A young client is diagnosed with major depressive disorder. Three weeks prior, the client's fiancé broke off their engagement, claiming the client was "too fat and ugly." During a one-on-one interaction with the nurse, the client says, "My fiancé is really wonderful and is not to blame for calling off the engagement. I look awful and I'm not much good for anything." What is the best response by the nurse?

Question

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Clients with major depressive disorder experience feelings of worthlessness, low self-esteem, hopelessness, and guilt. Anger is turned inward and they may misinterpret reality and have an idealistic perception of a lost entity. They may blame themselves for what has happened, such as losing a loved one or being fired from a job. The nurse needs to remain nonjudgmental, listen to the client attentively, and convey a caring and accepting attitude to promote trust. Allowing the client to identify and verbalize feelings, including anger, in a comfortable environment will help the client see the situation in a more realistic way and come to terms with what has happened. (Option A) The nurse is challenging the client's perception of reality; this will increase the client's anxiety and inhibit further communication. (Option B) The nurse is offering an opinion and challenging the client's statement; this is not a therapeutic response. (Option C) The nurse is offering an opinion; it is not a therapeutic response. Educational objective: Nursing interventions for a depressed client who expresses feelings of worthlessness and guilt and has a distorted sense of reality include listening attentively, encouraging the client to verbalize feelings about what has happened, and helping the client view the situation in a more realistic way.

A Young Client Is Diagnosed with Major Depressive Disorder