to DSM-5.

Answer and Explanation

The Correct Answer is D

Choice A rationale:

Signs of normal bereavement. Bereavement refers to the period of grief and mourning after the loss of a loved one. While fatigue and feelings of worthlessness can be experienced during bereavement, difficulty concentrating is not a typical sign. Additionally, bereavement-related symptoms typically improve over time as the individual processes their loss. The combination of extreme fatigue, difficulty concentrating, and thoughts of worthlessness suggests a more severe and persistent condition than normal bereavement.

Choice B rationale:

Symptoms of bipolar disorder. Bipolar disorder is characterized by alternating episodes of depression and mania (or hypomania). The client's symptoms of extreme fatigue, difficulty concentrating, and thoughts of worthlessness are primarily indicative of a depressive episode, which is only one aspect of bipolar disorder. Bipolar disorder requires the presence of manic or hypomanic episodes, which are not mentioned in the client's presentation.

Choice C rationale:

Indicators of substance-induced mood disorder. Substance-induced mood disorder occurs as a result of substance use or withdrawal and involves changes in mood and affect. While substances can lead to symptoms similar to depression, the combination of symptoms presented by the client (fatigue, difficulty concentrating, thoughts of worthlessness) is more indicative of a primary mood disorder rather than one directly caused by substance use.

Choice D rationale:

Criteria for diagnosing MDD according to DSM-5. The client's symptoms of extreme fatigue, difficulty concentrating, and thoughts of worthlessness align with the criteria for Major Depressive Disorder (MDD) as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). These criteria include the presence of specific symptoms for a specified duration, causing significant impairment in functioning. The symptoms should not be better explained by other conditions or substances. In this case, the client's presentation closely matches the criteria for diagnosing MDD.

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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.

A. A manic episode. B. Bipolar disorder. C. Anhedonia, a characteristic of MDD. D. Adjustment disorder.

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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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:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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