Chapter 14: Depressive Disorders Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical Approach, 8th Edition MULTIPLE CHOICE 1. A patient became severely depressed when the last of the family’s six children moved out of
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the home 4 months ago. The patient repeatedly says, “No one cares about me. I’m not worth anything.” Which response by the nurse would be the most helpful? a. “Things will look brighter soon. Everyone feels down once in a while.” b. “Our staff members care about you and want to try to help you get better.” c. “It is difficult for others to care about you when you repeatedly say the same negative things.” d. “I’ll sit with you for 10 minutes now and 10 minutes after lunch to help you feel that I care about you.” ANS: D
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Spending time with the patient at intervals throughout the day shows acceptance by the nurse and will help the patient establish a relationship with the nurse. The therapeutic technique is “offering self.” Setting definite times for the therapeutic contacts and keeping the appointments show predictability on the part of the nurse, an element that fosters trust building. The incorrect responses would be difficult for a person with profound depression to believe, provide false reassurance, and are counterproductive. The patient is unable to say positive things at this point.
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PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 14-27, 57 (Table 14-4) | Page 14-16 (Case Study and Nursing Care Plan) TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
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2. A patient became depressed after the last of the family’s six children moved out of the home 4
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months ago. Select the best initial outcome for the nursing diagnosis Situational low self-esteem related to feelings of abandonment. The patient will a. verbalize realistic positive characteristics about self by (date). b. agree to take an antidepressant medication regularly by (date). c. initiate social interaction with another person daily by (date). d. identify two personal behaviors that alienate others by (date).
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ANS: A
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Low self-esteem is reflected by making consistently negative statements about self and self-worth. Replacing negative cognitions with more realistic appraisals of self is an appropriate intermediate outcome. The incorrect options are not as clearly related to the nursing diagnosis. Outcomes are best when framed positively; identifying two personal behaviors that might alienate others is a negative concept.
PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 14-27, 53 (Table 14-2) | Page 14-16 (Case Study and Nursing Care Plan) | Page 274 TOP: Nursing Process: Outcomes Identification MSC: Client Needs: Psychosocial Integrity
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