N2NN3 week 12 review

Front

An older adult comes into the ER complaining of insomnia, irritability, anorexia and lack of energy. Which of the following would be important for the nurse to include as part of the initial assessment?

Back

A depression assessment

Answer explanation

A depression assessment is priority because this is often not recognized in older adults. Nurses need to be aware of the signs and symptoms of depression and complete the proper screening. Older adults may have a more atypical presentation and not use the word 'depressed'. The patient may require a psychiatric consult or suicide risk assessment based on their responses, but this is not indicated based on their presentation. Labs will also likely be ordered.

Front

The nurse knows SIGECAPS is a pneumonic for the signs and symptoms of depression. The C stands for:

Back

Concentration deficit

Answer explanation

S- sleep disorder

I - interest deficit

G- Guilt

E - Energy deficit

C- Concentration deficit

A - Appetite disorder

P- psychomotor retardation / agitation

S - suidicality

Front

How does electro-convulsive therapy (ECT) help relieve depression?

Back

Produces a seizure that temporarily alters brain chemicals.

Answer explanation

ECT produces a tonic-clonic seizure that temporarily increases brain chemicals serotonin, dopamine, and norepinephrine

Front

Which of the following therapeutic communication skills is MOST likely to encourage a depressed patient to vent their feelings? Reality orientation, Projective identification, Direct confrontation, Silence, active listening

Back

Silence, active listening

Answer explanation

Use of therapeutic communication skills such as silence and active listening encourages verbalization of feelings.

Front

The nurse is teaching a patient and her family about the causes of depression. Which of the following causative factors should the nurse emphasize as the most significant? Brain structure abnormalities, Chemical imbalance, Social environment, Recessive gene transmission

Back

Chemical imbalance

Answer explanation

Chemical imbalance of neurotransmitters in the brain is the most significant factor in depression. However, the exact cause has not been established so other factors may be involved. A person's social environment including lack of support systems may also increase the risk of depression.

Front

A depressed pt tells the nurse "I'm powerless and I'm not worthy of having friends. Sometimes I take too many pills". The nurse's priority in planning care for this pt. is:

Back

Continued assessments for suicidal ideation

Answer explanation

This client is at risk of suicide so it would be important to complete suicide assessments on a regular basis. This other actions may also be part of the care provided but would not be the priority issue.

Front

A nurse is monitoring a depressed adolescent who may be suicidal. Which behaviour indicates that the pt is at high risk for suicide? Refusing to communicate, Attempting to manipulate others, Arguing with family members when they visit, Giving a cherished book of poems to another pt

Back

Giving a cherished book of poems to another pt

Answer explanation

This can be a sign that the pt has a plan to commit suicide and should be thoroughly assessed

Front

A neighbour asks a nurse "How is Carol? She is my best friend and goes to your depression clinic." How should the nurse reply?

Back

I cannot discuss any pt with you

Answer explanation

This is the only answer that does not indicate that Carol has been coming to the clinic for treatment.

Front

A moderately depressed pt suddenly begins smiling and saying the crisis is over. How should the nurse respond? Options: Suggest a reduction in medication, Allow increased 'in-room' activities, Increase the level of suicide precautions, Allow the client off-unit privileges if interested

Back

Increase the level of suicide precautions

Answer explanation

A sudden improvement and denial of further depression / suicidal ideation may be an indication that the individual has a plan for suicide and therefore increased observations or precautions to reduce or prevent harm should be implemented

Front

What is an acceptable rate of participant follow up in an RCT?

Back

Greater than 80%