A nurse is providing dietary teaching to a client who has a prescription for tranylcypromine. The nurse should instruct the client to avoid which of the following foods while taking this medication?

Choice A reason: Asking how the client is feeling is supportive but does not address the immediate risk of harm. While therapeutic, it is not the priority in a crisis situation where safety must be assessed first.

Choice B reason: Offering to call someone for support is helpful but secondary. Before involving others, the nurse must determine if the client is at risk of self-harm.

Choice C reason: Asking about past coping strategies is useful for long-term support but does not address the immediate crisis. It assumes the client is safe, which must be confirmed first.

Choice D reason: Assessing for suicidal ideation is the priority because the client has experienced a traumatic loss and is showing signs of severe distress. The nurse must determine if the client is at risk of harming themselves before proceeding with other interventions. Ensuring safety is always the first priority in crisis care.

Choice A reason: Encouraging the client to verbalize their feelings about hoarding is the first step because it establishes rapport and allows the nurse to understand the client’s perspective. Hoarding disorder is often associated with deep emotional distress, anxiety, and fear of loss. By exploring feelings first, the nurse builds trust and creates a foundation for further interventions. This therapeutic communication is essential before moving into education or referrals.

Choice B reason: Referring the client to a support group is beneficial but should not be the first action. Without first establishing trust and understanding the client’s feelings, the client may resist external interventions. Support groups are effective later in the care plan once the client is ready to engage with others.

Choice C reason: Discussing health risks is important but should follow after the nurse has explored the client’s feelings. Starting with risks may feel confrontational or judgmental, which could increase resistance. The nurse must first understand the client’s emotional attachment to hoarding before addressing risks.

Choice D reason: Completing the Hoarding Scale Self-Report is a useful assessment tool, but it is not the first action. The client may not be ready to engage in structured assessments until rapport and trust are established.