NCLEX-RNPsychosocial IntegrityMedium
A client is admitted to the psychiatric unit with severe depression. During the initial assessment, the client states, 'I just want to end it all. I have nothing left to live for.' Which of the following is the most appropriate nursing response?
- A“It sounds like you’re feeling hopeless. Can you tell me more about what’s happening?”
- B“You shouldn’t talk like that. Things will get better soon.”
- C“I will let your doctor know what you just told me.”
- D“Why do you feel that way? Many people care about you.”
Show answer & explanationAnswer & explanation
Correct answer: A. “It sounds like you’re feeling hopeless. Can you tell me more about what’s happening?”
This response uses therapeutic communication by reflecting the client's feelings ('It sounds like you’re feeling hopeless') and then inviting further communication ('Can you tell me more about what’s happening?'). This encourages the client to express more without judgment or minimization.
Why the other options are wrong
- B. This response dismisses the client's feelings and offers false reassurance, which closes off communication.
- C. While informing the doctor is necessary, it is not the most appropriate immediate nursing response to the client's direct statement, as it bypasses the opportunity for therapeutic engagement.
- D. Asking 'why' can put the client on the defensive and offering false reassurance or minimizing feelings is not therapeutic.
Therapeutic Communication (Validation & Exploration)
Therapeutic communication involves actively listening, validating the client's feelings, and encouraging further expression without judgment or offering false reassurance.
- Reflecting feelings is key.
- Open-ended questions promote dialogue.
- Avoid 'why' questions and false reassurance.
Memory trick: Validate, Explore, then Elevate.