A nurse is admitting a client who has major depressive disorder. Which of the following actions should the nurse take during the orientation phase of the therapeutic relationship?

A. Apple juice: Thin liquids like apple juice can be difficult for clients with dysphagia to control, increasing the risk of aspiration. These should generally be thickened or avoided based on the client’s swallowing ability.

B. Oatmeal: Soft, pureed, or thick foods like oatmeal are easier to swallow and reduce the risk of aspiration. Oatmeal has a cohesive texture that allows safer swallowing for clients with dysphagia.

C. Broth: Clear liquids such as broth are thin and can easily enter the airway, increasing the risk of choking or aspiration in clients with swallowing difficulties.

D. Toast: Dry, hard foods like toast can be difficult to chew and form into a cohesive bolus, making swallowing unsafe for clients with dysphagia.

A. "Why do you think your life is not worth it anymore?": Asking “why” can feel judgmental and may cause the client to withdraw rather than share openly. It directs the conversation toward justification rather than safety assessment, delaying the nurse’s responsibility to determine immediate suicide risk.

B. "You can trust me and tell me what you are thinking": While supportive, this statement is too vague and does not address the urgent need to assess suicidal intent. It does not guide the client toward providing specific information needed to evaluate the level of risk and plan for safety.

C. "I need to know what you mean by misery": This response explores the client’s feelings but does not directly address the expressed suicidal thoughts. Focusing on the term “misery” may allow critical details about planning or intent to go unassessed during a potentially dangerous moment.

D. “Do you have a plan to end your life?”: This is an appropriate and essential safety-focused response because it directly assesses the client’s level of suicidal intent and the presence of a plan. Determining whether a plan exists helps the nurse evaluate the immediacy of the risk and initiate protective interventions without delay.