The nurse enters a room for an initial assessment and the client shouts, 'Get out of my room! I'm tired of being bothered!' What is an appropriate way to respond?

• A. I will leave the room and return later
• B. You seem upset; I will come back later
• C. What is concerning you this morning?
• D. Would you prefer that I leave?

Answer: (C)

Opening with an open-ended, nonjudgmental question is the best way to engage a distressed patient during an initial assessment. Saying, "What is concerning you this morning?" invites the patient to express what’s bothering them in their own words, which helps you understand their needs, validates their feelings, and re-establishes control for the patient in the interaction. This approach can de-escalate tension and builds rapport, setting the stage for a productive assessment.

The other responses are more limiting. Simply leaving the room ends the encounter without addressing the patient’s distress. Acknowledging that the patient seems upset is helpful but still frames the situation from the nurse’s observation rather than inviting the patient to describe their concerns. Asking whether the patient would prefer that you leave is a yes/no question that doesn’t elicit specific information about what is upsetting them.