A nurse is providing teaching about relapse prevention to a client who has schizophrenia. Which of the following statements by the client indicates an understanding of the teaching?

Choice A Reason:
This response is open-ended and encourages the client to express their feelings and thoughts. It shows empathy and allows the nurse to gather more information about the client's emotional state. Open-ended questions are crucial in therapeutic communication as they help build rapport and trust, which are essential in managing clients with major depressive disorder. According to nursing guidelines, assessing the client's feelings and thoughts is a primary step in understanding their mental health status and planning appropriate interventions.

Choice B Reason:
Asking "Why did you feel like giving away your belongings?" might come across as judgmental or confrontational. It could make the client feel defensive or misunderstood. In therapeutic communication, it's important to avoid "why" questions as they can imply criticism and may not encourage the client to open up. Instead, focusing on the client's feelings and experiences is more effective in understanding their condition.

Choice C Reason:
Saying "Everyone feels a little down sometimes" minimizes the client's feelings and can be perceived as dismissive. Clients with major depressive disorder often feel isolated and misunderstood, and such a response could exacerbate these feelings. It's important for nurses to validate the client's emotions and provide support rather than downplaying their experiences.

Choice D Reason:
While suggesting a support group can be helpful, it is not the most immediate or appropriate response in this context. The client has expressed a significant behavior (giving away personal belongings) that could indicate suicidal ideation or severe depression. The nurse's priority should be to assess the client's current emotional state and risk factors before suggesting long-term solutions like support groups.

Choice A Reason:
Constant talking, also known as pressured speech, is a common symptom of mania in bipolar disorder. During a manic episode, individuals often experience a rapid flow of speech that is difficult to interrupt. This symptom is indicative of the heightened energy levels and racing thoughts associated with mania. Pressured speech can be overwhelming for both the individual and those around them, as it often includes rapid shifts in topics and an inability to focus on one subject.

Choice B Reason:
Expressing feelings of inferiority is more commonly associated with depressive episodes rather than manic episodes. During a depressive episode, individuals may experience low self-esteem, feelings of worthlessness, and a pervasive sense of sadness. These symptoms are in contrast to the elevated mood and increased self-confidence typically seen in mania.

Choice C Reason:
Memory loss is not a primary indicator of mania. While cognitive impairments can occur in bipolar disorder, they are not specific to manic episodes. Memory loss can be associated with various conditions, including depression, anxiety, and other neurological disorders. It is important to differentiate between symptoms specific to mania and those that may arise from other conditions.

Choice D Reason:
Sleeping over 10 hours a day is indicative of hypersomnia, which is more commonly seen in depressive episodes. During a manic episode, individuals typically experience a decreased need for sleep and may function on very little rest without feeling tired. The reduced need for sleep is a hallmark symptom of mania and helps distinguish it from depressive episodes.