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Therapeutic Nursing Interventions for Depression

Total questions: 39

Worksheet time: 20mins

Name
Class
Date
1.
  1. Which action would the nurse take to encourage a depressed client lying in bed to go to the dining room to eat?

a)
  1. Send a lunch tray to the client’s room

b)
  1. Offer to accompany the client to the dining room

c)
  1. Explain that all clients that are expected to go to the dining room for meals

d)
  1. Provide information about the importance of eating to maintain health

2.
  1. A middle-aged client has lost 20 lb over the last 2 months cries easily, sleeps poorly, and refuses to participate in any family or social activities that she previously enjoyed.

  2. Which nursing intervention is the best intervention to implement with this client? 

a)
  1. Provide the client with a high-calorie, high-protein diet

b)
  1. Reduce the client’s crying episodes by setting firm, consistent limits

c)
  1. Assure the client that they will regain her usual function in a short time

d)
  1. Allow the client to externalize their feelings, especially anger, in a safe manner 

3.
  1. A depressed client is brought to the emergency department after taking an overdose of a sedative. After lavage the client says, “Let me die. I’m no good.”

  2. Which response by the nurse is most appropriate? 

a)
  1. “Tell me why you did this”

b)
  1. “You must have been upset to try to take your life.”

c)
  1. “Of course you’re good; we’ll take excellent care of you”

d)
  1. “You’ve been through a rough time; let me take care of you”

4.
  1. Which approach by the nurse is most therapeutic when a depressed client resists becoming involved in an activity and complains and claims to be worthless?

a)
  1. Listen to the client and delay activities until another time

b)
  1. Involve the client in an activity in which success can be ensured

c)
  1. Encourage the client to select an activity in which there is some interest

d)
  1. Schedule the client for activities that can be implemented independently

5.

Which intervention will best accomplish the goal of establishing trust when caring for a depressed client?

a)
  1. Spend a day with the client

b)
  1. Ask the client at least one question daily

c)
  1. Wait for the client to initiate the conversation

d)
  1. Visit frequently for short periods with the client each day

6.

A nurse has been assigned to work with a depressed client on a one-on-one basis. The next morning the client refuses to get out of bed, saying, "I'm too sick to be helped, and I don't want to be bothered."

Which response by the nurse is the most therapeutic?

a)

"You won't feel better unless you make the effort to get up and get dressed."

b)

"I know you'll feel better again if you just make an attempt to help yourself."

c)

"Everyone feels this way in the beginning as they confront their feelings. I'll sit with you."

d)

"I know you don't feel like getting up, but you might feel better if you did. Let me help you get started."

7.

A depressed client often sleeps past the expected time of awakening and throughout the day spends excessive time resting and sleeping.

Which nursing intervention is appropriate for this client?

a)

Restrict the client's access to the bedroom

b)

Offer the client in a series of relaxation tapes

c)

Reschedule the client's bedtime to an earlier hour

d)

Suggest that the client exercise before going to bed

8.

On the day after admission a suicidal client asks a nurse, "Why am I being watched around the clock, and why can't I walk around the whole unit?

Which reply is most appropriate?

a)

"Why do you think we're observing you?"

b)

"What makes you think we're observing you?"

c)

"We're concerned that you might try to hard yourself."

d)

"We're following your doctor's instructions, so there must be a reason."

9.

Which factor will the nurse consider most important when evaluating a newly admitted, depressed client's current risk for suicide?

a)

History of suicide attemps

b)

Lack of interest in appearance

c)

How long the depression has existed

d)

Impending anniversary of the loss of a loved one

10.

A nurse stops by the room of a newly admitted depressed client and offers to talk with the tearful client to the evening meal. The client looks intently at the nurse but says nothing.

Which response by the nurse is most therapeutic?

a)

"I'll be at the desk if you need me."

b)

"You must tell me what you're feeling now."

c)

"We'll walk together to dinner when you calm down."

d)

"It must be very difficult for you to be on a psychiatric unit."

11.

Which nursing approach should be implemented when a client with a diagnosis of major depression refuses to participate in unit activities?

a)

Plan one rest period during each activity

b)

Explain why the staff believes that the activities are the therapeutic

c)

Encourage the client to express negative feelings about the activities

d)

Accept the client's feelings about activities calmly while setting firm limits

12.

A nurse is planning care for a depressed client. Which approach is most therapeutic?

a)

Allow the client time to complete activities

b)

Help the client focus on the family support system

c)

Encourage the client to perform repetitious menial tasks

d)

Tell the client repeatedly that the stuff views the client as worthwhile

13.

