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:
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.
Correct Answer is D
Explanation
Choice A rationale:
"MDD is less severe than dysthymia but lasts for at least 2 years." This statement is incorrect. Major Depressive Disorder (MDD) is characterized by the presence of a major depressive episode, which can be severe and persistent, lasting for at least two weeks. Dysthymia, on the other hand, is a chronic but milder form of depression that lasts for at least two years, not MDD.
Choice B rationale:
"Dysthymia is characterized by alternating episodes of mania and depression." This statement is incorrect. Dysthymia is a chronic mood disorder characterized by a persistent low mood and other depressive symptoms. It does not involve alternating episodes of mania and depression. Alternating episodes of mania and depression are characteristic of bipolar disorder, not dysthymia.
Choice C rationale:
"Unlike MDD, dysthymia does not impair social or occupational functioning." This statement is incorrect. Both Major Depressive Disorder (MDD) and dysthymia can significantly impair social, occupational, and other areas of functioning. In fact, dysthymia's chronic nature often leads to long-term impairment in various aspects of an individual's life, similar to MDD.
Choice D rationale:
"Dysthymia is chronic and lasts for at least 2 years, but is less severe than MDD." This statement is accurate. Dysthymia is a chronic form of depression that persists for at least two years. While it may not exhibit the same level of severity as a major depressive episode, its long-term nature can still have a substantial impact on an individual's quality of life. This distinguishes it from MDD, which can have episodic occurrences.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.