As the discharge date for a client to leave gets closer, the client states, “I’m afraid to leave here. I’m afraid for my well-being and safety.” Which nursing statement is most supportive?

Choice A Reason:

Ask the client direct questions about the hallucinations.

This response is the most appropriate because it allows the nurse to assess the content and nature of the hallucinations directly. By understanding what the client is experiencing, the nurse can better evaluate the risk of harm to the client or others and develop an appropriate care plan. Direct questioning helps in identifying whether the hallucinations are commanding the client to perform harmful actions, which is crucial for ensuring safety. This approach aligns with therapeutic communication techniques that emphasize understanding the client’s experience and providing appropriate interventions.

Choice B Reason:

Act as if the hallucinations are real.

This response is not appropriate because it can reinforce the client’s delusions and hallucinations, making it harder for them to distinguish between reality and their hallucinations. It is important for the nurse to maintain a reality-based approach while being empathetic and supportive. Acknowledging the client’s feelings without validating the hallucinations helps in maintaining a therapeutic environment.

Choice C Reason:

Instruct the client to argue with the voices.

Instructing the client to argue with the voices is not recommended as it can increase the client’s distress and confusion. Instead, the nurse should help the client develop coping strategies to manage the hallucinations, such as distraction techniques or reality testing. Encouraging the client to engage in a confrontation with their hallucinations can exacerbate their symptoms and is not a therapeutic approach.

Choice D Reason:

Explain to the client that the hallucinations will subside soon.

This response is not appropriate because it provides false reassurance. Hallucinations may not subside quickly, and the client needs realistic support and coping strategies to manage their symptoms. Providing false hope can undermine the client’s trust in the nurse and the treatment process. Instead, the nurse should focus on helping the client manage their symptoms effectively.

Choice A Reason:

“This is a difficult transition. Let’s formulate a plan to keep you feeling safe.”

This response is the most supportive because it acknowledges the client’s feelings and offers a proactive solution. By recognizing the difficulty of the transition and suggesting a plan to ensure the client’s safety, the nurse provides reassurance and practical support. This approach helps to build trust and shows empathy, which is crucial in a therapeutic relationship.

Choice B Reason:

“It’s the policy that patients can only live here for 30 days. Let’s try to extend it.”

While this response acknowledges the client’s fear, it focuses on policy rather than addressing the client’s immediate emotional needs. Extending the stay might not be feasible or beneficial in the long term. The primary goal should be to empower the client to feel safe and supported outside the facility.

Choice C Reason:

“You’ve had a month to come up with a plan to work on your well-being.”

This response can come across as dismissive and unsupportive. It implies that the client should have already resolved their fears, which may increase their anxiety and feelings of inadequacy. The focus should be on providing immediate support and reassurance rather than criticizing the client’s progress.

Choice D Reason:

“Hopefully you learned from being in counseling. I’m sure this will work out fine.”

This response is overly optimistic and does not address the client’s current fears. It provides false reassurance without offering any concrete support or solutions. The client needs to feel heard and supported, not just reassured that everything will be fine.