A nurse is preparing to administer ceftriaxone 1 g IM every 12 hr. Available is ceftriaxone injection 450 mg/mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth.)

A. I think you should give the doctor a chance:
This response is not therapeutic because it dismisses the client's feelings and does not address the underlying issue. Telling the client to "give the doctor a chance" minimizes the client's fears and can be perceived
as invalidating. Acknowledging the client’s delusion or belief, rather than trying to directly convince them it is wrong, would be more appropriate.

B. Tell me more about your feelings towards the doctor:
Encouraging the client to elaborate on their feelings is a therapeutic approach that shows the nurse’s willingness to listen without judgment. This allows the nurse to gain insight into the client’s thought process and helps establish trust. It also helps the nurse to assess the severity of the delusion and the client's emotional state related to the belief.

C. That is absolutely not true, sir:
This response is confrontational and may escalate the client's anxiety or distress. Directly disputing the delusion can reinforce the client's sense of mistrust and can contribute to the client feeling misunderstood. It’s important to avoid challenging or arguing with delusions, as this can harm the therapeutic relationship.

D. Why would the doctor want to do that?:
This response may unintentionally reinforce the delusion by focusing on the specifics of the false belief. Instead of helping the client explore their feelings in a therapeutic way, it might lead them to rationalize or elaborate on their delusion further. It's better to focus on the client's emotional state rather than engaging with the content of the delusion.

E. You seem to be worried about seeing the doctor:
This response acknowledges the client’s emotional state and validates their feelings. It does not challenge or argue with the delusion but redirects the conversation to the client's anxiety or fear, which is an appropriate way to approach a client with schizophrenia. It opens up space for the client to discuss their concerns in a non-confrontational manner.

A) Administer PRN medication for agitation: Administering PRN medication may be necessary if the client’s agitation becomes unmanageable, but it is important to first attempt non-pharmacological interventions, such as reducing stimuli, before resorting to medication. This approach helps in managing the client's agitation in a more holistic manner and avoids over-reliance on medication.

B) Request a prescription for physical restraints: Restraints should be considered a last resort and only after less restrictive interventions, like reducing stimuli or verbal de-escalation techniques, have been attempted. Restraints can escalate aggression and increase the risk of harm, so they should not be the first intervention in managing agitation.

C) Place the client in seclusion: Seclusion should only be used as a last resort when other methods have failed, and the client poses a risk to themselves or others. It is a restrictive intervention that can have negative psychological effects, so it is better to try less intrusive measures first, such as reducing environmental stimuli.

D) Attempt to reduce environmental stimuli: Reducing environmental stimuli is a non-invasive, first-line intervention for managing agitation. It helps decrease overwhelming sensory input and can calm the client down. This approach involves creating a quieter, more controlled environment, which can assist in de-escalating the situation before more drastic measures are needed.