Assessment of a client reveals severe and sudden mood swings from mania to depression. Which diagnosis should the nurse suspect?

A. Irritability is a common symptom of depression in adolescents. They may become easily annoyed, frustrated, or angered, often over minor issues.

B. Euphoria, which refers to an exaggerated feeling of happiness or excitement, is not typically associated with depression. Instead, it may indicate a different mood disorder, such as bipolar disorder.

C. Adolescents with depression often experience decreased energy levels or fatigue. They may feel physically drained and lack motivation to engage in usual activities.

D. Social withdrawal and isolation from peers is a significant behavioral indicator of depression. Adolescents may avoid social activities, stop participating in hobbies, or spend more time alone.

E. Grandiosity refers to an exaggerated sense of one's importance, abilities, or achievements. This symptom is more characteristic of certain mood disorders like bipolar disorder or narcissistic personality disorder rather than depression.

F. Feelings of loneliness and social isolation are common in adolescents with depression. They may feel disconnected from others, even if they are physically present in social settings.

D. Denial is a defense mechanism where individuals refuse to acknowledge or accept a painful or distressing reality. In this case, despite objective medical evidence (biopsy results and MRI findings), the client persists in believing that the diagnosis of terminal cancer is incorrect. This refusal to accept the reality of the situation is characteristic of denial.

A. Anger typically involves feelings of frustration, resentment, or hostility towards others or the situation. While anger can be a reaction to receiving a terminal diagnosis, it is not reflective of refusing to accept the diagnosis itself.

B. Anxiety involves feelings of worry, fear, or unease about future events or uncertainties. While anxiety can accompany a terminal diagnosis, it does not manifest as outright refusal or disbelief in the diagnosis itself.

C. Withdrawal refers to a retreat or disengagement from social interactions or activities. It can be a coping mechanism in response to stress or difficult emotions. However, withdrawal does not specifically relate to refusing to accept a diagnosis like terminal cancer.