A nurse is educating a group of teenagers about warning signs of suicide. Which of the following signs should the nurse emphasize as potential indicators of suicidal ideation? (Select three.).

Choice B:

Encouraging active patient involvement.

Choice D:

Reflecting the patient's feelings and thoughts.

Choice A rationale:

Closed-ended questions often limit conversation and do not encourage deeper exploration of feelings or thoughts. In a therapeutic relationship with a patient at risk for suicide, the focus should be on open communication and building trust, which is not achieved through the use of closed-ended questions. Therefore, this choice is not suitable for building rapport and trust.

Choice B rationale:

Encouraging active patient involvement is crucial for establishing a therapeutic relationship. It empowers the patient to share their thoughts, concerns, and feelings openly. This choice promotes a sense of collaboration and trust between the nurse and the patient, creating a safe space for discussing sensitive topics like suicidal thoughts.

Choice C rationale:

Imposing personal opinions can create a power imbalance and hinder the therapeutic relationship. Patients should feel that their thoughts and feelings are respected and valued. Imposing personal opinions could alienate the patient and undermine the trust-building process.

Choice D rationale:

Reflecting the patient's feelings and thoughts involves active listening and showing empathy. This technique validates the patient's emotions and experiences, fostering a sense of understanding and trust. Reflecting feelings and thoughts demonstrates that the nurse is genuinely engaged and interested in the patient's perspective.

Choice E rationale:

Disregarding the patient's preferences goes against the principles of patient-centered care and building a therapeutic relationship. The patient's preferences and needs should be acknowledged and respected to establish trust and rapport. Disregarding preferences can lead to feelings of invalidation and hinder the development of a meaningful connection.

Choice A rationale:

The nursing diagnosis "Impaired coping" signifies that the client is experiencing difficulty in dealing with stressors and challenges. While it's true that impaired coping can contribute to various negative outcomes, the most critical concern when dealing with a client diagnosed with impaired coping and suicidal ideation is the risk of self-inflicted harm, which aligns with choice A. Clients with impaired coping and suicidal ideation are at a heightened risk for engaging in self-destructive behaviors, including attempts at self-inflicted, life-threatening injury. This choice is the most relevant and urgent, as it directly addresses the potential harm the client may cause to themselves due to their impaired coping skills.

Choice B rationale:

Although feelings of aloneness can contribute to psychological distress and could potentially be relevant to the client's situation, choice B does not directly address the immediate risk of self-inflicted injury associated with impaired coping and suicidal ideation. The focus in this case should be on the client's safety and preventing self-harm.

Choice C rationale:

This choice accurately describes one aspect of impaired coping but does not specifically address the increased risk of self-inflicted harm or the severity of the situation presented in the question. While impaired coping does involve the inability to use appropriate skills to manage stressors, the urgency of addressing the immediate risk of self-inflicted injury takes precedence in this scenario.

Choice D rationale:

Negative self-evaluation may contribute to impaired coping, but the question specifically relates to the client's risk for self-inflicted, life-threatening injury. While negative self-evaluation could be part of the client's overall presentation, it's not the most direct or urgent concern in this situation.