A score of 1 to 10 on the Global Assessment Functioning (GAF) scale would indicate that a client was at risk for:

Choice A rationale
Telling the patient to be quiet and sit down immediately may seem like a quick solution, but it is not the most therapeutic response. This approach may come across as dismissive and authoritarian, which could escalate the patient’s agitation.
Choice B rationale
This is the most appropriate initial intervention. By expressing a desire to understand the patient’s feelings, the nurse opens up a line of communication and shows empathy. This can help de-escalate the situation and make the patient feel heard and understood.
Choice C rationale
Telling the patient to go to their room and control themselves can come across as dismissive and invalidating. It does not address the patient’s feelings or concerns and may escalate the situation.
Choice D rationale
Asking “What is going on?” is a good way to encourage the patient to express their feelings, but it may not be as effective as Choice B. The phrasing in Choice B is more direct and shows more empathy and concern for the patient’s emotional state.

Choice A rationale
The statement “Why did you get so angry when she ignored you?” indicates a need for further training in effective therapeutic communication techniques. Asking “why” can make patients defensive and is generally avoided in therapeutic communication.
Choice B rationale
The statement “It is doubtful the president is out to get you” is a reality-oriented response and can be appropriate in certain contexts, such as when a patient is experiencing delusions.
Choice C rationale
The statement “Tell me more about the day your child died” invites the patient to share more about their experiences and feelings, which is a key aspect of therapeutic communication.
Choice D rationale
The statement “I don’t understand what you mean. Can you give me an example?” is an appropriate therapeutic communication technique, as it seeks to clarify the patient’s message.