A nurse is assessing a client who has schizophrenia. Which of the following behaviors should the nurse anticipate?

Choice A reason:Sublimation is a defense mechanism where negative emotions, like anger, are channeled into positive or socially acceptable activities, such as exercise. Working out in the gym when feeling mad transforms the emotion into a constructive outlet, reflecting adaptive use of sublimation.

Choice B reason:Forgetting the event suggests repression or dissociation, not sublimation. This response does not involve channeling emotions into productive activities and is not adaptive for addressing anxiety.

Choice C reason:Denying anxiety indicates denial, not sublimation. This statement avoids acknowledging the emotion rather than redirecting it into a positive action, making it non-adaptive.

Choice D reason:Expressing inability to move past the tragedy reflects rumination or despair, not sublimation. It does not involve transforming negative emotions into constructive behaviors, so it is not an adaptive response.

Choice A reason:Major depressive disorder carries a high risk of suicide, especially in acute settings. Monitoring for self-harm is the priority to ensure the client’s safety, as it addresses an immediate, life-threatening risk before other interventions.

Choice B reason:Administering antidepressants is important for managing depression, but it is not the priority over safety. Antidepressants take weeks to become effective, and the risk of self-harm must be addressed first.

Choice C reason:Assisting with activities of daily living supports the client’s functional needs, but it is not the priority. Safety concerns, such as self-harm risk, take precedence in acute depression.

Choice D reason:Encouraging fluid intake is important for physical health, but it is not the priority in major depressive disorder. Preventing self-harm is critical due to the high risk of suicide in this condition.