A nurse is assessing a client who has been experiencing persistent feelings of sadness, fatigue, and difficulty concentrating. The client denies any history of manic episodes. Which of the following conditions should the nurse consider as a possible differential diagnosis for this client?

Bipolar disorder.

Dysthymia.

Substance-induced mood disorder.

Adjustment disorder.

Answer and Explanation

The Correct Answer is B

Choice A rationale:

Bipolar disorder involves both depressive episodes and manic episodes. The client in question denies any history of manic episodes, making bipolar disorder less likely as a diagnosis. Manic episodes are characterized by elevated mood, increased energy, impulsivity, and risky behavior.

Choice B rationale:

Dysthymia, also known as persistent depressive disorder, involves chronic feelings of sadness and a lack of interest or pleasure in activities. It is a milder form of depression that persists for at least two years in adults. The client's persistent feelings of sadness align more closely with the criteria for dysthymia.

Choice C rationale:

Substance-induced mood disorder occurs when the client's mood disturbances are a direct result of substance use or withdrawal. Since there is no mention of substance use or withdrawal in the client's history, this choice is less relevant to the scenario.

Choice D rationale:

Adjustment disorder is characterized by the development of emotional or behavioral symptoms in response to an identifiable stressor, and these symptoms typically resolve within six months of the stressor's resolution. In the scenario, there is no indication of a recent stressor, and the client's symptoms seem to be chronic rather than time-limited, making adjustment disorder less likely.

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Correct Answer is C

Explanation

Choice A rationale:

Bipolar disorder involves distinct periods of both elevated mood (mania or hypomania) and depressive episodes. The scenario describes persistent feelings of sadness, guilt, worthlessness, weight loss, and insomnia, which are characteristic symptoms of major depressive disorder (MDD) but not necessarily indicative of bipolar disorder.

Choice B rationale:

An adjustment disorder is characterized by emotional or behavioral symptoms that arise within three months of experiencing a stressor (e.g., a major life change or event). The persistent feelings of sadness, guilt, worthlessness, weight loss, and insomnia described in the scenario are beyond the typical time frame for an adjustment disorder.

Choice C rationale:

The correct answer. Major depressive disorder (MDD) is characterized by persistent feelings of sadness, loss of interest or pleasure, changes in weight or appetite, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue, feelings of worthlessness or excessive guilt, difficulty concentrating, and recurrent thoughts of death or suicide. The client's symptoms align closely with the diagnostic criteria for MDD.

Choice D rationale:

A normal response to stress usually involves transient feelings of sadness or anxiety in response to a stressor. However, the client's symptoms of persistent feelings of sadness, guilt, worthlessness, weight loss, and insomnia are indicative of a more serious and prolonged condition like major depressive disorder (MDD).

A. A manic episode. B. Bipolar disorder. C. Anhedonia, a characteristic of MDD. D. Adjustment disorder.

Correct Answer is C

Explanation

Choice A rationale:

A manic episode is characterized by a distinct period of abnormally elevated, expansive, or irritable mood, often accompanied by increased energy, decreased need for sleep, and impulsive behavior. The client's description does not align with a manic episode.

Choice B rationale:

Bipolar disorder involves cycling between periods of mania or hypomania and depression. The client's statement does not provide evidence of mood cycling, which is characteristic of bipolar disorder.

Choice C rationale:

The client's statement directly describes anhedonia, which is a key characteristic of major depressive disorder (MDD). Anhedonia involves the inability to derive pleasure from activities that were previously enjoyable, and it is a central diagnostic criterion for MDD.

Choice D rationale:

Adjustment disorder is a condition characterized by emotional or behavioral symptoms that develop in response to a specific stressor. The client's statement is more indicative of a pervasive and ongoing lack of enjoyment, which aligns with the concept of anhedonia in MDD rather than the time-limited nature of adjustment disorder.

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A nurse is assessing a client who has been experiencing persistent feelings of sadness, fatigue, and difficulty concentrating. The client denies any history of manic episodes. Which of the following conditions should the nurse consider as a possible differential diagnosis for this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is experiencing persistent feelings of sadness, guilt, and worthlessness. They also report significant weight loss and insomnia. The nurse suspects the client may have:

Correct Answer is C

Explanation

A client is sharing their experiences with a nurse. The client states, "I just can't seem to enjoy anything anymore. Even activities I used to love don't bring me pleasure." This statement by the client is indicative of:

Correct Answer is C

Explanation

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