A nurse is assisting with the care of a client.

Complete the diagram by dragging from the choices below to specify what condition the client is most likely experiencing, 2 actions the nurse should take to address that condition, and 2 parameters the nurse should monitor to assess the client's progress.

Rationale for correct choices:

• Major depressive disorder: The client demonstrates classic manifestations including flat affect, poor hygiene, lack of eye contact, hopeless statements about life not being worth living, recent job loss, and alcohol use. These findings are consistent with a depressive disorder rather than cognitive or psychotic conditions.

• Remain in the room with the client: The client expresses hopelessness and passive thoughts suggesting life has little value, placing them at risk for self-harm. Remaining with the client provides safety, conveys support, and allows for immediate intervention if distress escalates.

• Assist the client to identify stressors: Job loss, injury, alcohol use, and impaired functioning are significant psychosocial stressors contributing to the client’s depressive symptoms. Helping the client identify these stressors supports therapeutic communication and initiates coping-focused care.

• Sleep patterns: Changes in sleep are common in major depressive disorder and are important indicators of symptom severity and response to treatment. Monitoring sleep helps evaluate progression or improvement of depressive symptoms.

• Suicidal ideation: Statements indicating life may not be worth living require close monitoring for suicidal thoughts. Ongoing assessment is essential to ensure safety and guide escalation of mental health interventions.

Rationale for incorrect choices:

• Dementia: The client is not described as having progressive memory loss, impaired orientation, or cognitive decline. The presentation is affective and situational rather than neurocognitive.

• Schizophrenia: There is no evidence of hallucinations, delusions, disorganized thinking, or psychosis. The client’s symptoms are mood-based rather than psychotic.

• Dependent personality disorder: While the client is distressed, there is no indication of pervasive submissive behavior or excessive reliance on others for decision-making.

• Determine client's level of orientation: The client is not displaying confusion or disorientation; their responses are appropriate and goal-directed, making this a lower priority intervention.

• Speak with the client using simple words: This approach is more appropriate for cognitive impairment or severe anxiety. The client is able to communicate effectively and does not demonstrate impaired comprehension.

• Encourage client to eat slowly: There is no evidence of gastrointestinal distress or eating-related concerns that would make this intervention relevant.

• Hallucinations: No sensory disturbances are reported or observed, making this an inappropriate monitoring focus.

• Wandering at night: This finding is associated with dementia or delirium and is not supported by the client’s presentation.

• Panic attacks: Although the client reports anxiety, there is no indication of acute panic episodes requiring focused monitoring.