A client is sharing their experiences with a nurse. The client states, "I just can't seem to enjoy anything anymore. Even activities I used to love don't bring me pleasure." This statement by the client is indicative of:

A manic episode.

Bipolar disorder.

Anhedonia, a characteristic of MDD.

Adjustment disorder.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

A manic episode is characterized by a distinct period of abnormally elevated, expansive, or irritable mood, often accompanied by increased energy, decreased need for sleep, and impulsive behavior. The client's description does not align with a manic episode.

Choice B rationale:

Bipolar disorder involves cycling between periods of mania or hypomania and depression. The client's statement does not provide evidence of mood cycling, which is characteristic of bipolar disorder.

Choice C rationale:

The client's statement directly describes anhedonia, which is a key characteristic of major depressive disorder (MDD). Anhedonia involves the inability to derive pleasure from activities that were previously enjoyable, and it is a central diagnostic criterion for MDD.

Choice D rationale:

Adjustment disorder is a condition characterized by emotional or behavioral symptoms that develop in response to a specific stressor. The client's statement is more indicative of a pervasive and ongoing lack of enjoyment, which aligns with the concept of anhedonia in MDD rather than the time-limited nature of adjustment disorder.

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Correct Answer is ["B","C","D"]

Explanation

Choice A rationale:

Genetic predisposition refers to a person's susceptibility to certain conditions based on their genetic makeup. While genetics can play a role in predisposing someone to depression, it is not considered a psychosocial factor. Genetic factors are biological in nature and do not directly involve social and psychological influences.

Choice B rationale:

The role of stress and life events is a significant psychosocial factor related to depression. Stressful life events, such as trauma, loss, or major life changes, can trigger or exacerbate depressive episodes in susceptible individuals. The interaction between these external stressors and an individual's psychological responses is a key aspect of psychosocial factors.

Choice C rationale:

Interpersonal relationships are another important psychosocial factor linked to depression. Poor interpersonal relationships, social isolation, and conflicts with friends or family can contribute to feelings of loneliness and despair, increasing the risk of developing depression.

Choice D rationale:

Cognitive factors, including negative thought patterns and distorted thinking, are considered psychosocial contributors to depression. Cognitive theories of depression emphasize how an individual's thought processes, self-perception, and interpretation of events can influence their emotional state. Dysfunctional thought patterns, such as excessive self-criticism or hopelessness, can contribute to the development and maintenance of depressive symptoms.

Choice E rationale:

Neurotransmitter imbalances are not psychosocial factors. They are more related to the biological underpinnings of depression rather than the social and psychological influences explored in psychosocial factors.

A. "Chronic stress can lead to hyperactivity of the HPA axis, resulting in elevated levels of cortisol that can support neuronal growth and survival.". B. "Chronic stress can lead to hypoactivity of the HPA axis, resulting in reduced levels of cortisol that enhance neurogenesis and synaptic plasticity.". C. "Chronic stress can lead to hyperactivity of the HPA axis, resulting in elevated levels of cortisol that can impair neurogenesis and synaptic plasticity.". D. "Chronic stress can lead to hypoactivity of the HPA axis, resulting in reduced levels of cortisol that improve neurotrophic factors and cognitive function.".

Correct Answer is C

Explanation

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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A client is sharing their experiences with a nurse. The client states, "I just can't seem to enjoy anything anymore. Even activities I used to love don't bring me pleasure." This statement by the client is indicative of:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

(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.

Correct Answer is ["B","C","D"]

Explanation

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?

Correct Answer is C

Explanation

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?

A nurse is assessing a client who has been experiencing persistent feelings of sadness, fatigue, and difficulty concentrating. The client denies any history of manic episodes. Which of the following conditions should the nurse consider as a possible differential diagnosis for this client?

(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.

A nurse is explaining the role of neurotransmitters in the pathophysiology of MDD to a group of nursing students. Which neurotransmitters are mentioned in the text as being involved in regulating mood, motivation, reward, cognition, and stress response?

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?

(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 nurse is conducting a mental health assessment on a client. The client reports feeling extremely fatigued, having difficulty concentrating, and having thoughts of worthlessness. The nurse recognizes these as: