A nurse at a primary care clinic is collecting data on a client for manifestations of depression. Which of the following client statements should the nurse identify as being consistent with depression?

A. Severe restlessness. Severe restlessness, known as akathisia, is a potential side effect of antipsychotic medications but is not indicative of agranulocytosis. Akathisia is associated with excessive movement and an inability to stay still, often requiring dose adjustment or medication to alleviate symptoms.
B. Respiratory depression and a comatose state. Respiratory depression and coma are not linked to agranulocytosis but may occur with overdose or central nervous system depression. Agranulocytosis affects white blood cell levels, leading to increased infection risk rather than sedation or respiratory suppression.
C. Sore throat and muscle aches. Sore throat and muscle aches are early signs of agranulocytosis, a potentially life-threatening condition characterized by a dangerously low neutrophil count. Clients taking clozapine must undergo regular white blood cell monitoring to detect agranulocytosis early and prevent severe infections.
D. Increased anxiety and suicidal ideations. Increased anxiety and suicidal ideations may be related to psychiatric conditions or medication effects but are not specific to agranulocytosis. Clozapine is primarily used for treatment-resistant schizophrenia and may help reduce suicidal behavior rather than induce it.

A. Splitting is a defense mechanism commonly used by clients with borderline personality disorder. It involves viewing people or situations as entirely good or entirely bad, leading to rapidly shifting opinions and emotional reactions. This black-and-white thinking can create division among healthcare providers, as the client may idealize one staff member while devaluing another, causing conflict within the team.
B. Reaction formation occurs when a person expresses the opposite of their true feelings, often due to discomfort with their actual emotions. While seen in some personality disorders, it is not a hallmark feature of borderline personality disorder and does not typically contribute to team division.
C. Denial involves refusing to acknowledge reality or facts that cause distress. Though common in various mental health conditions, it does not specifically create division among healthcare providers in the way splitting does. Clients with borderline personality disorder may use denial, but it is not their primary defense mechanism.
D. Regression is a defense mechanism where an individual reverts to earlier developmental behaviors in response to stress. While it can be seen in borderline personality disorder, it does not typically lead to splitting within the healthcare team, as it primarily affects the client’s own coping mechanisms rather than interpersonal dynamics.