A nurse is collecting data from a client who has had major depressive disorder for 5 years. Which of the following statements made by the client should the nurse identify as a covert statement regarding suicide?

Rationale:

A. Put a simple lock on the client's bedroom door: Locking the client's door could pose a safety risk, especially in the event of an emergency such as a fire. It also restricts the client's autonomy and may increase confusion or agitation in clients with Alzheimer's disease.

B. Give the client a barbiturate medication at bedtime: Barbiturates are not recommended for older adults due to their sedating effects and risk of dependence, falls, and worsening cognitive function. Non-pharmacologic strategies are preferred first in managing sleep disturbances.

C. Encourage the client to take frequent walks during the day: Physical activity during the day helps reduce nighttime restlessness and improve sleep patterns. Walking can also help regulate circadian rhythms, promote relaxation, and reduce wandering behavior at night.

D. Allow the client to nap for at least 1 hr during the day: Long daytime naps may disrupt the sleep-wake cycle, worsening insomnia and nighttime wandering. Limiting daytime napping and encouraging activity is more effective in promoting restful nighttime sleep.

Rationale:

A. Deliver 2 L of oxygen via partial nonrebreather mask: While oxygen can support airway function, it does not address the underlying cause of anaphylaxis. Airway closure due to an allergic reaction requires immediate pharmacologic intervention, not just oxygen delivery.

B. Give epinephrine intramuscularly: Epinephrine is the first-line treatment for anaphylaxis. It counteracts bronchoconstriction, airway edema, and hypotension by stimulating alpha and beta receptors, and should be administered immediately when signs of airway compromise are present.

C. Administer diazepam PO: Diazepam is used for anxiety or seizures, not for acute allergic reactions. It has no effect on reversing airway swelling or bronchospasm and would delay the appropriate emergency treatment needed in this situation.

D. Notify the radiology department: Contacting the radiology department is not relevant or urgent in this scenario. The client is experiencing a life-threatening reaction that requires immediate medical intervention, not communication with non-emergency services.