A patient with a history of depression reports not feeling well ...

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A patient with a history of depression reports not feeling well rested in recent weeks. Before making the assumption that the complaint is related to depression, a nurse should investigate whether the patient has had any recent changes in:
 
  a. work schedule that affect the hours of sleep.
  b. vacations taken within the same time zone.
  c. fluid intake with reduced overall intake of water.
  d. food intake with decreased intake of heavy foods before bedtime.

Question 2

The diagnosis of hypomania in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), has the same seven criteria as mania, except only three of the symptoms must be present and the hypomania must last at least:
 
  a. 1 day
  b. 4 days
  c. 1 week
  d. 1 month

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Answer to Question 1

A
Changes in schedule that affect circadian rhythms, such as work shifts that alter usual sleep patterns, can result in fatigue that is not related to mental health status. Other factors that alter sleep include changes in light and darkness and temperature changes. Vacations in the same time zone should not affect sleep, whereas food and fluid intake should enhance sleep by reducing risk of nocturia or indigestion.

Answer to Question 2

B
The defining characteristics of hypomania include the same seven criteria for mania, but to diagnose hypomania, only three symptoms need to be present. These three symptoms need only to have lasted 4 days. In contrast to mania, hypomanic symptoms need not cause any disturbances in functioning but must be observable by others.

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Excellent

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