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 B
Explanation
Rationale:
A. While inappropriate clothing might indicate a need for assessment of the client’s awareness or physical comfort, it is not as immediate a concern as the client's behavior.
B. The comment to the nurse is concerning as it may indicate disorganized thinking or potential for inappropriate behavior, which requires immediate attention for safety and therapeutic intervention.
C. A heart rate of 102/min is slightly elevated but not the most urgent issue compared to the client's behavior.
D. Elevated blood pressure should be monitored, but the priority is the client’s inappropriate behavior, which may affect safety.
Correct Answer is C
Explanation
Rationale:
A. Somatic symptom disorder involves physical symptoms without a clear medical cause, but the client's intention to be the center of attention is more characteristic of factitious disorder.
B. Functional neurological symptom disorder involves neurological symptoms with no identifiable neurological basis, which does not align with the client’s motivations.
C. Factitious disorder involves the intentional production of symptoms to assume the sick role and gain attention, which aligns with the client's desire to be the center of a dramatic medical situation.
D. Illness anxiety disorder involves preoccupation with having a serious illness despite a lack of symptoms but does not involve intentionally causing harm.