A client is admitted with a diagnosis of major depression and states, “Nothing brings me pleasure anymore.” Which behaviors will the nurse assess that correlate with the diagnosis?

Choice A reason: Difficulty focusing and helplessness are depressive symptoms, but flight of ideas is characteristic of mania, not major depression. This combination does not fully align with the diagnosis, as mania involves elevated mood, which is inconsistent with the client’s statement. Choice B reason: Depressed mood and guilt are hallmarks of major depression, but pressured speech is a manic symptom, involving rapid, excessive talking. This does not correlate with the anhedonic, low-energy presentation of major depression described by the client. Choice C reason: Changes in sleep pattern and fatigue are common in depression, but grandiose mood is a manic feature, not associated with major depression. This contradicts the client’s anhedonia, making this combination inconsistent with the diagnosis of major depression. Choice D reason: Anhedonia (loss of pleasure), feelings of worthlessness, and difficulty focusing are core symptoms of major depression, reflecting altered serotonin and dopamine levels affecting mood, self-perception, and cognition. These align with the client’s statement and the diagnosis, making this the correct choice.