A depressed client has been sitting alone in a chair most of the day and displays no interest in eating. Which nursing intervention will best help to meet this client's nutritional needs?

a)

Stay with the client during meals

b)

Take the client to the dining room

c)

Bring the client a tray of finger foods

d)

Talk with the client about the importance of nutrition

14.

Which nursing action is therapeutic when caring for a client diagnosed with depression?

a)

Playing a game of chess with the client

b)

Allowing the client to make personal decisions

c)

Sitting down next to the client at frequent intervals

d)

Providing the client with frequent periods of time for reflection

15.

A depressed client says, "I'm no good. I'm better off dead."

Which nursing intervention should be implemented first?

a)

Reply, "I think you're good; you should think about living"

b)

Respond, "I'll stay with you until you're less depressed"

c)

Alert the staff to schedule 24-hour observation of the client

d)

Unobtrusively remove those articles that may be used in a suicide attempt

16.

A client who has been attending a day treatment facility for 1 month with the diagnosis of major depression is to be discharged in a week. Which comment by the nurse is most appropriate?

a)

"We have just a few sessions left. I'lm really pleased at your progress."

b)

"Your discharge date has been set for next week. That's wonderful news."

c)

"We have five sessions remaining. We need to start making plans to end our sessions."

d)

"I understand that your discharge is set for next week. I'm wondering how you feel about that."

17.

During a special meeting to discuss the unexpected suicide of a recently discharged client, a nurse overhears another client moan softly, "I'm next. Oh my God, I'm next. They couldn't protect him, and they can't protect me, either." Which nursing response is most therapeutic?

a)

"That person was a lot sicker than you are."

b)

"You seem to be afraid that you'll hurt yourself."

c)

"That was different. He was at home, but you're here."

d)

"There's no need to worry. We'll protect you even after you're discharged."

18.

Which medication would the nurse expect to be prescribed for a client who experiences elevated heart rate and severe anxiety before public speaking events?

a)

Tricyclics

b)

Beta blockers

c)

Monoamine oxidase inhibitors (MAOIs)

d)

Selective serotonin reuptake inhibitors (SSRIs)

19.

A nurse moves into the working phase of a therapeutic relationship with a depressed client who has a history of suicide attempts.

Which question should the nurse ask the client who has a history of suicide attempts. Which question should the nurse ask the client when exploring alternative coping strategies?

a)

How have you managed your problems in the past?

b)

What do you feel that you've learned from this suicide attempt?

c)

How will you manage the next time your problems start piling up?

d)

Were there other things on in your life that made you want to die?

20.

Which information should be considered when working with depressed young children?

a)

It is important to include the family in the treatment plan

b)

The goal of therapy is for the child to gain insight into problems

c)

Depressed children are treated in much the same way as depressed adults

d)

Antidepressant medication is the treatment of choice for depressed children

21.

A client who was forced into early retirement is found to have severe depression. The client says, "I feel useless, and I've got nothing to do."

Which is the best initial response by the nurse?

a)

Tell me more about feeling useless

b)

Volunteering can help you fill your time

c)

Your illness is adding to your current feelings

d)

Let's talk about what you'd like to be doing right now

22.

A nurse has been caring for a suicidal client for 3 weeks on an inpatient unit. One morning the client greets the nurse cheerfully and states, "Everything is looking up. I'm not going to have problems for very long." Which assessment does the client's behavior and statement indicate?

a)

Increased risk for suicide

b)

Increased level of anxiety

c)

Positive response to treatment

d)

Resolution of suicidal ideation

23.

A nurse becomes aware of an older client's feeling of loneliness when the client states, "I only have a few friends. My daughter lives in another state and couldn't care less whether I live or die. She doesn't even know I'm in the hospital."

Which interpretation of the client's statement is accurate?

a)

Call for help to prevent the client from acting on suicidal thoughts

b)

Manipulative attempt to persuade the nurse to call the daughter

c)

Reflection of depression that is causing feelings of hopelessness

d)

Request for information about social support groups in the community

24.

Which assessment information contributes to the nurse's suspicion that the client is at an increased risk for suicide?

a)

Psychomotor retardation

b)

Decreased physical activity

c)

Deliberate thoughtful behavior

d)

Overwhelming feelings of guilt

25.

