A nurse is providing care to a client who is preparing to undergo surgery. The client inquires about advance directives. Which of the following statements should the nurse make?

Choice A reason: Asking about a plan assesses immediate suicide risk, as a specific intent with means indicates high lethality. This prioritizes safety per psychiatric protocols, identifying actionable steps over background factors, aligning with scientific urgency to prevent harm by targeting the most direct threat indicator first.

Choice B reason: Family history of suicide is a risk factor, but not the priority over a current plan. It provides context, not imminent danger data. Scientifically, past events inform predisposition, yet assessing active intent trumps historical trends for acute intervention in suicidal ideation scenarios.

Choice C reason: Support systems reduce isolation, a suicide risk factor, but don’t gauge immediate intent. Asking about this is secondary to planning, as it addresses coping, not current danger level. Psychiatric evidence prioritizes intent assessment over social resources for urgent safety evaluation in ideation cases.

Choice D reason: Stressors contribute to ideation but identifying them is less urgent than a plan. They offer context, not actionable risk data. Scientifically, while stressors are relevant, determining if the client has a concrete method outweighs exploring triggers for prioritizing life-saving interventions in acute suicidal states.

Choice A reason: Every 2 hours for wheezing is incorrect; montelukast is daily, not PRN. Scientifically, it’s a leukotriene inhibitor for prevention, not acute relief, showing misunderstanding of its chronic asthma management role versus rescue inhalers.

Choice B reason: Once daily in the evening is correct for montelukast, optimizing its anti-inflammatory effect overnight. Scientifically, this aligns with pharmacokinetics and asthma’s nocturnal worsening, indicating accurate understanding of its administration for long-term control.

Choice C reason: Stopping with steroids is wrong; montelukast complements, not replaces, them. Scientifically, it targets different pathways (leukotrienes vs. corticosteroids), and combined use enhances control, reflecting a misgrasp of its additive role in asthma therapy.

Choice D reason: Two months for efficacy is false; montelukast acts within days. Scientifically, its leukotriene blockade reduces inflammation quickly, not over months, suggesting misunderstanding of its rapid onset in asthma symptom prevention per evidence.