The nurse recognizes the client in the emergency department from a picture in the local paper. The client has recently received a major scholarship for high academic achievement. The client tells the nurse that he hears voices that tell him he is worthless. He has tried to kill himself. What statement is the most appropriate for the nurse to use first when attempting to establish a therapeutic relationship

Options for the question have not been given. They are as follows:

a) "Would you like me to call your parents?"

b) "I am sorry this is happening to you."

c) "You have a lot to live for."

d) "The voices are not real."

b) "I am sorry this is happening to you."

Explanation:

The client is having hallucinations of voices telling him that he is worthless. He is suffering from low confidence and does not feel good enough even though he has achieved significantly in life. He also has history of self harm. So, the client has started to shut out the world and be in his own thoughts.

In this case, before approaching any treatment, it is necessary for the nurse to make the client comfortable. She should be empathetic and show genuine concern which will make the client trust her more. If the nurse just abruptly tells the client that his hallucination is not real or that she wants to inform his parents, he might become even more reclusive. He might even refuse to participate in the future treatment.

So instead of forcing him to understand his condition or telling him to be positive, it is first important for the nurse to build a healthy connection with him. Thus, option b) is correct.

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