An adolescent hospitalized after a physical outburst tells the nurse, "I’m going to kill my father, but you can’t tell anyone." Select the nurse’s best response.

Choice A reason: Zolpidem, a nonbenzodiazepine sedative, affects the central nervous system, causing sedation and impaired coordination, particularly in the elderly. Age-related declines in metabolism and balance increase fall risk, a critical nursing consideration. Monitoring mobility and ensuring safety measures are essential to prevent injuries, making this the correct choice.

Choice B reason: While zolpidem may cause daytime drowsiness, this is not the primary nursing consideration compared to fall risk in the elderly. Drowsiness is a general side effect, but the elderly’s heightened vulnerability to falls due to sedation and impaired coordination takes precedence, making this choice less critical.

Choice C reason: Zolpidem has a lower dependence risk than benzodiazepines, and dependence is not inevitable. This assumption overstates the risk and is not the primary nursing consideration. Fall prevention, especially in vulnerable populations like the elderly, is more urgent due to immediate safety concerns, making this choice incorrect.

Choice D reason: Zolpidem induces sedation rapidly, typically within 15–30 minutes, not requiring 4 weeks. This choice is factually incorrect, as prolonged use is not necessary for efficacy. The primary concern is immediate side effects like falls, not a delayed onset, making this an invalid nursing consideration.

Choice A reason: Focusing on the nurse’s experiences shifts attention from the patient, undermining therapeutic communication. This violates psychiatric nursing principles, which prioritize patient-centered dialogue to build trust and explore feelings, making this a non-therapeutic technique that disrupts effective mental health care.

Choice B reason: Making value judgments imposes the nurse’s beliefs on the patient, creating a judgmental environment. This hinders open communication, fosters defensiveness, and undermines trust, contrary to therapeutic communication goals in mental health nursing, making this a correct choice for non-therapeutic behavior.

Choice C reason: Giving advice assumes the nurse knows best, disempowering the patient and limiting self-exploration. Therapeutic communication encourages patients to find their own solutions, making advice-giving non-therapeutic, as it disrupts autonomy and trust, correctly identifying this as a non-therapeutic technique.

Choice D reason: Active listening, involving empathy and nonverbal cues, is a cornerstone of therapeutic communication. It fosters trust and validates patient feelings, essential in mental health care. This technique enhances therapeutic relationships, making it incorrect as a non-therapeutic communication example.