A nurse in a mental health facility is planning a training program for new staff members on managing aggressive clients. Which of the following instructions should the nurse plan to include?
Assume authority by standing directly in front of the client.
Attempt to calm the client with therapeutic touch.
Offer the client a PRN medication to reduce their anxiety.
Bring other staff members to talk the client down.
The Correct Answer is C
Choice A reason: Standing directly in front of an aggressive client may be perceived as threatening and escalate the situation. Staff should maintain a safe distance and non-confrontational posture.
Choice B reason: Therapeutic touch is contraindicated in aggressive situations. Physical contact may provoke further aggression or be misinterpreted.
Choice C reason: Offering PRN medication is a safe and effective de-escalation strategy. It helps reduce agitation and prevent escalation when used appropriately.
Choice D reason: Bringing multiple staff members may overwhelm or intimidate the client. It should only be done if safety is compromised and intervention is necessary.
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Correct Answer is B
Explanation
Choice A reason: Identifying triggers is important but not the priority during a panic episode. The client may be too overwhelmed to engage in this process initially.
Choice B reason: Providing a quiet, low-stimulation environment helps reduce sensory overload and promotes safety. It is the first step in de-escalating panic-level anxiety.
Choice C reason: Teaching coping techniques is essential but should follow environmental stabilization. The client may not be receptive to learning during acute distress.
Choice D reason: Encouraging verbalization is therapeutic but may not be feasible during a panic attack. The priority is calming the environment first.
Correct Answer is C
Explanation
Choice A reason: Rheumatoid arthritis is not a contraindication for ECT unless it involves cervical spine instability. It should be assessed but is not an immediate concern.
Choice B reason: Kidney failure requires monitoring of fluid and electrolyte balance but is not a direct contraindication to ECT.
Choice C reason: Congestive heart failure poses a significant risk due to the hemodynamic changes induced by ECT, including sympathetic stimulation and increased cardiac workload. This must be reported and evaluated.
Choice D reason: Diabetes requires glucose monitoring but does not contraindicate ECT unless there are associated cardiovascular complications.
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