A client with a history of chronic renal failure receives hemodialysis treatment three times per week through an arteriovenous (AV) fistula in the left arm. Which priority intervention should the nurse include in the care plan?

Choice A reason: Schizophrenia alone does not typically warrant court-mandated outpatient treatment unless associated with criminal behavior. Living with family suggests stability, reducing the likelihood of court intervention. Mandates are linked to legal infractions, not diagnosis alone, making this client less likely for mandated treatment.

Choice B reason: Petty theft may lead to legal consequences, but courts typically mandate treatment for offenses directly tied to mental health or substance use, like DUI. A single theft may not justify mandated outpatient mental health treatment unless it explicitly stems from a diagnosable condition requiring intervention.

Choice C reason: Two DUI offenses indicate repeated substance use (alcohol) posing public safety risks. Courts often mandate outpatient treatment for substance abuse in DUI cases to address addiction and prevent recidivism, making this client the most likely to receive a court-ordered treatment mandate for outpatient care.

Choice D reason: Job loss due to depression does not typically result in court-mandated treatment, as it lacks a criminal component. Treatment may be recommended, but courts intervene when behavior poses legal or safety risks, like DUI, making this client less likely for mandated outpatient treatment.

Choice A reason: Saying “I am not sure I follow you” seeks clarification, encouraging the patient to elaborate without dismissing their feelings. It fosters open communication, allowing the nurse to understand the patient’s concerns better, which supports therapeutic interaction and validates the patient’s emotional expression in a clinical setting.

Choice B reason: Noticing lip-biting acknowledges nonverbal cues, signaling the nurse’s attentiveness to the patient’s emotional state. This observation invites further discussion without judgment, promoting trust and validating the patient’s feelings, which is therapeutic and does not undermine or belittle their concerns in a mental health context.

Choice C reason: Stating “You appear tense” reflects observation of the patient’s emotional state, prompting exploration of underlying issues. It validates the patient’s feelings without dismissal, encouraging dialogue. This therapeutic approach supports emotional expression and does not belittle concerns, making it appropriate in a nurse-patient interaction.

Choice D reason: Saying “Everything will be alright” dismisses the patient’s concerns by offering false reassurance without addressing specific issues. This minimizes their emotional experience, potentially invalidating feelings and discouraging open communication, which can undermine trust and hinder therapeutic progress in managing mental health concerns.