Major Depressive Disorder Practice Questions
20 free Major Depressive Disorder practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
According to the DSM-5, how long must core symptoms persist to consider a diagnosis of a major depressive episode?
- A 1 week
- B 2 weeks
- C 1 month
- D 6 months
Correct answer: 2 weeks
The DSM-5 requires symptoms to persist for at least two weeks and represent a significant change from previous functioning.
Which two symptoms must be present (at minimum) for a diagnosis of a major depressive episode?
- A Insomnia together with persistently low energy
- B Depressed mood or loss of interest/pleasure
- C Weight change with psychomotor agitation
- D Suicidal ideation with feelings of guilt
Correct answer: Depressed mood or loss of interest/pleasure
One of the two must be depressed mood or markedly diminished interest/pleasure (anhedonia), plus other symptoms.
A client states, 'I haven’t enjoyed anything in weeks. I feel hopeless and worthless.' These comments reflect which symptom cluster?
- A Cognitive/psychomotor symptoms
- B Mood and interest symptoms
- C Appetite and sleep symptoms
- D Suicidal symptoms only
Correct answer: Mood and interest symptoms
Loss of interest ('haven’t enjoyed anything') plus hopelessness/worthlessness relate directly to mood and interest changes characteristic of MDD.
Which of the following is not a diagnostic criterion symptom of MDD in the DSM-5?
- A Diminished ability to think or concentrate
- B Recurrent use of substances such as alcohol
- C Psychomotor agitation or retardation
- D Feelings of worthlessness or excessive guilt
Correct answer: Recurrent use of substances such as alcohol
Substance use is not itself one of the nine criteria; the symptoms must not be better explained by substance/medication use or another medical condition.
The nurse knows that major depressive disorder most significantly impairs which areas of functioning?
- A Mainly sleep and appetite regulation
- B Work, social, and domestic functioning
- C Mainly sensory abilities such as vision and hearing
- D Mainly short-term memory recall
Correct answer: Work, social, and domestic functioning
MDD causes clinically significant distress or impairment in occupational, social or other important areas of functioning.
In planning a group session for clients with MDD, which content is most appropriate?
- A Avoiding any discussion of the members' mood
- B Psychoeducation about symptoms, treatment, and coping
- C Administering medication with no group discussion
- D Bypassing members who express hopelessness
Correct answer: Psychoeducation about symptoms, treatment, and coping
Group mental-health sessions for MDD should include psychoeducation (symptoms, treatment, coping), which supports client understanding and engagement.
A client reports 'I sleep all day and I can’t get out of bed.' This could indicate which subtype or feature of MDD?
- A 'I feel tired and worn out all the time.'
- B 'I can't seem to enjoy anything anymore.'
- C 'My family would be better off without me.'
- D 'I really miss the person I used to be.'
Correct answer: 'My family would be better off without me.'
Hypersomnia and increased appetite are typical of the 'atypical features' specifier of MDD.
When assessing for suicide risk in MDD, which statement by a client warrants the highest priority?
- A Tricyclic antidepressants as first choice
- B Selective serotonin reuptake inhibitors (SSRIs)
- C Benzodiazepines for mood elevation
- D Stimulants for energy and motivation
Correct answer: Selective serotonin reuptake inhibitors (SSRIs)
Expressions of self-worthlessness and that others would be better off without the individual indicate imminent suicide risk and require immediate intervention.
Pharmacotherapy for major depressive disorder often uses which class of medications as first-line treatment?
- A Tricyclic antidepressants only
- B Selective serotonin reuptake inhibitors (SSRIs)
- C Benzodiazepines only
- D Stimulants
Correct answer: Selective serotonin reuptake inhibitors (SSRIs)
SSRIs are commonly used as initial pharmacologic treatment because of efficacy and tolerability in MDD.
A client states during a group: 'I can’t concentrate. My mind goes blank while I’m trying to read.' This symptom reflects which diagnosis element?
- A Appetite disturbance and weight change
- B Impaired concentration or indecisiveness
- C Psychomotor retardation and slowing
- D Elevated or expansive mood
Correct answer: Impaired concentration or indecisiveness
Difficulty concentrating or indecisiveness is one of the DSM-5 diagnostic criteria for a major depressive episode.
