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?
Bipolar disorder.
Dysthymia.
Substance-induced mood disorder.
Adjustment disorder.
The Correct Answer is B
Choice A rationale:
Bipolar disorder involves both depressive episodes and manic episodes. The client in question denies any history of manic episodes, making bipolar disorder less likely as a diagnosis. Manic episodes are characterized by elevated mood, increased energy, impulsivity, and risky behavior.
Choice B rationale:
Dysthymia, also known as persistent depressive disorder, involves chronic feelings of sadness and a lack of interest or pleasure in activities. It is a milder form of depression that persists for at least two years in adults. The client's persistent feelings of sadness align more closely with the criteria for dysthymia.
Choice C rationale:
Substance-induced mood disorder occurs when the client's mood disturbances are a direct result of substance use or withdrawal. Since there is no mention of substance use or withdrawal in the client's history, this choice is less relevant to the scenario.
Choice D rationale:
Adjustment disorder is characterized by the development of emotional or behavioral symptoms in response to an identifiable stressor, and these symptoms typically resolve within six months of the stressor's resolution. In the scenario, there is no indication of a recent stressor, and the client's symptoms seem to be chronic rather than time-limited, making adjustment disorder less likely.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
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.
Correct Answer is D
Explanation
Choice A rationale:
Depression is not solely caused by genetic factors. While genetics do play a role in predisposing individuals to depression, it's a complex interplay between genetic susceptibility and environmental influences that contribute to the development of the disorder.
Choice B rationale:
Genetic factors are not minor players in depression. Research suggests that genetics can significantly influence a person's susceptibility to depression. However, environmental factors, such as trauma, stress, and life experiences, also contribute substantially to the onset and course of depression.
Choice C rationale:
The relationship between genetics and depression is not as straightforward as specific genes causing depression independently of environmental factors. Depression is a multifactorial disorder influenced by a combination of genetic, biological, psychological, and environmental factors.
Choice D rationale:
This is the correct answer. Genetic factors do contribute to an individual's vulnerability to depression. Studies of families, twins, and heritability have demonstrated a genetic component to depression. However, it's crucial to recognize that genetic predisposition interacts with environmental factors. Trauma, loss, chronic stress, and other environmental triggers can precipitate depressive episodes in genetically susceptible individuals.
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