A nurse is conducting an admission interview with a new client who tells the nurse, "My life is so stressful. I can't take it anymore." Which of the following responses should the nurse make first?
"How have you dealt with stress in the past?"
"Are you thinking of harming yourself?"
"Let's talk more about what you are experiencing."
"Tell me what makes you feel stressed."
The Correct Answer is B
The nurse should make safety a priority and assess the client's risk for suicide first, before exploring other aspects of the client's stress level. The client's statement indicates hopelessness and despair, which are warning signs of suicidal ideation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
The client's statement reflects a loss of interest and pleasure in life, which is a major symptom of clinical depression. The other statements are normal expressions of grief that do not necessarily indicate depression, although they may warrant further assessment and support from the nurse.
Correct Answer is D
Explanation
Alprazolam is a benzodiazepine that can provide rapid relief of anxiety symptoms during a panic attack. Atomoxetine is a selective norepinephrine reuptake inhibitor that is used to treat attention-deficit/hyperactivity disorder, not anxiety disorders. Journaling and watching television are not appropriate interventions during an acute panic attack, as they do not address the client's physiological and psychological needs.
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