A client has been diagnosed with major depressive disorder. One clinical symptom of this diagnosis is what?

Claims by family, friends, or coworkers that the client is depressed.

Demonstrated examples of unwise decisions.

A significant decrease in appetite.

Self-report of being sad after a break-up.

Answer and Explanation

The Correct Answer is C

Choice A reason: Claims by others are not a diagnostic criterion for major depressive disorder. Diagnosis relies on objective symptoms like anhedonia or appetite changes, driven by serotonin and dopamine dysregulation in the amygdala and prefrontal cortex, not subjective external observations.

Choice B reason: Unwise decisions are not a specific symptom of major depressive disorder. Impaired decision-making may occur due to prefrontal cortex dysfunction, but diagnostic criteria focus on mood, appetite, or sleep changes, reflecting serotonin and norepinephrine imbalances.

Choice C reason: A significant decrease in appetite is a core diagnostic symptom of major depressive disorder, linked to serotonin dysregulation affecting hypothalamic appetite regulation and amygdala-driven emotional distress, contributing to reduced food intake and weight loss in affected individuals.

Choice D reason: Sadness after a break-up is a normal emotional response, not a diagnostic criterion for major depressive disorder. Diagnosis requires pervasive symptoms like appetite loss or anhedonia, driven by sustained serotonin and dopamine imbalances, not situational sadness.

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Correct Answer is D

Explanation

Choice A reason: A 12-hour shift in a trauma center is stressful but not a critical incident requiring debriefing. Chronic stress may elevate cortisol, but critical incident stress debriefing targets acute trauma exposure, not routine workplace demands.

Choice B reason: Oncology nursing involves chronic emotional stress, not an acute critical incident. Chemotherapy care may cause burnout via sustained cortisol elevation, but debriefing is for sudden, traumatic events, not ongoing patient care challenges.

Choice C reason: Home health nursing for mental illness involves ongoing stress, not a single traumatic event. Chronic exposure may dysregulate serotonin and cortisol, but critical incident stress debriefing is reserved for acute, overwhelming trauma, not routine care.

Choice D reason: Treating car bombing victims is a critical incident, causing acute stress via amygdala-driven fear and cortisol surges. Debriefing mitigates PTSD risk by processing trauma, restoring prefrontal cortex regulation, and reducing long-term neurochemical imbalances, making this the appropriate choice.

A. I really doubt that one person can be blamed for all the bad things that happen. B. Let's look at one bad thing that happened to see if another explanation exists. C. How does your belief in fate relate to your cultural heritage? D. You are being exceptionally hard on yourself when you say those things.

Correct Answer is B

Explanation

Choice A reason: This response dismisses the patient’s cognitive distortion without engaging in therapeutic exploration. Major depressive disorder involves negative cognitive biases due to altered serotonin and dopamine signaling in the prefrontal cortex, impairing rational attribution of causality. This choice fails to facilitate cognitive restructuring, missing the opportunity to address neurocognitive mechanisms underlying overgeneralization.

Choice B reason: This response uses cognitive-behavioral techniques to challenge overgeneralization, a distortion linked to dysfunctional prefrontal cortex activity and low serotonin levels in depression. Examining a specific event encourages re-evaluation of faulty attributions, promoting neuroplasticity through cognitive restructuring, which can enhance rational thinking and reduce depressive symptoms by altering maladaptive neural pathways.

Choice C reason: This response shifts focus to cultural beliefs, irrelevant to the patient’s cognitive distortion. Depression involves altered amygdala-prefrontal cortex interactions, leading to negative self-attribution. Exploring cultural heritage does not address serotonin deficiency or facilitate cognitive reframing, making it ineffective for correcting overgeneralized thinking driven by neurochemical imbalances.

Choice D reason: This response acknowledges self-criticism but fails to engage in active cognitive restructuring. Depression involves hyperactive amygdala responses and reduced prefrontal inhibition, perpetuating negative self-perceptions. Without guiding the patient to explore alternative explanations, this choice misses the chance to alter maladaptive neural pathways, limiting its therapeutic impact on distorted thinking.

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A client has been diagnosed with major depressive disorder. One clinical symptom of this diagnosis is what?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which health care worker should be referred to critical incident stress debriefing?

Correct Answer is D

Explanation

A patient diagnosed with major depressive disorder tells the nurse, "Bad things that happen are always my fault." To support the patient to reframe this overgeneralization, the nurse's best response is:

Correct Answer is B

Explanation

The experience of trauma causes neurochemical changes in the brain that play a role in encoding fear memories that are implicated in Post Traumatic Stress Disorder. The nurse identifies the involvement of which neurotransmitters?

The nurse preparing to teach a patient diagnosed with post-traumatic stress disorder (PTSD) about recommended psychotherapy and psychopharmacology will discuss:

During lunch, a patient cuts herself with a plastic eating utensil. The patient refuses redirection and continues to attempt to cut herself. The patient is safely secured in a restraint chair. What is the next priority action for the nurse?

A patient diagnosed with bipolar disorder has rapidly changing mood cycles. The health care provider prescribes an anticonvulsant medication. Which drug should the nurse anticipate will be prescribed?

After being told that his family will not be attending visitation, a 70-year-old patient turns over a table in a crowded common area. Which action takes priority?

A nurse states, "I evaluated a new patient using the modified SAD PERSONS scale and got a score of 10. Should I send the patient home?" Select the best reply.

A client with schizophrenia is being treated with olanzapine (Zyprexa) 10 mg daily. The client asks the nurse how this medicine minimizes hallucinations. The nurse explains that the mechanism by which olanzapine controls the client's psychotic symptoms is believed to be what?

A nurse is preparing to administer lactated Ringer's 100 mL IV over 15 minutes. The nurse should set the IV infusion pump to deliver how many mL/hr? (Round to the nearest whole number.)