A depressed patient says, "nothing matters anymore." What is the most appropriate response by the nurse?

Try to stay hopeful. Things have a way of working out."

"Are you having thoughts of suicide?"

"Tell me more about what interested you before you became depressed."

"I am not sure I understand what you are trying to say."

Answer and Explanation

The Correct Answer is B

A. Offering platitudes can minimize the patient’s feelings and may shut down further disclosure.
B. Directly asking about suicidal thoughts is the most important and therapeutic response because the statement expresses hopelessness, a major risk factor for suicide. This question assesses immediate safety and guides next steps (ask about intent, plan, means; implement suicide precautions and notify the provider as indicated).
C. Exploring past interests can be therapeutic later, but it does not address the immediate safety concern suggested by the patient’s hopeless statement.
D. Saying you don’t understand is vague and avoids addressing the potential crisis; a direct, nonjudgmental assessment of suicidal ideation is required.

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Correct Answer is B

Explanation

A. The patient’s symptoms are physiological and neurological, not intentional behaviors for attention.

B. Alcohol withdrawal delirium (delirium tremens) typically occurs 48–72 hours after the last drink and includes tremors, agitation, anxiety, diaphoresis, tachycardia, hallucinations, and nightmares—all present in this patient.

C. Although head injury can cause confusion and agitation, the timing of symptoms following alcohol withdrawal aligns more closely with delirium tremens.

D. Acute psychosis can present with hallucinations, but in this case, the onset following alcohol cessation and accompanying autonomic hyperactivity point toward alcohol withdrawal delirium.

A. Self-awareness enhances the nurse's advocacy role. B. Positive feelings promote the development of sympathy for patients. C. Strong negative feelings interfere with assessment and judgment. D. Strong positive feelings lead to healthy transference with the victim.

Correct Answer is C

Explanation

A. While self-awareness is beneficial, the primary reason for monitoring personal feelings is to prevent bias and maintain objectivity, not only to enhance advocacy.

B. Sympathy may be natural, but unchecked positive feelings do not replace professional assessment or judgment.

C. Nurses who experience anger, frustration, or judgment toward the family or situation may misinterpret information, make biased decisions, or fail to provide appropriate support. Awareness of personal feelings helps maintain objective and effective care.

D. Strong positive feelings can still lead to boundary issues or inappropriate transference, which is not the intended goal of professional self-awareness.

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A depressed patient says, "nothing matters anymore." What is the most appropriate response by the nurse?

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