A nurse at a primary care clinic is assessing a client for manifestations of depression. Which of the following client statements should the nurse identify as being consistent with depression?
"I can't sit still. I feel like I need to be doing things around the house."
"Lately, I feel like I am more alert than usual and can focus better."
"When I went to my provider, they told me I have high blood pressure."
"I can't get my mind to stop racing at night. I'm only sleeping a couple of hours.”
The Correct Answer is D
Rationale:
A. Feeling restless and needing to be active can be more indicative of anxiety or agitation rather than depression.
B. Increased alertness and improved focus are not typical symptoms of depression; rather, depression often involves decreased energy and focus.
C. High blood pressure is not directly related to depressive symptoms.
D. Difficulty sleeping and racing thoughts at night are consistent with depression, particularly when accompanied by poor sleep quality.
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Correct Answer is D
Explanation
Rationale:
A. Action involves actively making changes or implementing strategies to alter behavior. The client's refusal to follow dietary advice indicates they are not actively engaging in behavior change.
B. Preparation entails planning and getting ready to make a change. The client’s statement shows no intention of preparing for a change.
C. Contemplation involves recognizing the need for change and considering it but not yet committed to making it. The client’s dismissive attitude suggests they are not at this stage.
D. Precontemplation is characterized by a lack of awareness or denial of the need for change. The client’s indifference to the dietary recommendations reflects this stage, as they are not yet considering changing their behavior.
Correct Answer is C
Explanation
Rationale:
A. Amphetamines can cause agitation and psychosis but are less commonly associated with delirium.
B. Antihistamines, particularly those with sedative properties, can contribute to delirium, but they are not the primary culprit.
C. Benzodiazepines, especially when used in high doses or in older adults, can cause delirium. They have sedative effects and can impair cognitive function, leading to confusion and delirium, particularly in vulnerable populations.
D. Sertraline, a selective serotonin reuptake inhibitor (SSRI), is generally not associated with causing delirium, though any medication can contribute to altered mental status depending on the patient’s overall health.