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:
Signs of normal bereavement.
Symptoms of bipolar disorder.
Indicators of substance-induced mood disorder.
Criteria for diagnosing MDD according to DSM-5.
The Correct Answer is D
Choice A rationale:
Signs of normal bereavement. Bereavement refers to the period of grief and mourning after the loss of a loved one. While fatigue and feelings of worthlessness can be experienced during bereavement, difficulty concentrating is not a typical sign. Additionally, bereavement-related symptoms typically improve over time as the individual processes their loss. The combination of extreme fatigue, difficulty concentrating, and thoughts of worthlessness suggests a more severe and persistent condition than normal bereavement.
Choice B rationale:
Symptoms of bipolar disorder. Bipolar disorder is characterized by alternating episodes of depression and mania (or hypomania). The client's symptoms of extreme fatigue, difficulty concentrating, and thoughts of worthlessness are primarily indicative of a depressive episode, which is only one aspect of bipolar disorder. Bipolar disorder requires the presence of manic or hypomanic episodes, which are not mentioned in the client's presentation.
Choice C rationale:
Indicators of substance-induced mood disorder. Substance-induced mood disorder occurs as a result of substance use or withdrawal and involves changes in mood and affect. While substances can lead to symptoms similar to depression, the combination of symptoms presented by the client (fatigue, difficulty concentrating, thoughts of worthlessness) is more indicative of a primary mood disorder rather than one directly caused by substance use.
Choice D rationale:
Criteria for diagnosing MDD according to DSM-5. The client's symptoms of extreme fatigue, difficulty concentrating, and thoughts of worthlessness align with the criteria for Major Depressive Disorder (MDD) as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). These criteria include the presence of specific symptoms for a specified duration, causing significant impairment in functioning. The symptoms should not be better explained by other conditions or substances. In this case, the client's presentation closely matches the criteria for diagnosing MDD.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Positive life events, although beneficial, are not typically considered contributors to the development of depression. Positive events generally have a positive impact on mental health and may even serve as protective factors against depression.
Choice B rationale:
High income is not commonly recognized as a direct contributor to depression. In fact, higher income can provide access to better resources and opportunities that might contribute to better mental health outcomes.
Choice C rationale:
Lack of social support is a well-established factor contributing to the development of depression. Social support plays a crucial role in buffering against stress and providing individuals with a sense of belonging and emotional connection. A lack of strong social ties can lead to feelings of isolation and increase vulnerability to depression.
Choice D rationale:
Optimistic thinking is typically considered a protective factor against depression rather than a contributor to its development. Optimistic thinking involves a positive outlook on life and the expectation of positive outcomes, which can act as a resilience factor against depressive symptoms.
Correct Answer is B
Explanation
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.
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