A nurse is performing a psychosocial assessment on an adolescent client.
Which of the following should indicate to the nurse a potential risk for suicide? (Select all that apply)

Choice A rationale: Agoraphobia is a type of anxiety disorder where the person fears and avoids places or situations that might cause them to panic, feel trapped, or helpless. The goal of treatment for agoraphobia is to help the person feel less anxious and fearful about being in places or situations that they perceive as difficult to escape from. This is often achieved through a combination of cognitive-behavioral therapy (CBT) and medication. In CBT, the person learns to understand and change thought patterns that lead to troublesome feelings, behaviors, and symptoms.

Gradual exposure to the feared situation, under controlled conditions, can help the person gain better control over their anxiety. Therefore, the statement “I plan to sit on a park bench for a few minutes each day” indicates an understanding of the goals of treatment as it suggests a willingness to gradually expose oneself to feared situations.

Choice B rationale: The statement “I can try participating in group therapy every week” does not necessarily indicate an understanding of the goals of treatment for agoraphobia. While group therapy can be beneficial for many mental health conditions, it is not specific to the treatment of agoraphobia. In the context of agoraphobia, the focus of treatment is more on individual cognitive-behavioral therapy and gradual exposure to feared situations.

Choice C rationale: The statement “I will join a book club in my neighborhood” does not necessarily indicate an understanding of the goals of treatment for agoraphobia. Joining a book club could potentially provide social support and a sense of community, which can be beneficial for mental health in general. However, it does not specifically address the fears and avoidance behaviors associated with agoraphobia.

Choice D rationale: The statement “I should avoid entering elevators and other closed spaces” indicates a misunderstanding of the goals of treatment for agoraphobia. Avoidance of feared situations is a common symptom of agoraphobia, and treatment aims to reduce this avoidance behavior, not reinforce it. Therefore, this statement suggests a need for further education about the goals of treatment.

Choice A rationale:

It's okay to feel scared. Let's talk about what you are afraid of.

Acknowledges the client's feelings: This response directly acknowledges the client's fear and regret, which is a crucial first step in providing emotional support. It validates the client's experience and creates a safe space for open communication.

Invites the client to share: By inviting the client to talk about their fears, the nurse encourages open expression of emotions. This can help the client to process their feelings and gain a sense of control over their situation.

Promotes understanding: By actively listening to the client's concerns, the nurse can gain a better understanding of their individual needs and fears. This understanding can then guide the nurse in providing tailored support and interventions.

Facilitates coping: Talking about fears can help the client to identify and explore coping strategies. The nurse can assist in this process by offering suggestions, providing resources, and teaching relaxation techniques.

Strengthens the nurse-client relationship: By demonstrating empathy, active listening, and support, the nurse can foster a trusting relationship with the client. This relationship can provide a source of comfort and reassurance during a challenging time.

Choice B rationale:

Don't worry. The important thing is you have now quit smoking.

Dismisses the client's feelings: This response minimizes the client's fear and regret, which can be invalidating and hinder emotional expression.

Focuses on the past: While it's important to acknowledge the positive step of quitting smoking, this response shifts the focus away from the client's current emotional state and concerns about the upcoming surgery.

Offers false reassurance: Telling the client not to worry can be unrealistic and unhelpful, as it doesn't address the underlying fears.

Choice C rationale:

Your doctor is a great surgeon. You will be fine.

Provides premature reassurance: While it's appropriate to express confidence in the medical team, this response may not fully address the client's emotional needs. It can also inadvertently downplay the seriousness of the surgery and potential risks.

Shifts focus away from the client: This response focuses on the surgeon's skills rather than the client's feelings and concerns.

Choice D rationale:

I understand your fears. I was a smoker also.

May be perceived as self-focused: While sharing a personal experience can sometimes build rapport, it's important to ensure the focus remains on the client's needs and experiences. This response could inadvertently shift the attention to the nurse's own story.

Does not directly address the client's fears: While expressing understanding can be helpful, it's important to follow up with s and encouragement to explore the client's specific concerns.