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

The correct answer is choicea. MDD is more prevalent in older adults.

Choice A rationale:

Major depressive disorder (MDD) is indeed more prevalent in older adults.This demographic often faces unique stressors such as chronic illness, loss of loved ones, and social isolation, which can contribute to higher rates of depression.

Choice B rationale:

MDD is not primarily caused by a single factor.It is a complex disorder with multiple contributing factors, including genetics, brain chemistry, environmental influences, and psychological factors.

Choice C rationale:

Anhedonia refers to the loss of interest or pleasure in activities that were once enjoyable, not excessive sleeping.Excessive sleeping is known as hypersomnia.

Choice D rationale:

MDD cannot be diagnosed if only one symptom is present.The diagnosis requires the presence of multiple symptoms, including depressed mood or anhedonia, for at least two weeks.

A. "Chronic stress can lead to hyperactivity of the HPA axis, resulting in elevated levels of cortisol that can support neuronal growth and survival.". B. "Chronic stress can lead to hypoactivity of the HPA axis, resulting in reduced levels of cortisol that enhance neurogenesis and synaptic plasticity.". C. "Chronic stress can lead to hyperactivity of the HPA axis, resulting in elevated levels of cortisol that can impair neurogenesis and synaptic plasticity.". D. "Chronic stress can lead to hypoactivity of the HPA axis, resulting in reduced levels of cortisol that improve neurotrophic factors and cognitive function.".

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.

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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 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?

Correct Answer is A

Explanation

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

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?

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:

(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 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?

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?

(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 client is concerned about the potential side effects of antidepressant medications. Which of the following side effects is commonly associated with antidepressant use?