What expected outcomes should the nurse document for a client diagnosed with a depressive disorder? (Select all that apply)
The client does not express suicidal ideation.
The client returns to work or school.
The client reports no side effects from medication.
The client expresses hopefulness for the future.
The client sleeps for 8 hours each night.
Correct Answer : A,B,D,E
Choice A rationale
The absence of suicidal ideation is a positive outcome for a client diagnosed with a depressive disorder. This indicates that the client is not experiencing thoughts of self-harm or death, which is a common symptom of severe depression.
Choice B rationale
Returning to work or school signifies that the client is able to resume normal activities and responsibilities, indicating an improvement in their mental health.
Choice C rationale
While it’s important for the client to report no side effects from medication, it’s not necessarily an expected outcome for a client diagnosed with a depressive disorder. Antidepressant medications can often have side effects, and managing these is part of the treatment process.
Choice D rationale
Expressing hopefulness for the future is a positive sign as it indicates that the client is not experiencing feelings of hopelessness, a common symptom of depression.
Choice E rationale
Regular sleep patterns, such as sleeping for 8 hours each night, are beneficial for mental health and can help in the management of depressive symptoms.
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Correct Answer is D
Explanation
Choice A rationale
While ineffective coping related to inadequate stress management is a valid nursing diagnosis, it is not the highest priority in this scenario. The client’s threat to commit suicide with a handgun indicates a clear and immediate risk.
Choice B rationale
Hopelessness related to recent divorce is a significant concern and may contribute to the client’s suicidal ideation. However, the immediate threat of suicide takes precedence.
Choice C rationale
Spiritual distress related to conflicting thoughts about suicide and sin may be a factor in the client’s mental state, but it is not the immediate concern. The client’s life is in danger, which must be addressed first.
Choice D rationale
Risk for suicide related to a highly lethal plan is the highest priority nursing diagnosis. The client has a clear plan (using a handgun) and means (access to a handgun), indicating a high risk for suicide.
Correct Answer is A
Explanation
Choice A rationale
The patient likely interpreted the UAP’s behavior as potentially harmful. This is a common reaction in confused older adults, especially when they are awakened unexpectedly. The patient may not have fully understood the situation and reacted out of fear or confusion.
Choice B rationale
While it’s true that older adults can sometimes demonstrate exaggerations of behaviors used earlier in life, there’s no information in the scenario to suggest this is the case.
Choice C rationale
There’s no evidence to suggest that the patient learned violent behavior by watching other patients act out. It’s more likely that the patient reacted out of fear or confusion.
Choice D rationale
While crowding can increase stress and agitation in some individuals, there’s no information in the scenario to suggest that this is a factor in the patient’s behavior.
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