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
Explanation
Choice A rationale:
Acetylcholine and gamma-aminobutyric acid (GABA) are not the primary neurotransmitters involved in regulating mood, motivation, reward, cognition, and stress response. Acetylcholine plays a role in memory and muscle control, while GABA is an inhibitory neurotransmitter that helps regulate anxiety and sleep. These neurotransmitters are not as closely associated with the functions mentioned in the question.
Choice B rationale:
Glutamate is a major excitatory neurotransmitter in the central nervous system, and epinephrine (also known as adrenaline) is a hormone that prepares the body for the fight-or-flight response. While both glutamate and epinephrine play important roles in various physiological responses, they are not primarily responsible for regulating mood, motivation, reward, cognition, and stress response as mentioned in the question.
Choice C rationale:
Serotonin, dopamine, and norepinephrine are all key neurotransmitters involved in the regulation of mood, motivation, reward, cognition, and stress response. These neurotransmitters have been extensively studied in the context of mood disorders like Major Depressive Disorder (MDD). Serotonin is often associated with feelings of well-being and happiness, dopamine is linked to pleasure and reward pathways, and norepinephrine is involved in the body's stress response. Imbalances in these neurotransmitters have been implicated in the development of mood disorders.
Choice D rationale:
Endorphins and oxytocin are important neurotransmitters, but they are not as directly related to the regulation of mood, motivation, reward, cognition, and stress response as the neurotransmitters mentioned in choice C. Endorphins are known for their role in pain modulation and feelings of pleasure, while oxytocin is often referred to as the "bonding hormone" and is associated with social connections and childbirth.
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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