A nurse in a provider’s office is assessing a client who has dementia. Which of the following findings should the nurse expect?

Choice A reason: Prescribing a sedative addresses symptoms but not the client’s suicidal ideation. Sedatives, like benzodiazepines, depress the central nervous system but carry addiction risks, especially in substance use disorder. This response fails to assess immediate safety risks, prioritizing medication over critical suicide risk evaluation.

Choice B reason: Stating counseling will regain custody is misleading and non-therapeutic, as it oversimplifies legal processes. Substance use disorder recovery requires addressing psychological despair, and false promises may erode trust. This response ignores the client’s suicidal statement, missing the priority of safety assessment.

Choice C reason: Suggesting family custody focuses on practicalities but ignores the client’s expressed hopelessness and suicidal intent. While custody solutions may be relevant later, immediate assessment of self-harm risk is critical, as substance use disorder increases suicide vulnerability due to impulsivity and emotional dysregulation.

Choice D reason: Asking about self-harm directly addresses the client’s suicidal statement, a critical risk in substance use disorder. Despair and loss can trigger suicidal ideation, and immediate assessment allows for safety planning, psychiatric evaluation, or crisis intervention, prioritizing the client’s safety and mental health stabilization.

Choice A reason: Inpatient hospitalization is for acute crises, not ongoing management of schizoaffective disorder without transportation. It disrupts home life and is resource-intensive, inappropriate for a stable client needing community-based support to manage symptoms like psychosis or mood disturbances effectively.

Choice B reason: Assertive Community Treatment (ACT) provides intensive, home-based support for clients with schizoaffective disorder, addressing transportation barriers. ACT teams deliver medication management, therapy, and social services, stabilizing symptoms like hallucinations and mood swings, making it ideal for homebound clients with complex needs.

Choice C reason: Telehealth counseling is useful but limited for schizoaffective disorder, which requires comprehensive care, including medication and social support. Without transportation, in-person needs (e.g., lab monitoring) may be unmet, making telehealth less effective than ACT for holistic management.

Choice D reason: Outpatient group therapy requires transportation, which the client lacks, and may not address the full spectrum of schizoaffective disorder needs, like medication adherence or crisis intervention. ACT’s home-based, multidisciplinary approach better meets the client’s complex, ongoing care requirements.