Which action will the nurse take to reduce social withdrawal in a deeply depressed client who remains curled up in bed and refuses to talk with staff?

a)

Sit with the client for set periods each hour

b)

Touch the client gently on the arm when the opportunity arises

c)

Urge the client to participate in simple games with other clients

d)

Inform the client that going to the lounge is required in the daytime

26.

Which approach is most direct in evaluating a newly admitted depressed client's potential for suicide?

a)

Questioning the client about plans for the future

b)

Inquiring whether the client is now considering suicide

c)

Discussing suicide with other clients while the client is in the group

d)

Asking family members whether the client has ever attempted suicide

27.

Which behavior by a client with major depressive disorder indicates to the nurse that a trusting relationship is beginning to develop?

a)

Establishes eye contact with the nurse

b)

Accompanies the nurse to the dining room

c)

Responds to the nurse when asked a question

d)

Permits the nurse to assist with dressing in the morning

28.

Which response and explanation does the nurse understand is occurring in a client who is not making eye contact and has a lack of interest in the environment after surgery for extensive pulmonary cancer?

a)

Normal, requiring no follow-up

b)

Expected, but needing to be addressed

c)

Unusual, indicating mental illness

d)

Serious, needing immediate acute care

29.

Which nursing objective is appropriate when caring for a client diagnosed with bipolar disorder, depressive episode?

a)

Feeling comfortable with the nurse

b)

Investigating new leisure activities

c)

Participating in small-group activities

d)

Initiating conversations about feelings

30.

Which characteristic causes the greatest difficulty for nurses caring for the severely depressed client?

a)

Client's lack of energy

b)

Negative cognitive processes

c)

Contagious quality of depression

d)

Client's psychomotor retardation

31.

A postpartum client reports a loss of interest in daily activities, loss of appetite, and sleeplessness and is diagnosed with depression. Which is the drug of choice for this condition if she is breastfeeding?

a)

Sertraline

b)

Fluoxetine

c)

Reboxetine

d)

Monoamine oxidase inhibitors (MAOIs)

32.

Which information should be considered when caring for clients who are at risk for suicide?

a)

A client who fails in a suicide attempt will probably not try again

b)

Formal suicide plans increase the likelihood that a client will attempt suicide

c)

It is best not to talk to clients about suicide because it may give them the idea

d)

Clients who talk about suicide are not planning it; they are using the threat to gain attention

33.

Which feeling will be most difficult for a client diagnosed with major depression and dependency issues to express?

a)

Need for comforting

b)

Anger toward others

c)

Remorse for past behaviors

d)

Feelings of low self-esteem

34.

A client prescribed escitalopram for major depression tells the nurse after 5 days, "It doesn't help, so what's the use of taking it?" Which response is appropriate?

a)

It can take 1 to 4 weeks to see an improvement

b)

It takes 6 to 8 weeks for this medication to have an effect

c)

I'll talk to your primary health care provider about increasing the dosage. That may help.

d)

You should have felt a response by now. I'll notify the primary health care provider right now.

35.

Which clinical manifestation does the nurse expect when assessing a client diagnosed with depression?

a)

Flight of ideas

b)

Suspicion of others

c)

Psychomotor retardation

d)

Intrusive social behaviors

36.

Which statement will the nurse make when teaching about suicide prevention?

a)

Only psychotic or depressed people commit suicide

b)

Suicide only occurs in the lower socioeconomic classes

c)

It is harmful to discuss the subject of suicide with clients

d)

People who are really serious about suicide give no clues

e)

Suicidal behavior is the leading cause of psychiatric hospitalization for young children

37.

On the fifth day of hospitalization the nurse notes that a depressed client remains lying on her bed when the clients are called to the dining room for lunch.

Which intervention will encourage the client to eat?

a)

Have a lunch tray sent to the client's room

b)

Offer to accompany the client to the dining room

c)

Explain that all clients are expected to go to the dining room for meals

d)

Provide information about the importance of eating to maintain health

38.

Which activity is most appropriate for a nurse to introduce to a depressed client during the early part of hospitalization?

a)

Board game

b)

Project involving drawing

c)

Card game with three other clients

d)

Small Aerobic exercise group

39.

Which nursing approach is appropriate for a depressed client who is very resistive and complains about inabilities and worthlessness?

a)

Involve the client in activities in which success can be ensured

b)

Listen to the client while postponing a planned activity for later

c)

Encourage the client to select an activity in which there is some interest

d)

Schedule the client's activities so tha