A nurse is caring for a client who has depressive disorder. The client states, "Everyone would be better off if I were not around." Which of the following responses should the nurse make?

"Why would you think a thing like that?"

"What would your family do without you?"

"Are you thinking of hurting yourself?"

"When you get better you will not feel this way."

Answer and Explanation

The Correct Answer is C

A. "Why would you think a thing like that?": This is incorrect. Asking “why” could make the client feel defensive or that their feelings are being dismissed, which can hinder further conversation. It is important to approach suicidal statements with sensitivity and direct concern.

B. "What would your family do without you?": This is incorrect. While this may seem like a caring response, it places responsibility on the client to think about their family, which may not be helpful if they are feeling overwhelmed by their own emotions. The focus should be on the client’s safety and well-being.

C. "Are you thinking of hurting yourself?": This is correct. It is essential to directly assess the client's safety when they express suicidal thoughts. Asking this question shows concern for the client’s immediate safety and opens the door for further discussion on their feelings and potential plans.

D. "When you get better you will not feel this way.": This is incorrect. This response may dismiss the client’s current feelings and suggests that their emotions are temporary, which could undermine the seriousness of their statements. It is important to validate the client's feelings and address their safety directly.

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Correct Answer is D

Explanation

A. "If I were you, I would contact your spiritual director.": While this may be a helpful suggestion for the client, it can come across as dismissive of the client’s personal beliefs and decision-making. The nurse should respect the client’s autonomy in making healthcare decisions.

B. "I'm sure that everything will be all right, regardless of your decision.": This statement may be dismissive of the client's concerns and the seriousness of their medical decision. It also minimizes the importance of the client’s decision, which should be respected.

C. "Making this decision is wrong.": This response is judgmental and violates the client’s autonomy. The nurse should avoid imposing personal beliefs and instead support the client’s choices.

D. "You have a right to change your mind.": This is the best response, as it acknowledges the client’s autonomy and the possibility that the client may reconsider their decision in the future. It provides a nonjudgmental and supportive statement that empowers the client.

A. Encourage the client to be assertive. B. Maintain a verbal no-harm contract with the client. C. Limit the client's social interactions. D. Assume responsibility for making the client's decisions.

Correct Answer is A

Explanation

A. Encourage the client to be assertive is correct. Encouraging assertiveness is important for a client with dependent personality disorder (DPD., as they often have difficulty making decisions or taking initiative. Teaching the client to express their needs, opinions, and desires is a key part of treatment and helps promote independence.

B. Maintain a verbal no-harm contract with the client is incorrect. While maintaining a no-harm contract may be appropriate for clients at risk for self-harm, this is not specific to dependent personality disorder. The main goal is to promote independence and healthy decision-making, not just ensuring safety.

C. Limit the client's social interactions is incorrect. In fact, encouraging healthy social interactions and gradual independence from others is often an important part of treatment for DPD. Limiting interactions could reinforce dependency and hinder progress.

D. Assume responsibility for making the client's decisions is incorrect. The nurse should encourage the client to make their own decisions and foster independence, rather than taking over their decisions, which could worsen the dependent behaviors.

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