Yes, you need a comma after asking.
You also need a space after the comma after "understanding" and ... is there something missing after "you mean by..."?
Also -- that is not a question at the end. The question mark needs to be replaced by a period.
In this sentence, I think i need a comma after asking, right?
When the communication was poorly understood,the nurse clarified the female patient's meaning by asking “I am not sure that I understand what you mean by 'depressed than usual’?"
2 answers
Yes, you need a comma after asking.
You also need a period, not a question mark, after usual'".
You also need a period, not a question mark, after usual'".