Choice A rationale:

Encouraging the client to express his feelings and concerns is a key intervention for someone diagnosed with adjustment disorder with depressed mood. This approach provides an outlet for the client to verbalize their emotions, which can help them process their thoughts and feelings. Through this expression, the client may gain insight into their emotional state and begin to develop healthier coping mechanisms.

Choice B rationale:

Advising the client to avoid contact with former coworkers is not an appropriate intervention. Social support is crucial during times of adjustment, and isolating oneself from supportive individuals can exacerbate feelings of depression and increase the risk of worsening mental health. Encouraging positive social interactions would be more beneficial.

Choice C rationale:

Suggesting the client take antidepressant medication for at least six months is not the primary intervention for adjustment disorder with depressed mood. Antidepressants are typically prescribed for major depressive disorder or other mood disorders. Adjustment disorder is usually managed through psychotherapy, counseling, and support rather than solely relying on medication.

Choice D rationale:

Teaching the client relaxation techniques such as deep breathing and progressive muscle relaxation is a valuable intervention, but it might not be the most effective as a standalone treatment for adjustment disorder with depressed mood. While relaxation techniques can help manage symptoms, addressing underlying emotional issues and facilitating emotional expression are more directly relevant to this disorder.

Choice A rationale:

Inquiring about the client's typical coping mechanisms provides insight into their ability to manage stressors effectively. This information helps the nurse tailor interventions and support strategies to enhance the client's coping skills.

Choice B rationale:

Identifying the sources of stress in the client's life is essential in understanding the triggers that contribute to their adjustment disorder with anxiety. Addressing these stressors can aid in developing coping strategies and reducing the impact of these stressors on the client's mental well-being.

Choice C rationale:

While physical activity and exercise can contribute to overall mental well-being, it might not be the primary focus when assessing coping skills for adjustment disorder with anxiety. The other options more directly target coping strategies and stress management.

Choice D rationale:

Exploring the client's goals can shed light on their motivations and aspirations. Having goals can positively influence a client's sense of purpose and hope, which can be integral in managing adjustment disorder with anxiety.

Choice E rationale:

While understanding the client's emotions about their current situation is important, this question may not directly assess coping skills. It's more focused on emotional self-awareness than evaluating how the client copes with stress.

Choice A rationale:

Excessive worry, nervousness, or fear are characteristic of generalized anxiety disorder, not adjustment disorder with disturbance of conduct.

Choice B rationale:

Feeling sad, hopeless, or having difficulty enjoying things corresponds to symptoms of major depressive disorder, not adjustment disorder with disturbance of conduct.

Choice C rationale:

Acting out, violating rules, and having problems with authority figures are behaviors indicative of adjustment disorder with disturbance of conduct. This type of adjustment disorder involves behavioral issues and challenges in adhering to social norms and rules.

Choice D rationale:

Experiencing mixed emotions, such as anxiety and depression, is common in various mental health conditions, but it's not specific to adjustment disorder with disturbance of conduct.

Choice A rationale:

The statement "I don’t care what happens to me anymore" indicates a lack of interest or investment in one's well-being, which is not a sign of improvement in adjustment disorder. Improvement involves a more positive outlook.

Choice B rationale:

This statement reflects the client's acknowledgment of missing their old life but actively attempting to move forward. This signifies progress in dealing with the emotional and conduct disturbances often seen in adjustment disorder.

Choice C rationale:

"I’m so angry at everyone who caused this to happen" indicates ongoing anger and blame towards others, which may suggest a lack of resolution in the emotional turmoil associated with adjustment disorder. Improvement typically involves a reduction in intense negative emotions.

Choice D rationale:

"I feel like nothing will ever change for the better" represents a pessimistic and hopeless perspective, indicating that the client does not perceive any potential for improvement. This mindset does not align with progress in adjustment disorder.

Choice A rationale:

Symptoms of adjustment disorder must appear within one month of exposure to the stressor. This time frame helps differentiate adjustment disorder from other mental health conditions that might have a longer onset period, such as major depressive disorder.

Choice B rationale:

Three months is a longer period than the typical onset for symptoms of adjustment disorder. The correct time frame is within one month to establish a clear connection between the stressor and the subsequent emotional and behavioral responses.

