A nurse is caring for a client who is in physical restraints after demonstrating aggressive behavior. Which of the following criteria must be met before the nurse can remove the restraints?

The client must be calm and cooperative.

The provider who prescribed the restraints must be present to assess the client before the restraints can be removed.

The client must verbalize remorse for their behavior.

The client only verbalizes anger toward the staff.

Answer and Explanation

The Correct Answer is A

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.

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Correct Answer is C

Explanation

Choice A rationale
While it’s true that some mutations can allow a virus to survive longer in the environment, this doesn’t necessarily increase the virus’s communicability, or its ability to spread from person to person.
Choice B rationale
A mutation that causes more severe disease can make an illness more dangerous, but it doesn’t necessarily make the virus more communicable. In fact, viruses that cause severe disease can sometimes be less communicable, because severely ill individuals are less likely to be moving around and spreading the virus.
Choice C rationale
The new mutation spreads easier from one individual to another. This is the definition of increased communicability. When a virus mutates in a way that allows it to spread more easily between individuals, this can lead to more cases of the disease, especially if the population is not immune to the new strain.
Choice D rationale

A mutation that requires a larger amount of the virus to cause disease would actually decrease the virus’s communicability. If more viral particles are needed to cause an infection, the virus would be less likely to spread from person to person.

A. “I was in a car crash two weeks ago and I have nightmares when I sleep.”. B. “I was physically abused as a child and have frequent flashbacks since then.”. C. “I was in a terrible car crash two years ago and I have been unable to drive since then.”. D. “My parents fought a lot when I was a child.

Correct Answer is A

Explanation

Choice A rationale
Acute Stress Disorder (ASD) is a mental health condition that can occur in the immediate aftermath of a traumatic event, with symptoms starting within four weeks of the event and lasting for a minimum of three days and up to one month. This client’s statement about experiencing nightmares following a car crash two weeks ago aligns with the diagnosis of ASD.

Nightmares are a common symptom of ASD, often replaying the traumatic event, leading to disrupted sleep and increased distress.
Choice B rationale
This statement is more indicative of Post-Traumatic Stress Disorder (PTSD), a related but distinct condition from ASD. PTSD is characterized by persistent and intrusive memories of the traumatic event, which can include flashbacks, and symptoms must last for more than a month and cause significant distress or functional impairment. The chronic nature of the symptoms described by the client, including frequent flashbacks since childhood, is more consistent with PTSD than ASD.
Choice C rationale
This statement could suggest a condition known as Specific Phobia, Situational Type. This is a type of anxiety disorder characterized by an intense, persistent fear of certain situations. The individual will avoid the situation or endure it with intense fear or anxiety. In this case, the client’s inability to drive following a car crash two years ago could indicate a specific phobia related to driving.
Choice D rationale
The experience described by the client in this statement is indicative of a dissociative symptom, which can be a feature of several different mental health disorders, including but not limited to Dissociative Disorders and PTSD1. The feeling of leaving one’s body is referred to as depersonalization, a type of dissociation that can occur as a response to trauma. However, without more information, it is difficult to align this statement with a specific diag

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A nurse is caring for a client who is in physical restraints after demonstrating aggressive behavior. Which of the following criteria must be met before the nurse can remove the restraints?

Nursing Test Bank

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Explanation

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Explanation

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