ATI LPN
Psychiatric Nursing: Contemporary Practice 6th Edition
Chapter 23 : Depression:Management of Depressive Moods and Suicidal Behavior Questions
Question 1 of 5
The nurse is caring for a client in the outpatient setting who has been diagnosed with a depressive disorder. Before the client is given a prescription for a tricyclic antidepressant, assessment for which of the following would be most important?
Correct Answer: C
Rationale: Tricyclic antidepressants (TCAs) have significant cardiac side effects, including the potential to cause arrhythmias, making assessment for cardiac arrhythmia (
C) critical, especially in clients with pre-existing heart conditions. Suicide (
A) is always a concern but not specific to TCAs, hypersomnia (
B) is a symptom, and erectile dysfunction (
D) is a side effect, not a pre-treatment concern.
Question 2 of 5
A client diagnosed with major depression was prescribed imipramine (Tofranil) and has been taking this medication for 1 week. The client took his last dose of imipramine (Tofranil) at 9:00 PM. The client is scheduled to have blood drawn to monitor the medication level the next morning. The nurse should instruct the client to have his blood drawn as close as possible to which time?
Correct Answer: A
Rationale:
To monitor tricyclic antidepressant levels like imipramine, blood should be drawn at trough levels, typically 10?12 hours after the last dose for steady-state accuracy. A 9:00 PM dose means 6:00 AM (
A) is closest to this window. Later times (B, C,
D) are too far from the last dose.
Question 3 of 5
The nurse is caring for a client with major depression. The client tells the nurse that she just isn?t sure that life is worth living. The nurse documents which nursing diagnosis as the priority?
Correct Answer: B
Rationale: The client?s statement reflects hopelessness (
B), a critical symptom of major depression linked to suicide risk, making it the priority nursing diagnosis. Low self-esteem (
A) is relevant but less urgent, anxiety (
C) is not directly indicated, and disturbed thought processes (
D) are less specific to the statement.
Question 4 of 5
A client is prescribed phenelzine (Nardil) to treat her depression. She is at a local café for lunch with a friend. Which of the following items on the menu would be least appropriate for the client to order?
Correct Answer: B
Rationale: Phenelzine, a monoamine oxidase inhibitor (MAOI), requires avoiding tyramine-rich foods like aged cheeses (e.g., blue cheese, Roquefort) in option B, as they can cause a hypertensive crisis. Roast beef (
A), eggs (
C), and steak (
D) are generally safe if not aged or fermented.
Question 5 of 5
A 34-year-old client with depression is admitted to an inpatient psychiatric unit. The nurse enters her room and initiates interaction with the client. When talking with the client, which approach would be least appropriate?
Correct Answer: B
Rationale: An animated and cheerful manner (
B) is least appropriate, as it may feel dismissive or overwhelming to a depressed client, undermining their emotional state. Quiet empathy (
A), matter-of-fact (
C), and respectful directness (
D) foster trust and align with the client?s needs.