A child has undergone a cardiac catheterization and is being prepared for discharge.

The nurse is instructing the parents and child about postprocedure care.

Which statements if made by the parents indicate the need for further teaching.

Choice A rationale

Asking "Have you thought about hurting yourself?" is the most therapeutic and appropriate initial response because it directly assesses for suicidal ideation, which is the immediate, life-threatening risk. Stating a wish to not be alive is a direct red flag that requires a non-judgmental, focused follow-up to determine the presence of a plan or intent. A direct question opens the door for the adolescent to disclose critical information needed for immediate safety planning and intervention.

Choice B rationale

Stating "You are just trying to escape your problems" is dismissive and invalidates the adolescent's stated feelings of sadness and despair. This response suggests the feelings are manipulative or weak, which would immediately shut down communication and damage the therapeutic relationship. It fails to address the underlying psychological pain and the immediate safety risk posed by the expression of wanting to be deceased.

Choice C rationale

Stating "Everyone feels sad once in a while" minimizes the severity of the adolescent's statement. While it is true that sadness is a universal emotion, expressing a wish for non-existence goes far beyond normal sadness and signals a severe crisis. Minimizing the feelings can make the adolescent feel misunderstood, ashamed, or isolated, potentially deterring them from sharing necessary details regarding suicidal thoughts or plans.

Choice D rationale

Asking "Have you told your parents how you feel?" shifts the focus away from the immediate priority, which is the adolescent's safety and direct assessment of suicidal intent. While parental involvement is important in pediatric mental health, the immediate responsibility of the nurse is to perform a direct safety assessment and ensure the adolescent is protected before addressing family communication or other support systems. —.

Choice A rationale

Providing false reassurance, such as stating "he will be okay," is not therapeutic because the outcome is uncertain, especially during active resuscitation efforts. The nurse must maintain honesty and support while acknowledging the gravity of the situation. Offering simple presence and resource information is much more supportive and appropriate for the family.

Choice B rationale

This response inappropriately questions the parents' actions and implies blame or judgment during an emotionally devastating crisis. Such a statement is highly unsupportive, unprofessional, and potentially damaging to the therapeutic relationship. The focus must remain on providing comfort, support, and necessary information to the grieving family.

Choice C rationale

Although it attempts to validate their feelings of fear, this response focuses on a specific, potentially guilt-inducing detail (the driving) which is likely irrelevant to the immediate need for support. It may exacerbate parental guilt during a critical time. A supportive response should be broad and non-judgmental, addressing their general distress and needs.

Choice D rationale

This statement is the most appropriate and therapeutic response, as it conveys non-judgmental presence, validation of the family's difficult emotional state, and an offer to provide information and answer questions. It establishes the nurse as a supportive resource for the family during a time of extreme crisis and uncertainty, which is the primary nursing role.