# A client hospitalized for depression says, "My family would be better off without me." Which response by the nurse is the priority?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=393686&lang=en  
> language: en  
> subject: Mental Health Concepts  
> category: PSI

## Question

A client hospitalized for depression says, "My family would be better off without me." Which response by the nurse is the priority?

## Option

1. You should focus on the positive things in your life.
2. Many people feel sad during hospitalization.
3. I will give you privacy so you can rest.
4. Are you thinking about killing yourself or making a plan to harm yourself? **✔ Correct answer**

**Correct answer: 4**

## 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.

## In-depth explanation

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 scenario

Clinical Practice Guide
Suicide safety assessment uses direct questions about thoughts, plan, means, intent, and protective factors, followed by safety precautions as indicated.

Caution
Never promise secrecy when a client may be at risk for self-harm.

## Key concepts

- **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.

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