A 35-year-old patient diagnosed with major depressive disorder (MDD) is prescribed selective serotonin reuptake inhibitors (SSRIs) for treatment. The patient asks the nurse about the expected onset of action for these medications. Which response by the nurse is most appropriate?
a) “You should start feeling better within a day or two.”
b) “It might take a few weeks before you notice an improvement.”
c) “SSRIs work immediately to alleviate symptoms.”
d) “You’ll notice significant changes in your mood within 24 hours.”
e) “The effects of SSRIs vary from person to person.”
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Rationale: Understanding the onset of action of antidepressants is crucial in managing patient expectations. While SSRIs are effective, they typically take several weeks (around 2-6 weeks) to exhibit their therapeutic effects. Educating the patient about the delayed onset of action helps manage their expectations and encourages adherence to the treatment plan.
A 28-year-old patient with depression is undergoing therapy and pharmacological treatment. During a follow-up visit, the nurse observes the patient exhibiting signs of agitation, confusion, and fever. The nurse suspects serotonin syndrome. Which medication might have contributed to these symptoms in the patient’s regimen?
a) Bupropion (Wellbutrin)
b) Sertraline (Zoloft)
c) Venlafaxine (Effexor)
d) Fluoxetine (Prozac)
e) Amitriptyline (Elavil)
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Rationale: Serotonin syndrome is a potentially life-threatening condition caused by excessive serotonin accumulation. Medications that increase serotonin levels, like venlafaxine, can precipitate this syndrome when combined with other serotonergic agents. Recognizing the potential for drug interactions leading to serotonin syndrome is crucial for patient safety and appropriate medication management.
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A 45-year-old patient diagnosed with depression and prescribed an antidepressant presents with complaints of persistent insomnia despite the medication. The nurse identifies that the patient adheres strictly to the prescribed dosage and timing. What intervention should the nurse suggest to help manage the insomnia?
a) Increasing the antidepressant dosage
b) Adding a benzodiazepine for sleep
c) Prescribing a different class of antidepressant
d) Implementing sleep hygiene practices
e) Suggesting the patient stop taking the antidepressant
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Rationale: Insomnia is a common symptom of depression and can persist despite antidepressant treatment. Recommending non-pharmacological interventions like sleep hygiene practices, such as maintaining a regular sleep schedule or avoiding stimulants before bedtime, is essential. These measures can complement medication therapy and improve sleep quality without altering the antidepressant regimen unnecessarily.
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NCLEX Practice Questions: Understanding Depression Causes and Symptoms
Understanding Depression: Causes and Symptoms
A 20-year-old college student visits the clinic reporting feelings of persistent sadness, loss of interest in activities, changes in appetite, difficulty sleeping, and poor concentration. The nurse suspects major depressive disorder (MDD). Which additional symptom would further support this diagnosis?
a) Hypomania
b) Hallucinations
c) Paranoid delusions
d) Excessive worrying
e) Euphoria
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Rationale: While symptoms like sadness, changes in sleep, appetite, and concentration are indicative of depression, the presence of hallucinations could suggest a more severe form of depression or a concurrent psychotic disorder. Recognizing psychotic symptoms aids in appropriate diagnosis and treatment planning for individuals with major depressive disorder with psychotic features.
1000 Medical-Surgical Questions
A 45-year-old patient is brought to the emergency department due to suicidal ideation. The patient expresses feeling worthless, hopeless, and describes a pervasive sense of guilt. The nurse recognizes these as common symptoms of depression and assesses for:
a) Grandiosity b) Auditory hallucinations c) Flight of ideas d) Psychomotor agitation e) Impulsivity
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Rationale: Assessing for psychomotor agitation is crucial in evaluating the severity of depression and the risk of self-harm. Patients experiencing depression may exhibit psychomotor changes such as restlessness, pacing, or increased physical activity, which can signal an elevated risk of suicide.
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A 30-year-old individual with depression complains of persistent physical symptoms, including headaches, backaches, and digestive issues, despite no apparent medical cause. The nurse recognizes these manifestations as potential:
a) Panic attacks
b) Conversion disorder
c) Generalized anxiety disorder
d) Hypochondriasis
e) Psychosomatic symptoms
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Rationale: Depressive disorders can manifest as physical symptoms without identifiable medical causes, known as psychosomatic symptoms. Recognizing these somatic complaints as potential manifestations of underlying depression is crucial in providing holistic care and addressing both the physical and mental health aspects of the patient.
1000 ANCC Questions
A 55-year-old patient presents to the clinic with symptoms of depression, reporting feelings of worthlessness, persistent sadness, and changes in appetite. The patient mentions difficulty concentrating at work and expresses concerns about being a burden to their family. The nurse identifies these symptoms as indicative of depression with:
a) Atypical features
b) Catatonic features
c) Melancholic features
d) Psychotic features
e) Seasonal pattern
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Rationale: Symptoms such as increased appetite or weight gain, oversleeping, feeling a heavy sensation in limbs, and sensitivity to interpersonal rejection characterize depression with atypical features. Recognizing these atypical symptoms aids in accurately diagnosing and planning treatment for individuals with this subtype of depression.
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NCLEX Practice Questions: Understanding Depression Causes and Symptoms
A 30-year-old patient diagnosed with depression presents with symptoms of excessive guilt, insomnia, and loss of interest in previously enjoyable activities. The patient is currently on antidepressant medication. The nurse observes the patient expressing intense suicidal thoughts and intent. What symptomatology might the patient be experiencing?
a) Hypochondriasis
b) Dysthymia
c) Anhedonia
d) Suicidal ideation
e) Psychomotor retardation
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Rationale: Suicidal ideation, thoughts, or intentions of self-harm are grave symptoms requiring immediate attention and intervention. Recognizing and promptly addressing these symptoms are crucial in ensuring patient safety and initiating appropriate interventions to prevent self-harm.
Understanding Depression: Causes and Symptoms
A 25-year-old patient with a history of depression reports experiencing episodes of persistent low mood, fatigue, and feelings of hopelessness over the last two years. The nurse suspects:
a) Bipolar disorder
b) Major depressive disorder (MDD)
c) Cyclothymic disorder
d) Persistent depressive disorder (PDD)
e) Adjustment disorder
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Rationale: Symptoms persisting for at least two years without remission periods align with the criteria for persistent depressive disorder (PDD), previously known as dysthymia. Recognizing the chronicity of symptoms helps differentiate PDD from other mood disorders and informs appropriate treatment strategies for long-term management.
Understanding Depression: NCLEX Priority Questions
NCLEX Questions: Focus on Medications for Depression
A 38-year-old patient arrives at the clinic reporting feelings of profound sadness, loss of energy, and persistent thoughts of worthlessness. The patient describes difficulties concentrating at work and a noticeable change in appetite, with significant weight loss over the past month. Which symptom may this patient be exhibiting, indicative of severe depression?
a) Hypomania
b) Anhedonia
c) Hypersomnia
d) Psychomotor agitation
e) Flight of ideas
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Rationale: Psychomotor agitation involves observable physical restlessness, pacing, or increased activity levels. It is a common symptom seen in severe depression, suggesting higher agitation and inner turmoil. Recognizing this symptom is essential as it may indicate an increased risk of self-harm or suicide in individuals experiencing severe depression, prompting immediate intervention and ensuring patient safety.
