A nurse in a long-term care facility notices two residents arguing in the day room over a game they are playing. Which of the following interventions should the nurse use first?

Choice A rationale
The client must be calm and cooperative. This is the most important criterion for removing physical restraints. Restraints are used to prevent patients from causing harm to themselves or others. Once the patient is calm and cooperative, it indicates that the risk of harm has decreased. The goal is always to use the least restrictive measures and to remove restraints as soon as possible.
Choice B rationale
The provider who prescribed the restraints must be present to assess the client before the restraints can be removed. This is not necessarily true. While a provider’s order is required to initiate restraints, the decision to remove them can often be made by the nurse based on their assessment of the patient.
Choice C rationale
The client must verbalize remorse for their behavior. This is not a requirement for removing restraints. The primary concern is the safety of the patient and others, not whether the patient expresses remorse.
Choice D rationale

The client only verbalizes anger toward the staff. If the client is still expressing anger, it may not be safe to remove the restraints. However, verbalizing anger alone is not a sufficient reason to keep a patient in restraints.

Choice A rationale
Families that are isolated from other people, such as extended family, friends, and neighbors, are not typically considered a protective factor against adverse childhood experiences. Social isolation can actually increase the risk of mental health issues, as it can lead to feelings of loneliness and lack of social support.
Choice B rationale
Families where caregivers have college degrees or higher can often provide a more stable environment, both emotionally and financially. Higher levels of education are often linked to

better understanding of child development and more effective parenting strategies. Additionally, higher education is often associated with higher income, which can reduce stressors related to financial instability.
Choice C rationale
Families that include young caregivers or single parents can face additional stressors, such as financial strain and lack of social support, which can increase the risk of adverse childhood experiences. Therefore, this is not typically considered a protective factor.
Choice D rationale
Children who don’t feel close to their guardians and don’t feel loved are at a higher risk of developing mental health disorders. Feeling unloved and uncared for can lead to feelings of insecurity, low self-esteem, and difficulty forming healthy relationships later in life.