A client is hospitalized following a suicide attempt after breaking up with her significant other.
The client says to the nurse, "When I get out of here, I'm going to try this again, and next time I'll get it right?" Which is the best response by the nurse?
"You are safe here. We will make sure nothing happens to you."
"You're just lucky your roommate came home to help you when she did."
"What exactly do you plan to do?"
"I don't understand. You have so much to live for."
The Correct Answer is C
A. While providing reassurance is important, this response does not directly address the client's statement about future attempts.
B. This response may minimize the seriousness of the client's statement and is not the best way to address the situation.
C. This response directly addresses the client's statement, seeking clarification on her plans. It is important to assess the level of risk and ensure the client's safety.
D. While expressing empathy and highlighting the client's positive qualities can be helpful, it may not directly address the immediate concern of the client's statement about future attempts.
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Related Questions
Correct Answer is D
Explanation
A) Incorrect. Reverse isolation is not indicated in this situation. The client's symptoms are likely due to a side effect of the medication, not an infectious process.
B) Incorrect. While it may be necessary to withhold the next dose of medication, the client's symptoms require more immediate attention.
C) Incorrect. The client's symptoms are indicative of a serious adverse reaction, and dietary changes would not address the issue.
D) Correct. The client's symptoms, including severe muscle stiffness, difficulty swallowing, drooling, diaphoresis, and elevated vital signs, are indicative of neuroleptic malignant syndrome (NMS), a potentially life-threatening side effect of antipsychotic medications like risperidone.
The nurse should notify the healthcare provider immediately for further guidance and intervention.
Correct Answer is D
Explanation
A. This response may be seen as evading the client's statement. It's important to provide a more direct response.
B. This response may come across as controlling or confrontational, which may not promote open communication.
C. This response is a good therapeutic technique as it encourages the client to reflect on past experiences with stopping medication.
D. This response provides a clear and factual statement about the purpose of the prescribed medication, encouraging the client to understand its importance.
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