NU371 HESI Case Study: Major Depressive Disorder Verified Guide

NU371 HESI Case Study: Major Depressive Disorder Verified Guide Client Presentation A client visits the community mental health clinic. The individual is divorced, has no children, and has a job that involves significant travel. This week, the client was in the office when a 6-story building collapsed, resulting in over 100 fatalities. The client has a medical history that includes hypothyroidism and depression. They report feeling increasingly depressed over an extended period, experiencing easy irritability, anxiety, and a lack of enjoyment in previously pleasurable activities. Assessment The triage nurse conducts a thorough assessment of the client’s reported issues and relays the findings to the Advanced Practice Registered Nurse in Psychiatric-Mental Health (APRN-PMH). The two nurses collaborate to create a care plan aimed at assessing and addressing the client’s anxiety. During the initial assessment, which areas should the nurse emphasize that are most indicative of anxiety? (Select all that apply. One, some, or all responses may be correct.) - a) Symptoms like restlessness, difficulty concentrating, and irritability. - b) Social behaviors such as withdrawal, avoiding family, and alcohol use. - c) Heightened symptoms of depression with a consistent low mood. - d) Behavioral changes including hallucinations. - e) Thoughts of self-harm or suicidal ideation. Correct answers: - a) Symptoms like restlessness, difficulty concentrating, and irritability. - c) Heightened symptoms of depression with a consistent low mood. - e) Thoughts of self-harm or suicidal ideation. Therapeutic Relationship The orientation phase of building a therapeutic relationship is crucial for fostering rapport. What is the best approach for the nurse to obtain subjective information from the client? - a) Ask the client to name the cause of their anxiety. - b) Suggest to the client that anxiety is leading to their depression. - c) Encourage the client to describe how anxiety impacts their regular activities. - d) Request the client to provide an example of their feelings when anxious. Correct answer: - d) Request the client to provide an example of their feelings when anxious. This question aims to clarify vague statements from a client experiencing anxiety. Group Session Interaction During a group session, the client shares their experience of significant workplace stress, noting they have filed multiple harassment complaints against their boss. The client expresses feeling the need to maintain a higher standard of performance compared to coworkers because of stricter evaluation criteria from their boss. Anxiety Level Recognition The nurse identifies the level of anxiety the client is experiencing as: - a) Mild - b) Moderate - c) Severe - d) Panic Correct answer: - c) Severe A person with severe anxiety generally focuses narrowly on a specific concern, such as their relationship with their employer and coworkers. Treatment Planning During the interview, the client reveals intense anxiety, irritability, feelings of depression, and suicidal thoughts as their reasons for seeking help. The nurse formulates a care plan to assist the client in managing their anxiety. What is the most effective approach for the nurse to assess the client's suicide risk? - a) Inquire which specific stressors contribute to their anxiety. - b) Explore the client’s social life at work and home. - c) Have the client explain what exacerbates their negative feelings. - d) Directly ask the client if they have a plan to harm themselves. Correct answer: - d) Directly ask the client if they have a plan to harm themselves. This assessment of suicidal intent and the existence of a viable plan is crucial in developing the care plan for the client. Client Symptoms Discussion The client reports persistent sweating, occasional chest pains, and numbness in their arms and hands. How should the nurse respond to the client's comments?