Which of the following symptoms occurring in bereavement could still meet criteria for MDD under the DSM-5?
- A Brief sadness for a single day after a spouse's death
- B Persistent depressed mood and suicidal ideation two weeks after loss
- C Acceptance of the loss with no mood symptoms
- D Mild sadness for one week with normal functioning
Correct answer: Persistent depressed mood and suicidal ideation two weeks after loss
The DSM-5 removed the bereavement exclusion; if symptoms meet full criteria for two weeks or more and include impairment, MDD may be diagnosed.
Which risk factor most strongly increases likelihood of developing MDD?
- A Living alone with limited social support
- B Family history of depression
- C Regular moderate coffee intake
- D Mild changes with the seasons
Correct answer: Family history of depression
A family history of depression (genetic predisposition) is a major risk factor for MDD.
The group nurse notices a member has significant weight loss, early morning awakening, and marked guilt. Which specifier might this reflect?
- A With anxious distress
- B With atypical features
- C With melancholic features
- D With seasonal pattern
Correct answer: With melancholic features
Melancholic features include weight loss, early morning awakening, excessive guilt, and mood worse in the morning.
Which physical health condition must be ruled out before diagnosing MDD because it may present with similar symptoms?
- A Hyperthyroidism
- B Seasonal allergy
- C Hemophilia
- D Myopia
Correct answer: Hyperthyroidism
Conditions such as thyroid dysfunction (hypo- or hyperthyroidism) can mimic depressive symptoms and should be assessed before a MDD diagnosis.
In group therapy for clients with MDD, what is a beneficial activity the nurse can introduce?
- A Discourage clients from discussing their daily routines
- B Encourage scheduling of pleasurable activities (behavioral activation)
- C Focus on depressive thoughts rather than any actions
- D Limit social interaction during the sessions
Correct answer: Encourage scheduling of pleasurable activities (behavioral activation)
Behavioral activation (scheduling pleasurable or meaningful activities) is an evidence-based intervention for depression and works well in group settings.
A client with MDD says: 'I feel hopeless, like things will never get better.' The nurse responds: 'What gives you even a small reason to hope today?' This is an example of what technique?
- A Direct confrontation of the client's belief
- B Motivational questioning to explore ambivalence
- C Making a diagnosis without the client's consent
- D Ignoring the client's expression of hopelessness
Correct answer: Motivational questioning to explore ambivalence
The nurse uses motivational and therapeutic questioning to help the client identify any reason for hope, which is appropriate in depressive treatment.
Which of the following best describes the course of MDD if left untreated?
- A Typically resolves within about one week
- B Often lasts six to nine months and may recur
- C Rarely recurs once an episode resolves
- D Largely confined to children and adolescents
Correct answer: Often lasts six to nine months and may recur
Untreated major depressive episodes often last several months and recurrence is common; full recovery may take time.
An adult group member reports low energy, slowed speech, and nearly daily psychomotor retardation. Which cluster is this?
- A Atypical features with reactive mood
- B Somatic/physical symptoms of MDD
- C Predominantly anxiety symptoms
- D Social phobia-related symptoms
Correct answer: Somatic/physical symptoms of MDD
Psychomotor retardation and low energy represent somatic and physical manifestations of major depressive disorder.
Which statement by a client suggests a need for immediate intervention in a depression group?
- A 'I've had a string of bad days these past two weeks.'
- B 'I don't enjoy the things I used to enjoy.'
- C 'Sometimes I think the world would be better off without me.'
- D 'I sleep more than usual but still feel tired.'
Correct answer: 'Sometimes I think the world would be better off without me.'
Expressions that one’s death would be better for others suggest suicidal ideation and require urgent assessment and intervention.
In planning discharge teaching for a depressed client, the nurse includes: 'Continue taking the antidepressant for ____ weeks before deciding it isn’t effective.' Which number reflects standard recommendation?
- A About 1 week of treatment
- B About 2 weeks of treatment
- C About 4 to 6 weeks of treatment
- D About 12 to 24 hours of treatment
Correct answer: About 4 to 6 weeks of treatment
Antidepressants typically require 4-6 weeks (often up to 6) for full therapeutic effect; premature discontinuation may undermine recovery.