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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?

"Chronic stress can lead to hyperactivity of the HPA axis, resulting in elevated levels of cortisol that can support neuronal growth and survival.".

"Chronic stress can lead to hypoactivity of the HPA axis, resulting in reduced levels of cortisol that enhance neurogenesis and synaptic plasticity.".

"Chronic stress can lead to hyperactivity of the HPA axis, resulting in elevated levels of cortisol that can impair neurogenesis and synaptic plasticity.".

"Chronic stress can lead to hypoactivity of the HPA axis, resulting in reduced levels of cortisol that improve neurotrophic factors and cognitive function.".

Answer and Explanation

The Correct Answer is C

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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Correct Answer is ["C","E"]

Explanation

Choice A rationale:

Symptoms of major depressive disorder (MDD) are characterized by causing significant distress, not mild distress. The distress associated with MDD is usually severe and impairs daily functioning.

Choice B rationale:

While insomnia is a common symptom of major depressive disorder (MDD), it is not necessary for the diagnosis. Other symptoms, such as changes in appetite, psychomotor agitation or retardation, fatigue, and diminished interest or pleasure, can also contribute to the diagnosis.

Choice C rationale:

The correct answer. Symptoms of major depressive disorder (MDD) must not be due to a medical condition. It's crucial to rule out medical conditions that can mimic depressive symptoms, such as hypothyroidism or certain neurological disorders.

Choice D rationale:

The presence of a manic or hypomanic episode would indicate a diagnosis of bipolar disorder, not major depressive disorder (MDD). Bipolar disorder involves distinct periods of both elevated mood and depressive episodes.

Choice E rationale:

The correct answer. To meet the diagnostic criteria for major depressive disorder (MDD) according to DSM-5, an individual must experience five or more symptoms of depression during a continuous two-week period. These symptoms must include either depressed mood or loss of interest/pleasure. The scenario did not specify all the symptoms, but the persistent feelings of sadness, guilt, worthlessness, weight loss, and insomnia described align with the criteria.

A. Bipolar disorder. B. An adjustment disorder. C. Major depressive disorder (MDD). D. A normal response to stress.

Correct Answer is C

Explanation

Choice A rationale:

Bipolar disorder involves distinct periods of both elevated mood (mania or hypomania) and depressive episodes. The scenario describes persistent feelings of sadness, guilt, worthlessness, weight loss, and insomnia, which are characteristic symptoms of major depressive disorder (MDD) but not necessarily indicative of bipolar disorder.

Choice B rationale:

An adjustment disorder is characterized by emotional or behavioral symptoms that arise within three months of experiencing a stressor (e.g., a major life change or event). The persistent feelings of sadness, guilt, worthlessness, weight loss, and insomnia described in the scenario are beyond the typical time frame for an adjustment disorder.

Choice C rationale:

The correct answer. Major depressive disorder (MDD) is characterized by persistent feelings of sadness, loss of interest or pleasure, changes in weight or appetite, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue, feelings of worthlessness or excessive guilt, difficulty concentrating, and recurrent thoughts of death or suicide. The client's symptoms align closely with the diagnostic criteria for MDD.

Choice D rationale:

A normal response to stress usually involves transient feelings of sadness or anxiety in response to a stressor. However, the client's symptoms of persistent feelings of sadness, guilt, worthlessness, weight loss, and insomnia are indicative of a more serious and prolonged condition like major depressive disorder (MDD).

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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?

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Naxlex Comprehensive Predictor Exams

(Select All That Apply): A nurse is teaching a group of nursing students about the diagnostic criteria for major depressive disorder (MDD) according to DSM-5. Which of the following are part of the diagnostic criteria? Select all that apply.

Correct Answer is ["C","E"]

Explanation

A client is experiencing persistent feelings of sadness, guilt, and worthlessness. They also report significant weight loss and insomnia. The nurse suspects the client may have:

Correct Answer is C

Explanation

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?

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 assessing a client for major depressive disorder (MDD). Which of the following signs and symptoms are consistent with the clinical presentation of MDD? Select all that apply.

A client wants to understand the factors that contribute to the development of depression. Which of the following factors are mentioned in the text as potential contributors to depression?

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?

(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.

(Select All That Apply): A nurse is educating a client about the psychosocial factors that can influence or be influenced by depression. Which of the following factors are associated with depression and its effects on cognitive processes? Select all that apply.