A nurse is caring for a client who attacked one of her friends and is admitted to the psychiatric unit. Which of the following actions should the nurse take first?
Explain the client that the behavior was unacceptable.
Explore the truth of the client's statements.
Set behavioral limits for the client.
Establish a client relationship
The Correct Answer is C
A. Explain to the client that the behavior was unacceptable: While addressing the behavior is important, it is more effective to first establish clear limits and boundaries to prevent further incidents.
B. Explore the truth of the client’s statements: This step involves assessing the client's statements and understanding their perspective, which is important but can be done after setting behavioral limits.
C. Set behavioral limits for the client: Establishing clear behavioral limits is crucial for maintaining safety and order in the psychiatric unit. It helps ensure that the client understands what is expected of them and the consequences of unacceptable behavior. This is particularly important if the client has exhibited aggressive behavior, as it helps prevent further incidents and maintains a safe environment for everyone.
D. Establish a client relationship: Building a therapeutic relationship is essential for effective treatment, but it should be done in the context of a safe environment where clear behavioral expectations have already been established.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
No explanation
Correct Answer is ["0.5"]
Explanation
To calculate the amount of ziprasidone 10 mg IM from the available concentration of 20 mg/mL, you can use the formula:
Amount (mL) = Desired Dose (mg) / Concentration (mg/mL)
Amount (mL) = 10 mg / 20 mg/mL
Amount (Ml) = 0.5 mL
Therefore, the nurse should administer 0.5 mL of ziprasidone per dose.
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