Choice C rationale:

Six months is beyond the specified time frame for the appearance of symptoms in adjustment disorder. The shorter time frame of one month is more relevant to this diagnosis.

Choice D rationale:

Twelve months exceeds the appropriate time frame for diagnosing adjustment disorder. The focus is on the relatively short period of one month for symptoms to manifest after exposure to a stressor.

Choice A rationale:

Including a social worker to help with financial and legal issues is important because adjustment disorder can lead to practical challenges in these areas due to the emotional and behavioral disturbances. Addressing these stressors can contribute to the client's overall well-being.

Choice B rationale:

While psychotropic medications might be used to manage certain symptoms, adjustment disorder primarily involves emotional and behavioral responses to stressors. Therefore, a psychiatrist's involvement is not the primary referral for this case.

Choice C rationale:

Cognitive-behavioral therapy (CBT) is a valuable intervention for adjustment disorder, focusing on changing maladaptive thought patterns and behaviors. However, the question specifies "unspecified symptoms," and other practical issues (financial and legal) are of greater concern at this stage.

Choice D rationale:

Joining a support group can be helpful for sharing experiences and coping strategies, but for the specific needs associated with adjustment disorder and its impact on financial and legal matters, a social worker's expertise is more relevant. 18. Correct answer: B - The client's statement reflects an effort to move on from the past. Correct answer: A - Symptoms of adjustment disorder must appear within one month of the stressor. Correct answer: A - A social worker can address practical issues arising from adjustment disorder.

Choice A rationale:

Difficulty sleeping can be an expected finding in a client with adjustment disorder due to the heightened anxiety and stress associated with the condition. Sleep disturbances, including difficulty falling asleep, staying asleep, or experiencing restless sleep, are common manifestations. The psychological distress from the divorce can lead to disruptions in the sleep-wake cycle, impacting overall sleep quality.

Choice B rationale:

Loss of appetite is another potential symptom in clients with adjustment disorder. The emotional turmoil resulting from the divorce can cause a reduced interest in food, leading to appetite changes and subsequent weight loss. This can be attributed to the physiological and psychological impact of stress on the body.

Choice C rationale:

Suicidal ideation is not a common symptom of adjustment disorder. While clients may experience emotional distress and mood disturbances, full-blown suicidal ideation is more often associated with more severe mental health conditions like major depressive disorder or generalized anxiety disorder.

Choice D rationale:

Impaired concentration is an expected symptom in adjustment disorder. The emotional strain and anxiety related to the divorce can lead to difficulty focusing, making decisions, and maintaining attention on tasks. This cognitive impairment is a direct consequence of the psychological distress.

Choice E rationale:

Increased energy is not typically associated with adjustment disorder. Rather, clients with this condition often experience fatigue, decreased energy levels, and a lack of motivation due to the emotional toll of the stressor (in this case, the divorce).

Choice A rationale:

Avoiding stress-triggering situations is not a comprehensive strategy for managing stress, especially for individuals with adjustment disorder. Total avoidance can hinder personal growth and does not address the underlying issues contributing to the disorder.

Choice B rationale:

Practicing positive self-talk and affirmations is an effective stress management technique. This technique helps individuals challenge negative thoughts, boost self-esteem, and develop a more optimistic outlook. This is particularly beneficial for clients with adjustment disorder to counter the negative emotions associated with their stressor.

Choice C rationale:

Setting realistic and attainable goals is an essential aspect of stress management. It provides a sense of purpose and accomplishment, contributing to improved self-esteem. For clients with adjustment disorder, achieving even small goals can enhance their sense of control and reduce feelings of helplessness.

Choice D rationale:

Seeking social support from friends and family is crucial for individuals with adjustment disorder. Positive social interactions provide emotional comfort, encouragement, and a sense of belonging, which can counteract the feelings of isolation and distress that often accompany adjustment disorder.

Choice E rationale:

Using alcohol or drugs to cope with stress is an unhealthy and counterproductive strategy. Substance use can exacerbate emotional distress, interfere with problem-solving skills, and lead to dependency. It does not address the root causes of the stress and can worsen the symptoms of adjustment disorder.

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