A nurse at a primary care clinic is collecting data on a client for manifestations of depression. Which of the following client statements should the nurse identify as being consistent with depression?

"Lately, I feel like I am more alert than usual and can focus better."

"I can't sit still. I feel like I need to be doing things around the house."

"When I went to my provider, they told me I have high blood pressure."

"I can't get my mind to stop racing at night. I'm only sleeping a couple of hours."

Answer and Explanation

The Correct Answer is D

A. "Lately, I feel like I am more alert than usual and can focus better.": Depression is commonly associated with difficulties in concentration, memory impairment, and slowed cognitive function rather than increased alertness or improved focus. Clients with depression often report feeling mentally sluggish or experiencing brain fog.
B. "I can't sit still. I feel like I need to be doing things around the house.": While some individuals with depression experience psychomotor agitation, it is more common for depression to present with fatigue, low energy, and decreased motivation. Restlessness may also be seen in anxiety disorders, but it is not a primary symptom of depression.
C. "When I went to my provider, they told me I have high blood pressure.": Hypertension is a medical condition that may have various causes, but it is not a direct manifestation of depression. However, chronic stress and depression can contribute to cardiovascular issues over time, though depression itself is primarily characterized by emotional and cognitive symptoms.
D. "I can't get my mind to stop racing at night. I'm only sleeping a couple of hours.": Insomnia and difficulty falling or staying asleep are hallmark symptoms of depression. Clients often experience ruminative thoughts, early-morning awakenings, or non-restorative sleep, which can contribute to worsened mood, fatigue, and impaired daily functioning.

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Correct Answer is B

Explanation

A. Tell the client that there is nothing there. Dismissing the client's perception may increase distress and reduce trust in the nurse-client relationship. A therapeutic approach acknowledges the client’s experience without reinforcing or denying hallucinations.
B. Ask the client to describe what is being seen. Encouraging the client to describe the hallucination helps assess its nature and severity. Understanding the content allows the nurse to provide appropriate support, ensure safety, and guide interventions.
C. Touch the client's arm reassuringly. Touching the client without consent, especially during a distressing hallucination, may escalate fear or agitation. Maintaining a calm and non-threatening presence is more appropriate.
D. Remove the client from the room. Relocating the client without assessing the hallucination may not address the underlying distress. Identifying triggers and using therapeutic communication are more effective initial interventions.

A. Suspiciousness of others B. Requiring frequent reassurance from others C. Inflated sense of self D. Lack of feelings of remorse

Correct Answer is A

Explanation

A. Suspiciousness of others: Paranoid personality disorder is characterized by pervasive distrust and suspicion of others, leading to difficulty forming relationships. Clients may misinterpret benign actions as malicious and hold long-standing grudges.
B. Requiring frequent reassurance from others: This is more characteristic of dependent personality disorder, where individuals struggle with self-confidence and rely on others for decision-making and emotional support.
C. Inflated sense of self: This is commonly seen in narcissistic personality disorder, where individuals display grandiosity, a need for admiration, and a lack of empathy for others.
D. Lack of feelings of remorse: This trait is associated with antisocial personality disorder, where individuals exhibit disregard for the rights of others, manipulative behavior, and a lack of guilt or remorse for their actions.

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A nurse at a primary care clinic is collecting data on a client for manifestations of depression. Which of the following client statements should the nurse identify as being consistent with depression?

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Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is A

Explanation

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