A client with MDD has been prescribed an SSRI antidepressant. The nurse should instruct the client to:

Choice A rationale:

Coherence, logic, relevance, and organization. Rationale: This choice is related to assessing the thought process, but it does not accurately address the specific signs described in the scenario: flight of ideas, racing thoughts, and tangentiality. These are characteristic features of a manic or hypomanic episode in bipolar disorder and involve a rapid flow of thoughts, lack of focus, and difficulty maintaining a coherent and organized thought process.

Choice B rationale:

Flight of ideas, racing thoughts, and tangentiality. Rationale: This statement is correct. Flight of ideas, racing thoughts, and tangentiality are indicative of disorganized thought processes commonly seen in manic episodes of bipolar disorder. Flight of ideas refers to a rapid succession of thoughts that may be loosely connected. Racing thoughts involve a constant stream of rapid thoughts, often making it difficult for the individual to concentrate. Tangentiality refers to veering off-topic during conversation and difficulty sticking to the main point.

Choice C rationale:

Themes, topics, beliefs, and perceptions. Rationale: While understanding themes, topics, beliefs, and perceptions is important in a comprehensive psychiatric assessment, this choice does not address the specific signs of disorganized thought processes mentioned in the scenario. Themes and beliefs might be explored during a broader assessment, but flight of ideas, racing thoughts, and tangentiality are more indicative of the manic phase in bipolar disorder.

Choice D rationale:

Signs of delusions, hallucinations, paranoia. Rationale: Delusions, hallucinations, and paranoia are important aspects to assess in individuals with bipolar disorder, but they are not directly related to the disorganized thought processes described in the scenario. Delusions are false beliefs, hallucinations involve sensory perceptions without external stimuli, and paranoia is excessive distrust or suspicion. These symptoms are more characteristic of psychotic disorders or severe mood episodes but are not specific to the described thought process.

Choice C rationale:

Responding with, "It sounds like you're feeling really hopeless right now," is an empathetic and therapeutic response. It reflects active listening and shows that the nurse acknowledges the client's feelings without making assumptions or offering false reassurance. This response validates the client's emotions and opens the door for further discussion, potentially leading to better understanding and support.

Choice A rationale:

Responding with, "Don't worry, things will get better soon," is dismissive and invalidating. It minimizes the client's feelings and offers premature reassurance without addressing the client's current emotional state.

Choice B rationale:

Responding with, "I know how you feel. I've been there too," shifts the focus from the client to the nurse. While sharing personal experiences can be helpful in certain contexts, it's important to prioritize the client's emotions and experiences first.

Choice D rationale:

Responding with, "You need to focus on the positive aspects of life," is directive and dismissive of the client's emotions. It implies that the client's feelings are invalid and suggests a solution without fully understanding the client's perspective.