How should a nurse address a patients lack of self-care due to severe anhedonia in major depressive disorder?

Develop a structured daily routine and encourage adherence.

Ignore it as a symptom of the depression that will resolve on its own.

Focus solely on medication management as the intervention.

Force them to engage in self-care activities without any support.

Answer and Explanation

The Correct Answer is A

Choice A reason: Anhedonia involves a significant loss of interest or pleasure, leading to total amotivation. A structured routine provides the external cognitive framework necessary to bypass the client's internal lack of drive, ensuring that basic physiological and hygiene needs are met while promoting a sense of gradual accomplishment.

Choice B reason: Ignoring a lack of self-care is clinically negligent. Patients with severe major depressive disorder may develop secondary physical complications, such as skin breakdown or infections, if hygiene is neglected. The nurse must intervene actively to maintain the patient's physical integrity and dignity during the depressive episode.

Choice C reason: While pharmacotherapy is essential for treating the underlying neurochemical imbalances in major depressive disorder, it is rarely sufficient as a standalone intervention for behavioral deficits. Comprehensive nursing care must include psychosocial and behavioral interventions to assist the patient in functioning while waiting for medications to take effect.

Choice D reason: Forcing a patient into activities without support is countertherapeutic and can exacerbate feelings of worthlessness or hopelessness. Effective nursing intervention requires a collaborative, supportive approach where the nurse assists with tasks or provides "scaffolding" to help the patient succeed in small, manageable steps.

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Correct Answer is C

Explanation

Choice A reason: Restricting a client's movements unnecessarily contradicts the principle of the least restrictive environment mandated by modern mental health legislation. While safety is paramount, routine restriction without specific clinical justification or following due process violates the client's right to liberty and can be considered false imprisonment in certain legal contexts.

Choice B reason: Nurses have an ethical and legal obligation to act as advocates for their clients. Refusing to advocate during involuntary admission proceedings undermines the client's right to legal representation and a fair hearing. The Mental Healthcare Act emphasizes protecting the individual's voice and ensuring their legal interests are represented.

Choice C reason: The Mental Healthcare Act of 2017 emphasizes the right to information. Clients must be made aware of their legal rights, the nature of their treatment, and the right to file complaints. Providing this information upon admission ensures the client can participate in their care and exercise their autonomy.

Choice D reason: Confidentiality is a cornerstone of psychiatric nursing and the Mental Healthcare Act. Disclosing a client's private medical or psychiatric history to family members without explicit consent or a legal mandate violates the client's right to privacy. Such breaches of trust can damage the therapeutic alliance and lead to legal liability.

A. Administering the medication without informing the client B. Documenting the client's reason for refusal C. Explaining the possible side effects of the medication D. Discussing alternative treatments with the client

Correct Answer is D

Explanation

Choice A reason: Administering medication without the client's knowledge, or covert administration, is a direct violation of the ethical principle of autonomy and the legal right to informed consent. This action is considered battery in many jurisdictions and fundamentally destroys the therapeutic trust required for successful long-term psychiatric treatment and recovery.

Choice B reason: Documentation is a professional and legal requirement following a medication refusal, but it is a passive action. While necessary for the medical record, simply writing down the refusal does not actively support or enhance the client's autonomous decision-making process or provide them with options for their care.

Choice C reason: Explaining side effects is part of the informed consent process, but it is often perceived as a persuasive tactic to gain compliance rather than a method to support independent choice. While educational, it focuses on the risks of the refused drug rather than empowering the client with broader clinical options.

Choice D reason: Autonomy is best supported by providing the client with various viable options and involving them in the decision-making process. By discussing alternative treatments—whether different medications or non-pharmacological therapies—the nurse respects the client's right to self-determination and fosters a collaborative relationship that values the client's input in their care.

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How should a nurse address a patients lack of self-care due to severe anhedonia in major depressive disorder?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which action by a nurse aligns best with the Mental Healthcare Act of 2017 when caring for a client with mental illness?

Correct Answer is C

Explanation

Which of the following strategies best supports a client's autonomy when they refuse a prescribed medication in a mental health setting?

Correct Answer is D

Explanation

Which factor most likely contributes to mental health stigma in communities following deinstitutionalization?

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A psych nurse is advocating for equal access to mental health resources for all patients. Which ethical principle are they primarily promoting?

In the treatment of major depressive disorder, why is it important for nurses to regularly assess clients for suicide risk?

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A client with illness anxiety disorder frequently visits multiple healthcare providers seeking different opinions about their health. Which approach should the nurse prioritize in managing this behavior?

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