Difficulty: Medium
Average Score: 73%
Simulated
A client with depression states, 'I donÔÇÖt see the point of living anymore.' Which nursing action is the priority?
Correct answer
A
Rationale
The correct answer is A: Ask if the client has a plan to harm themselves. This is the priority because the client's statement indicates suicidal ideation, which requires immediate assessment of risk. Assessing for a suicide plan helps determine the level of risk and guides further interventions.
Summary:
B: Encouraging group therapy may be beneficial but is not the priority when there is a risk of harm.
C: Teaching coping skills is important but not the immediate priority when safety is a concern.
D: Notifying the family is important, but assessing the client's safety takes precedence.
Summary:
B: Encouraging group therapy may be beneficial but is not the priority when there is a risk of harm.
C: Teaching coping skills is important but not the immediate priority when safety is a concern.
D: Notifying the family is important, but assessing the client's safety takes precedence.