A nurse is caring for a young adult client who says he is experiencing increased anxiety and an inability to concentrate. Which of the following responses should the nurse make?

Choice A reason: Asking “why” places the client on the defensive and implies judgment, which can shut down communication. “Why” questions often elicit rationalizations rather than diagnostic detail, and they are less effective than open, neutral prompts. In anxiety assessment, the nurse should prioritize characterizing onset, duration, triggers, severity, functional impairment, and associated symptoms. A neutral, time-focused question helps establish chronology and guides subsequent targeted assessment without assigning blame. Choice B reason: This is a labeling and judgmental statement that violates therapeutic communication principles. It risks stigmatizing the client, exacerbating distress, and damaging rapport. Such phrasing can undermine trust and prevent accurate assessment. Therapeutic communication requires empathy, validation, and neutrality to facilitate disclosure of symptoms, stressors, and coping strategies. Judgments impede the nurse’s ability to gather clinically relevant information and formulate a safe, effective plan. Choice C reason: Focusing on duration opens the door to a clinically useful timeline, clarifying whether symptoms are acute, subacute, or chronic. Duration informs differential diagnosis (e.g., adjustment-related anxiety versus generalized anxiety), helps identify precipitating events, and frames severity and functional impact. It also allows the nurse to explore patterns, exacerbating factors, and any recent changes in sleep, substance use, or stressors. This neutral, open prompt fosters rapport and supports a systematic assessment. Choice D reason: Redirecting to parents presumes their involvement and may be culturally insensitive or irrelevant for a young adult. It can prematurely shift responsibility away from the nurse’s professional role in assessment and support. The priority is to assess the client’s current symptoms comprehensively and determine safety, impairment, and need for further evaluation. Involving family may be appropriate later, with consent, but it is not the first-line response for establishing a clinical picture.