Mr. Feisty has mild Alzheimer's disease (AD) diagnosed 2 years ago after progressive short-term memory decline. His wife reports that over the last three weeks he has shown irritable mood, anhedonia, early-morning awakening, low energy, reduced appetite with ~5 lb (2.3 kg) loss, and difficulty concentrating beyond his baseline cognitive impairment. He has skipped two community senior-center activities he previously enjoyed. No hallucinations or delusions. He denies active suicidal intent but says, "Sometimes I wonder if it would be easier if I didn't wake up." No recent illness, fever, or falls. No alcohol or illicit drug use. Which symptoms should a nurse identify that would support a diagnosis of depression? (Select all that apply)

A. Passive death wish: Statements expressing thoughts about not waking up reflect passive suicidal ideation, which is a recognized symptom of depressive disorders. Even without active intent, this type of thinking signals psychological distress and depressive cognition. Such expressions require careful assessment and monitoring. B. Anhedonia: Loss of interest or pleasure in previously enjoyed activities is a core symptom of depression. Withdrawal from social and recreational activities, such as skipping senior-center events, reflects reduced motivation and emotional engagement. This change represents a departure from prior functioning rather than progression of dementia alone. C. Progressive short-term memory decline: Gradual short-term memory decline is a hallmark feature of Alzheimer’s disease and was present prior to the recent symptom changes. It reflects underlying neurodegeneration rather than a mood disorder. The timeline suggests this symptom predates the depressive features. D. Sudden onset of confusion: Acute confusion developing over a short period is more consistent with delirium, often related to medical illness or medication effects. There is no evidence of fluctuating consciousness or acute cognitive change beyond baseline impairment. E. Sleep disturbances: Early-morning awakening and changes in sleep patterns are common biological symptoms of depression. Disrupted sleep contributes to fatigue, impaired concentration, and mood changes. These alterations support the presence of a depressive episode rather than dementia progression alone.