A nurse is caring for a client who has major depressive disorder. Which of the following actions should the nurse take when developing a relationship with the client?

Share personal information to help the client feel comfortable.

Set boundaries with the client regarding personal space.

Tell the client if she reminds the nurse of a personal friend or relative.

Develop an emotional commitment to the client.

Answer and Explanation

The Correct Answer is B

A.   Sharing personal information can blur the professional boundaries and hinder the therapeutic relationship. The nurse's focus should be on the client's needs and well-being.
B.   Maintaining professional boundaries is essential in therapeutic relationships. It helps to establish trust and ensures the nurse can provide effective care without becoming emotionally involved.
C.   Comparing the client to someone else can be misleading and inappropriate. It's important to focus on the client as an individual and avoid making comparisons.
D.   While empathy and compassion are crucial in nursing, developing an emotional commitment can compromise objectivity and hinder the nurse's ability to provide effective care.

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Correct Answer is B

Explanation

A. Depression is characterized by persistent feelings of sadness, loss of interest or pleasure in activities, changes in sleep and appetite, and difficulties with daily functioning. However, depression alone might not fully explain the abrupt change if there were no prior context of mood swings or manic behavior.
B. Bipolar disorder is marked by extreme mood swings that include manic or hypomanic episodes and depressive episodes. The observed behaviors—active participation and high energy followed by a
sudden shift to tearfulness and withdrawal—are consistent with the mood cycling seen in bipolar disorder. The manic or hypomanic phase could explain the previous high level of activity, while the depressive phase explains the sudden refusal to engage and withdrawal.
C. Psychotic behavior involves a loss of touch with reality, including hallucinations, delusions, and disorganized thinking. The behaviors described (active participation and then sudden withdrawal) do not specifically indicate psychosis.
D. Dysthymic disorder (now referred to as Persistent Depressive Disorder in the DSM-5) is characterized by a chronic, mild depression lasting for at least two years. It typically involves a more consistent, persistent low mood rather than the abrupt shifts seen in bipolar disorder.

A. Asking for the day off B. Delegating appropriate care assignments to unlicensed assistive personnel C. Writing down long lists of needed interventions before starting the day's work D. Asking a coworker to take one of her patients

Correct Answer is B

Explanation

A. This is a temporary solution and doesn't address the underlying issue of workload.
B. This is a healthy coping mechanism as it involves effective time management and prioritization. Delegating tasks that can be safely performed by others allows the nurse to focus on more complex patient care needs.
C. This can be helpful but doesn't necessarily reduce the overall workload.
D. While this might provide temporary relief, it's not a sustainable solution and can create resentment among colleagues.

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