A client hospitalized for depression says, "My family would be better off without me." Which response by the nurse is the priority?
1I'm here to listen if you want to talk about what's bothering you.
2It's common to have these thoughts when you're feeling depressed.
3Are you thinking about killing yourself or making a plan to harm yourself?✓ Correct answer
4What makes you feel like your family would be better off without you?
Explanation
A statement suggesting death or worthlessness requires direct suicide risk assessment. Asking clearly about suicidal thoughts, plan, means, and intent does not put the idea into the client mind and is the priority for safety. Minimizing, giving privacy, or redirecting to positives can miss imminent risk.
Clinical Judgment Indirect suicidal statements require direct, specific assessment before reassurance or privacy.
Memory Tip If death is hinted, ask directly.
KR vs US NCLEX therapeutic communication favors clear safety assessment over vague reassurance.
Clinical Practice GuideSuicide safety assessment uses direct questions about thoughts, plan, means, intent, and protective factors, followed by safety precautions as indicated.
CautionNever promise secrecy when a client may be at risk for self-harm.
Suicidal Ideation — Thoughts about death, self-harm, or killing oneself that require safety assessment.
Suicide Risk Assessment — Direct assessment of suicidal thoughts, plan, means, intent, prior attempts, and protective factors.
Therapeutic Communication — Purposeful communication that validates feelings and gathers safety-critical information.