A nursing student is studying major depressive disorder. Which student statement indicates that learning has occurred?

“1% of the population is affected by depression yearly.”

“2% to 5% of women experience depression during their lifetimes.”

“1% to 3% of men become clinically depressed.”

“Major depression is a leading cause of disability in the United States.”

Answer and Explanation

The Correct Answer is D

Major depressive disorder is a chronic psychiatric condition characterized by persistent low mood, anhedonia, and functional impairment. It affects neurotransmitter systems including serotonin, norepinephrine, and dopamine. Symptoms must persist for at least 2 weeks and include changes in sleep, appetite, energy, and cognition. It is highly comorbid with anxiety and substance use disorders and is a major contributor to global disease burden due to its impact on daily functioning and productivity.

Rationale for correct answer

4. Disability impact is profound in major depression. It interferes with occupational, social, and physical functioning, making it one of the top causes of disability globally and in the U.S.

Rationale for incorrect answers

1. Prevalence is underestimated. Annual prevalence of major depression is closer to 7% in the general population, not 1%.

2. Women experience higher lifetime prevalence, around 10–25%, not 2–5%. Hormonal and psychosocial factors contribute significantly.

3. Men have lower reported rates due to underdiagnosis, but actual lifetime prevalence is closer to 5–12%, not 1–3%.

Take Home Points

Major depressive disorder is a leading cause of disability due to its chronicity and impact on functioning.
Lifetime prevalence is significantly higher than 1–5%, especially among women.
Men may underreport depressive symptoms, contributing to underestimated prevalence.
Accurate epidemiological understanding is essential for early recognition and intervention.

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Correct Answer is B

Explanation

Depression with psychomotor retardation often presents as withdrawal, slowed movements, and diminished verbal engagement. Clients may appear disengaged or nonresponsive, but this reflects internal suffering rather than defiance. Establishing a therapeutic alliance requires consistent presence, emotional attunement, and non-demanding interaction. Early interventions should prioritize trust-building over verbal or social engagement, especially when the client is isolating.

Rationale for correct answer

2. Making short, frequent visits and sitting quietly communicates presence without pressure. This approach respects the client’s current emotional state and initiates connection through nonverbal support. It lays the foundation for trust and future engagement by showing reliability and empathy without demanding interaction.

Rationale for incorrect answers

1. Inviting the client to group therapy prematurely may feel overwhelming and intrusive. It assumes readiness for social interaction, which contradicts her current withdrawn behavior and may increase anxiety or resistance.

3. Introducing her to other clients is premature and socially demanding. It bypasses the essential first step of building a one-on-one therapeutic relationship and may reinforce feelings of isolation if she declines.

4. Exploring stressors requires verbal engagement and insight, which the client is not currently demonstrating. This intervention is more appropriate once rapport is established and the client is emotionally ready to reflect.

Take Home Points

Psychomotor retardation in depression requires gentle, nonverbal therapeutic engagement.
Trust-building precedes verbal or social interventions in severely withdrawn clients.
Avoid overwhelming clients with premature group or social activities.
Consistent, quiet presence is a powerful tool in initiating therapeutic relationships.

A. Apathy B. Somatic delusion C. Difficulty falling asleep D. Social isolation

Correct Answer is A

Explanation

Severe depression is a mood disorder characterized by persistent sadness, loss of interest, and impaired functioning. It affects emotional expression, cognition, and physical behavior. Affective symptoms reflect changes in mood and emotional tone. These include anhedonia, apathy, hopelessness, and feelings of worthlessness. Neurobiologically, dysregulation of serotonin, norepinephrine, and dopamine pathways contributes to affective flattening and emotional blunting. These symptoms are central to diagnosis and often precede cognitive or somatic manifestations.

Rationale for correct answer

1. Apathy reflects a diminished emotional responsiveness and lack of motivation, which are hallmark affective symptoms in major depressive disorder. It indicates a blunting of emotional tone and loss of interest in previously valued activities, consistent with affective flattening.

Rationale for incorrect answers

2. Delusion is a psychotic symptom, not affective. Somatic delusions involve false beliefs about bodily functions or health and are categorized under thought content disturbances, not mood alterations.

3. Insomnia is a physiological symptom. Difficulty falling asleep is a vegetative sign of depression, linked to circadian rhythm disruption and hyperarousal, but it does not reflect affective tone.

4. Isolation is behavioral. Social withdrawal results from decreased energy and motivation but is considered a behavioral response to affective and cognitive symptoms, not an affective symptom itself.

Take Home Points

Affective symptoms in depression include apathy, anhedonia, and hopelessness, reflecting emotional blunting.
Somatic delusions are psychotic features and not part of affective symptomatology.
Sleep disturbances are vegetative signs and reflect physiological dysregulation in depression.
Social isolation is a behavioral consequence, not a direct affective alteration.

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A nursing student is studying major depressive disorder. Which student statement indicates that learning has occurred?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A newly admitted depressed client isolates herself in her room and just sits and stares into space. How best might the nurse begin an initial therapeutic relationship with this client?

Correct Answer is B

Explanation

Which symptom is an example of an affective alteration exhibited by clients diagnosed with severe depression?

Correct Answer is A

Explanation

A newly admitted client diagnosed with major depressive disorder isolates self in room and stares out the window. Which nursing intervention would be the most appropriate to implement initially, when establishing a nurse-client relationship?

Which statement describes a major difference between a client diagnosed with major depressive disorder and a client diagnosed with dysthymic disorder?

Which intervention takes priority when working with newly admitted clients experiencing suicidal ideations?

Which of the following conditions is considered to be the only absolute contraindication for ECT?

A client recently diagnosed with depression tells a nurse that she is 2 months pregnant and is reluctant to take an antidepressant medication. The client asks what other treatment options are available. Which type of therapy should a nurse recommend as an alternate treatment for depression?

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A depressed client states that her daughter uses amphetamines, then asks the nurse, “What will happen when my daughter can’t get them and goes into withdrawal from them?” Which response by the nurse would be helpful information for the client?

The nurse is interviewing a client admitted to an in-patient psychiatric unit with major depressive disorder. Which is the primary goal in the assessment phase of the nursing process for this client?