During intake assessment, the nurse is most likely to hear a client with major depressive disorder say which of the following statements about depression? (SELECT ALL THAT APPLY)
I’d rather be dead than living like this. I do not want to be alive.
If I can just keep ignoring feelings.
I deserve to be this way. I’ve not accomplished anything important in my life.
This is a bad episode, but I will be well soon.
I am determined to fight this episode and get through it.
Correct Answer : A,C,D
Choice A Reason:
“I’d rather be dead than living like this. I do not want to be alive.”
This statement reflects a common symptom of major depressive disorder, which is suicidal ideation. Individuals with major depressive disorder often experience feelings of hopelessness and worthlessness, leading them to believe that life is not worth living. This statement is a clear indication of the severity of the individual’s depressive symptoms and the need for immediate intervention to ensure their safety.
Choice B Reason:
“If I can just keep ignoring feelings.”
This statement is less likely to be heard from a client with major depressive disorder. Ignoring feelings is a coping mechanism that some individuals might use, but it does not directly reflect the core symptoms of major depressive disorder, which include persistent sadness, loss of interest in activities, and significant impairment in daily functioning. Therefore, this choice is not as indicative of major depressive disorder as the other statements.
Choice C Reason:
“I deserve to be this way. I’ve not accomplished anything important in my life.”
This statement reflects feelings of guilt and worthlessness, which are common symptoms of major depressive disorder. Individuals with this disorder often have a negative self-view and believe that they are failures or that they deserve to suffer. This statement highlights the individual’s low self-esteem and the pervasive negative thoughts that characterize major depressive disorder.
Choice D Reason:
“This is a bad episode, but I will be well soon.”
This statement reflects a more optimistic outlook, which is less common in individuals with major depressive disorder. However, it can still be heard from some clients who experience episodic depression and have hope for recovery. This statement indicates that the individual recognizes their current state as temporary and believes in the possibility of improvement, which can be a positive sign in the context of treatment.
Choice E Reason:
“I am determined to fight this episode and get through it.”
This statement reflects a proactive and positive attitude towards managing depression, which is less characteristic of major depressive disorder. While determination and resilience are important for recovery, individuals with major depressive disorder often struggle with motivation and energy, making it difficult for them to adopt such a mindset. Therefore, this choice is less likely to be heard from a client with major depressive disorder.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
This statement indicates that the client understands the nature of recovery from alcohol abuse. Recovery is indeed a lifelong process that involves continuous effort and commitment. Recognizing that recovery comes in steps shows that the client is aware of the ongoing nature of the process and the need for sustained effort and support. This understanding is crucial for successful long-term recovery.
Choice B Reason:
This statement is incorrect because it reflects a misunderstanding of the recovery process. Detoxification is just the first step in recovery, and it involves removing alcohol from the body. However, recovery involves much more than just detoxification. It includes ongoing therapy, support groups, lifestyle changes, and coping strategies to maintain sobriety and prevent relapse. Therefore, thinking that recovery is complete after detoxification is a misconception.
Choice C Reason:
This statement is also incorrect because it suggests that the goal of recovery is merely to decrease drinking. The goal of recovery from alcohol abuse is to achieve and maintain sobriety, not just to reduce alcohol consumption. Effective recovery involves abstaining from alcohol, addressing the underlying issues that led to alcohol abuse, and developing healthy coping mechanisms and support systems.
Choice D Reason:
While Al-Anon can indeed assist in the recovery process, this statement alone does not indicate that the client has fully understood the nature of recovery. Al-Anon is a support group for friends and family members of people with alcohol use disorder, and it can provide valuable support and resources. However, recognizing the lifelong and step-by-step nature of recovery is a more comprehensive indication of learning.
Correct Answer is C
Explanation
The correct answer is c. Replace fluids.
Choice A Reason: Apply restraints
Applying restraints is generally not the first-line intervention for managing alcohol withdrawal. Restraints should only be used if the patient poses an immediate threat to themselves or others and all other less restrictive measures have failed. The primary focus in the initial phase of alcohol withdrawal is to manage physiological stability and prevent complications.
Choice B Reason: Identify social supports
While identifying social supports is important for long-term recovery and overall mental health, it is not the highest priority during the initial phase of alcohol withdrawal. The immediate concern is to address the acute physiological symptoms and prevent severe complications such as seizures or delirium tremens.
Choice C Reason: Replace fluids
Replacing fluids is the highest priority in the initial phase of alcohol withdrawal. Dehydration is a common issue in patients undergoing withdrawal, and maintaining fluid balance is crucial for preventing complications. Ensuring adequate hydration helps stabilize the patient and supports overall physiological function during the withdrawal process.
Choice D Reason: Orient to reality
Orienting the patient to reality is important, especially if they are experiencing confusion or delirium. However, it is not the highest priority in the initial phase of alcohol withdrawal. The primary focus should be on stabilizing the patient’s physiological condition, including fluid replacement and monitoring vital signs.
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