A nurse is developing a plan of care for a school-age child who has ADHD. Which of the following interventions should the nurse include in the plan?

A. "We can ask the physician to prescribe a sedative": Offering a sedative is not an appropriate immediate response. While medication may be helpful in managing symptoms, the nurse should first assess the client’s emotional state and risk for self-harm.
B. "Have you thought about harming yourself?": This response is the most appropriate as it directly addresses the client’s emotional distress and risk for self-harm. It opens up a conversation for the nurse to assess the severity of the client's suicidal ideation and ensure their safety.
C. "Can a family member try to obtain temporary custody of your child?": While this may be a valid question later on, it shifts the focus away from the client’s current emotional distress and potential self-harm. The immediate concern should be assessing the client’s safety, not discussing custody.
D. "If you attend counseling, you will get your child back": This response may provide false hope or pressure the client, as there are no guarantees about regaining custody. The nurse should focus on providing support and addressing immediate safety concerns rather than making promises.

A. The client is experiencing anisognosia: Anisognosia, a lack of awareness of one's own illness, is common in various psychiatric disorders, particularly in psychotic disorders like schizophrenia. While it is concerning, it does not typically require immediate reporting.

B. The client is experiencing command hallucinations: Command hallucinations, where the client hears voices telling them to take harmful actions, pose a direct safety risk. These should be immediately reported to the provider for further evaluation and intervention.

C. The client is exhibiting concrete thinking: Concrete thinking is common in individuals with certain psychiatric conditions, such as schizophrenia or intellectual disabilities. While it limits abstract thought, it is not an immediate cause for alarm.

D. The client is exhibiting a blunted affect: A blunted affect, or reduced emotional expression, is a common symptom in various mental health disorders. It is important for diagnosis and treatment planning but is not an immediate emergency or urgent situation.