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 ["A"]

Explanation

Choice A rationale:

Electroconvulsive therapy (ECT) and other somatic therapies are considered main treatment options for Major Depressive Disorder (MDD). ECT involves passing electric currents through the brain to induce controlled seizures, and it's often used in severe cases of depression that haven't responded to other treatments. Somatic therapies encompass a range of interventions that directly target the body, such as transcranial magnetic stimulation (TMS) and vagus nerve stimulation (VNS). These treatments are supported by extensive research and clinical evidence, particularly for cases where pharmacological interventions haven't been effective or suitable.

Choice B rationale:

Pharmacological interventions are indeed a mainstay in MDD treatment. However, while they are effective for many individuals, they might not work for everyone and can have side effects. Hence, the treatment approach should be tailored to the individual's needs and preferences.

Choice C rationale:

Herbal supplements are not considered main treatment options for MDD according to established clinical guidelines. While some herbal supplements might have anecdotal support for mood enhancement, their efficacy and safety are not well-established through rigorous scientific research and clinical trials.

Choice D rationale:

Physical exercise has been shown to have a positive impact on mood and can be a beneficial adjunct to MDD treatment. However, it's typically not considered a standalone main treatment option. Rather, it's often recommended as a complementary approach alongside other evidence-based treatments.

Choice E rationale:

Mindfulness-based cognitive therapy (MBCT) is a psychological approach that combines mindfulness meditation with cognitive behavioral techniques. While MBCT has shown promise in preventing relapse for individuals with recurrent depression, it's usually used as a psychotherapeutic adjunct to other main treatments like pharmacological interventions or psychotherapy.

A. Acetylcholine and gamma-aminobutyric acid (GABA). B. Glutamate and epinephrine. C. Serotonin, dopamine, and norepinephrine. D. Endorphins and oxytocin.

Correct Answer is C

Explanation

Choice A rationale:

Acetylcholine and gamma-aminobutyric acid (GABA) are not the primary neurotransmitters involved in regulating mood, motivation, reward, cognition, and stress response. Acetylcholine plays a role in memory and muscle control, while GABA is an inhibitory neurotransmitter that helps regulate anxiety and sleep. These neurotransmitters are not as closely associated with the functions mentioned in the question.

Choice B rationale:

Glutamate is a major excitatory neurotransmitter in the central nervous system, and epinephrine (also known as adrenaline) is a hormone that prepares the body for the fight-or-flight response. While both glutamate and epinephrine play important roles in various physiological responses, they are not primarily responsible for regulating mood, motivation, reward, cognition, and stress response as mentioned in the question.

Choice C rationale:

Serotonin, dopamine, and norepinephrine are all key neurotransmitters involved in the regulation of mood, motivation, reward, cognition, and stress response. These neurotransmitters have been extensively studied in the context of mood disorders like Major Depressive Disorder (MDD). Serotonin is often associated with feelings of well-being and happiness, dopamine is linked to pleasure and reward pathways, and norepinephrine is involved in the body's stress response. Imbalances in these neurotransmitters have been implicated in the development of mood disorders.

Choice D rationale:

Endorphins and oxytocin are important neurotransmitters, but they are not as directly related to the regulation of mood, motivation, reward, cognition, and stress response as the neurotransmitters mentioned in choice C. Endorphins are known for their role in pain modulation and feelings of pleasure, while oxytocin is often referred to as the "bonding hormone" and is associated with social connections and childbirth.

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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

(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.

Correct Answer is ["A"]

Explanation

A nurse is explaining the role of neurotransmitters in the pathophysiology of MDD to a group of nursing students. Which neurotransmitters are mentioned in the text as being involved in regulating mood, motivation, reward, cognition, and stress response?

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

(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.

(Select All That Apply): A nurse is educating a client about the psychosocial factors that can influence or be influenced by depression. Which of the following factors are associated with depression and its effects on cognitive processes? 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 is experiencing persistent feelings of sadness, guilt, and worthlessness. They also report significant weight loss and insomnia. The nurse suspects the client may have:

(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.