A female client's husband, in whom a chronic illness was recently diagnosed, is hospitalized. She states that she cannot stop worrying about what is going to happen with her husband's treatment and how they are going to pay the bills because he will not be working. What reaction is the client most likely experiencing?

D. Depersonalization disorder is a dissociative disorder where individuals feel detached from themselves, as if they are observing their own thoughts, feelings, sensations, or actions from outside their body. This can lead to a sense of unreality or detachment from the environment or one's own experiences. It is often triggered by stressful events or trauma, and it can occur in individuals experiencing grief or loss, such as the surviving husband in this scenario.

A. Dissociative fugue involves sudden, unexpected travel away from home or one's customary place of activities, accompanied by an inability to recall one's past. It is usually associated with amnesia for personal information and is not characterized by depersonalization symptoms.

B. DID involves the presence of two or more distinct personality states or identities within an individual, which alternate and take control of behavior. Each identity may have its own unique way of perceiving and interacting with the environment, which differs from the symptoms described in the scenario.

C. Dissociative amnesia involves the inability to recall important personal information, usually related to stressful or traumatic events. While depersonalization symptoms can occur in dissociative amnesia, the hallmark feature is memory loss rather than the feeling of detachment from one's body.

B. This is the most appropriate initial action. One-to-one observation ensures constant monitoring of the client's safety and prevents further harm, such as another suicide attempt or self-harm. Given the client's history of depression and recent suicide attempt, ensuring their safety is paramount.

A. This option is not the first priority because while addressing anorexia nervosa is important, safety concerns related to the suicide attempt and potential substance abuse take precedence. Making a weight gain contract requires the client's cooperation and readiness, which may not be feasible immediately upon admission.

C. While assessing the severity of depression is crucial, it is secondary to ensuring immediate safety in this context. The client's safety must be established first through continuous observation and intervention.

D. While important to understand the substances involved in the suicide attempt, this action is secondary to ensuring ongoing safety through direct observation. Toxicology results can guide subsequent treatment decisions but are not as urgent as immediate safety measures.