A client with depression is not attentive to personal hygiene, uses television watching as a means of escape from responsibilities, and describes an inability to enjoy the things that once gave them pleasure. Which coping strategy should the nurse include in the plan of care?

A) Why do you think you have a hostile work environment?:Asking this question might come across as dismissive or challenging the client’s perception of their experience. It is important to validate the client’s feelings and experiences rather than questioning their interpretation of the situation.

B) How have you responded to those in your work environment about these events?:This response encourages the client to reflect on their actions and coping strategies. It shows empathy and interest in understanding the client’s perspective and experiences, which can help build rapport and provide valuable insights for further discussion and support.

C) Have you considered resigning from your position?:Suggesting resignation might not be appropriate at this stage, as it could increase the client’s stress and anxiety. It is important to explore the client’s feelings and experiences first before discussing potential solutions or changes in their employment situation.

D) Have the feelings associated with these events brought you to the clinic?:While this question acknowledges the client’s feelings, it may not provide an opportunity for the client to elaborate on their experiences and coping strategies. It is important to focus on understanding the client’s actions and responses to the events they described.

A) Praising the client for her new behavior can be encouraging and may boost her self-esteem. However, it’s essential to approach this cautiously, as excessive praise might overwhelm her or be perceived as insincere. While positive reinforcement is valuable, it should not be the sole focus of the intervention.

B) Offering her a choice of activities can promote autonomy and encourage engagement, but given her recent shift from despondency to exhibiting energy, it’s crucial to assess her mood and mental state carefully first. Providing choices may be helpful, but it should be accompanied by vigilant monitoring to ensure her safety.

C) Involving her in group therapy could facilitate social interaction and support, but it may not be appropriate immediately. After several days of nonverbal behavior, she may still be vulnerable. Group settings could be overwhelming, and her readiness to participate should be carefully evaluated.

D) Observing her actions continuously is the most critical action at this stage. The change in her behavior—from being despondent and nonverbal to talking and exhibiting energy—can indicate a potential shift toward increased risk for impulsivity or self-harm. Continuous observation allows the nurse to assess her safety and intervene if her behavior escalates, ensuring she is supported during this transitional phase.