A patient with depression tells the nurse, “Sometimes I think people would be better off without me being alive.” Which closed-ended question should the nurse ask next to assess the patient’s safety?

Choice A reason: Expressing empathy, such as acknowledging the difficulty of the loss, fosters a therapeutic connection. It validates the patient’s emotions, encouraging open expression of grief, which is essential for processing loss and aligns with therapeutic communication principles, making this choice therapeutic.

Choice B reason: Asking the patient to elaborate on their feelings is a therapeutic open-ended question. It promotes exploration of emotions, facilitating grief processing by engaging the patient’s prefrontal cortex in reflecting on their experience, making this a therapeutic response and incorrect for the question.

Choice C reason: Saying “You’ll feel better soon” minimizes the patient’s grief, dismissing their current emotional state. This nontherapeutic response can inhibit emotional expression, as it implies a timeline for grief recovery, potentially disrupting the patient’s natural mourning process, making this the correct choice.

Choice D reason: Offering support and encouraging discussion is therapeutic, as it builds trust and validates the patient’s experience. This response engages the patient in processing grief, supporting emotional regulation through empathetic communication, making it a therapeutic response and incorrect for the question.

Choice A reason: Reflecting the patient’s guilt and inviting further discussion is therapeutic, as it validates emotions and encourages exploration of feelings. This engages the patient’s emotional processing, fostering coping and reducing self-blame through empathetic communication, making this the correct choice.

Choice B reason: Telling the patient not to blame themselves dismisses their feelings, potentially inhibiting emotional expression. This nontherapeutic response fails to explore the patient’s guilt, which could stem from perceived control over their condition, making this choice incorrect.

Choice C reason: Advising to focus on the future minimizes the patient’s current emotional distress, a nontherapeutic approach. It overlooks the need to process guilt, which can affect diabetes management adherence, making this response less effective than exploring feelings.

Choice D reason: Downplaying diabetes as “not a big deal” invalidates the patient’s emotional experience, a nontherapeutic response. It fails to address guilt, which could impact psychological adjustment to the diagnosis, making this choice incorrect for therapeutic communication.