A nurse is visiting the home of a client who has alcohol use disorder. The client smells heavily of alcohol and his clothes are unclean. Which of the following responses should the nurse make?

• A. What would your family think about your drinking?
• B. Why aren't you taking better care of yourself?
• C. You should stop drinking and seek treatment.
• D. You seem to be having a difficult time.

Answer: (D)

An empathetic, nonjudgmental approach is the key to communicating with someone who has alcohol use disorder. When the nurse says, “You seem to be having a difficult time,” the message is supportive and validating. It acknowledges distress without blaming the client, which helps reduce defensiveness and invites the person to talk more openly about what they’re experiencing that day. This kind of statement builds trust, supports rapport, and creates a safe space for assessment and discussion about options for care.

Other responses tend to shut down conversation. Asking what family would think about the drinking can shift focus to others’ judgments and may make the client defensive or guarded. Chiding the client for not taking better care of themselves implies blame and can damage the therapeutic relationship. Telling the client to stop drinking and seek treatment is directive and paternalistic; it may trigger resistance because it doesn’t engage the client’s own motivations or readiness to change.

In contrast, the chosen response aligns with a person-centered, collaborative approach that encourages the client to share more about what they’re going through, which is essential for effective assessment, safety planning, and potential next steps in care. If you’re following up, you’d typically pair that with open-ended questions to explore the client’s perspective and needs.