A patient reports, "I am overwhelmed by stress." Which question by the nurse would be most important to use in the initial assessment of this patient?

A) "Tell me about your family history. Do you have any relatives who have problems with stress?"
B) "Tell me about your exercise. How much activity do you typically get in a day?"
C) "Tell me about the kinds of things you do to reduce or cope with your stress."
D) "Stress can interfere with sleep. How much did you sleep last night?"

The most important data to collect during an initial assessment is that which reflects how stress is affecting the patient and how he is coping with stress at present. This data would indicate whether or not his distress is placing him in danger (e.g., by elevating his blood pressure dangerously or via maladaptive responses, such as drinking) and would help the nurse understand how he copes and how well his coping strategies and resources serve him. Of the choices presented, the highest priority would be to determine what he is doing to cope at present, preferably via an open-ended inquiry. Family history, the extent of his use of exercise, and how much sleep he is getting are all helpful but seek data that is less of a priority. Also, the manner in which such data is sought here is likely to provide only brief responses (e.g., how much sleep he got on one particular night is probably less important than how much he is sleeping in general).