During a client's major depressive episode, what finding indicates a high risk for suicide that should be immediately addressed by the nurse?

Choice A reason: Anhedonia, or the lack of interest in daily activities, is a core diagnostic criterion for major depressive disorder. While it reflects the severity of the depression, it is a common finding and does not necessarily indicate an imminent transition to suicidal action as clearly as a sudden mood shift. Choice B reason: A sudden, unexplained improvement in mood or a transition from agitation to calm is a classic "red flag" for imminent suicide. This often occurs because the client has finally made a definitive decision to end their life, resulting in a sense of relief and the energy necessary to carry out a plan. Choice C reason: Feelings of worthlessness and excessive guilt are standard symptoms of the cognitive triad of depression. While they contribute to the overall risk profile, they are chronic features of the illness and are less predictive of an immediate suicide attempt than a sudden behavioral change. Choice D reason: Increased appetite and weight gain (atypical depression features) or decreased appetite are common somatic variations in depression. These changes in vegetative signs are clinically significant for diagnosis and treatment planning but do not serve as acute indicators of immediate self-harm risk.