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

Apathy

Somatic delusion

Difficulty falling asleep

Social isolation

Answer and Explanation

The Correct Answer is A

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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Free Nursing Study Resources

Correct Answer is ["A","B","C"]

Explanation

Electroconvulsive therapy (ECT) is a procedure that induces a controlled seizure to treat severe psychiatric conditions. Prior to ECT, specific medications are administered to reduce cardiac complications, facilitate anesthesia, and prevent muscle injury. These agents are chosen to optimize safety and seizure quality without interfering with the therapeutic mechanism.

Rationale for correct answers

1. Glycopyrrolate is an anticholinergic used pre-ECT to reduce salivary secretions and prevent bradycardia during the procedure. Its peripheral action minimizes central side effects, making it ideal for ECT preparation.

2. Thiopental sodium is a barbiturate anesthetic that induces rapid unconsciousness before ECT. It has a short duration of action and minimal impact on seizure threshold, making it suitable for brief procedures.

3. Succinylcholine is a neuromuscular blocker administered to prevent musculoskeletal injury during the seizure. It produces short-term paralysis, reducing the risk of fractures or dislocations during convulsions.

Rationale for incorrect answers

4. Lorazepam is a benzodiazepine that raises the seizure threshold and may blunt the therapeutic seizure. Its sedative properties interfere with ECT efficacy, making it contraindicated before the procedure.

5. Divalproex sodium is an anticonvulsant that suppresses seizure activity. Administering it before ECT would counteract the intended seizure induction, reducing treatment effectiveness.

Take Home Points

Pre-ECT medications include anticholinergics, anesthetics, and muscle relaxants to optimize safety and seizure quality.
Benzodiazepines and anticonvulsants are avoided as they interfere with seizure induction.
Glycopyrrolate prevents bradycardia and excessive secretions during ECT.
Succinylcholine minimizes physical injury by inducing short-term paralysis during the seizure.

A. Irritability with authority B. Being uninterested in school C. A change in behaviors over a 2-week period D. Feeling insecure at a social gathering

Correct Answer is C

Explanation

Depressive disorder in youth presents differently than in adults, often with behavioral and somatic complaints rather than verbalized sadness. Diagnostic criteria emphasize a persistent change in functioning. Irritability, withdrawal, and academic decline may be present, but diagnosis hinges on sustained shifts in mood or behavior. The DSM-5 outlines that symptoms must last at least two weeks and cause significant impairment. Early recognition is critical, as untreated depression in youth increases risk for substance use, academic failure, and suicide.

Rationale for correct answer

3. A sustained behavioral change over a 2-week period meets the DSM-5 threshold for diagnosing depressive disorders in children and adolescents. This duration reflects a persistent alteration in mood, energy, or functioning, distinguishing clinical depression from transient emotional states.

Rationale for incorrect answers

1. Irritability alone is nonspecific and may reflect normal developmental defiance, oppositional behavior, or situational stress. Without duration or associated symptoms, it cannot confirm depression.

2. Uninterest in school may stem from academic challenges, peer conflict, or boredom. While it can be a symptom of depression, it lacks diagnostic specificity without broader behavioral context.

4. Insecurity in social settings is common in adolescence due to developmental changes in self-concept and peer dynamics. It may reflect social anxiety or shyness, not necessarily depression.

Take Home Points

Depression in youth requires a persistent change in mood or behavior lasting at least two weeks.
Irritability is common but not diagnostic without other sustained symptoms.
School disengagement may signal depression but must be evaluated in context.
Social discomfort alone does not indicate depressive disorder; broader patterns must be assessed.

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

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following medications may be administered before electroconvulsive therapy? Select all that apply.

Correct Answer is ["A","B","C"]

Explanation

Which is the key to understanding if a child or adolescent is experiencing an underlying depressive disorder?

Correct Answer is C

Explanation

A client has just been admitted to the psychiatric unit with a diagnosis of major depressive disorder. Which of the following behavioral manifestations might the nurse expect to assess? Select all that apply.

A client diagnosed with major depressive disorder is being considered for electroconvulsive therapy (ECT). Which client teaching should the nurse prioritize?

Which client statement is evidence of the etiology of major depressive disorder from a genetic perspective?

Which client is at highest risk for the diagnosis of major depressive disorder?

A client diagnosed with major depressive disorder has an outcome that states, “The client will verbalize a measure of hope about the future by day 3.” Which client statement indicates this outcome was successful?

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?

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

Which nursing diagnosis would be most appropriate for the client who has undergone the full course of electroconvulsive therapy (ECT)?