A psychiatric unit has several patients with personality disorders. Which of the following behaviors should the nurse address first?
The patient who is superficial in group therapy
The patient who threatens other patients
The patient who is lying to others in group
The patient who makes sexual jokes
The Correct Answer is B
A: The patient who is superficial in group therapy may not be engaging deeply with the therapeutic process, which can hinder their progress. However, this behavior does not pose an immediate threat to the safety of others or the therapeutic environment. It is important for the nurse to address this issue to encourage more meaningful participation, but it is not the most urgent concern.
B: The patient who threatens other patients presents an immediate risk to the safety and well-being of others in the unit. Threatening behavior can escalate to physical violence, causing harm to patients and staff. Addressing this behavior first is crucial to maintaining a safe and therapeutic environment. The nurse must intervene promptly to de-escalate the situation, ensure the safety of all individuals, and implement appropriate measures to prevent further threats.
C: The patient who is lying to others in the group can disrupt the trust and cohesion within the therapeutic setting. While honesty is important for effective therapy, this behavior does not pose an immediate danger. The nurse should address this issue to maintain the integrity of the group therapy process, but it is not as urgent as addressing threats of violence.
D: The patient who makes sexual jokes may be engaging in inappropriate behavior that can make others uncomfortable and disrupt the therapeutic environment. While this behavior needs to be addressed to maintain a respectful and professional atmosphere, it does not pose an immediate threat to safety. The nurse should intervene to correct this behavior, but it is not the highest priority compared to threats of violence.
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Related Questions
Correct Answer is D
Explanation
A: Using seclusion should be a last resort and only used when the patient poses an immediate threat to themselves or others. It is not a proactive strategy for managing frustration.
B: Ensuring the patient understands harsh consequences for violent episodes may not be effective in preventing aggression and can increase feelings of frustration and resentment.
C: Responding to emotional outbursts with negative reinforcement can escalate the situation and is not a therapeutic approach.
D: Creating a quiet and relaxing room provides a safe space for the patient to calm down and manage their emotions. This proactive strategy helps prevent escalation and supports the patient’s ability to cope with frustration
Correct Answer is C
Explanation
A: Telling the patient their behavior is upsetting the milieu and asking them to stay in their room may escalate the situation by making the patient feel dismissed and isolated.
B: Avoiding addressing the behavior and giving PRN pain medication without discussing the patient’s concerns does not address the underlying issue and may reinforce the behavior.
C: Listening empathetically to the patient and collaborating with them to manage pain is the most effective approach. It shows the patient that their concerns are being heard and that the nurse is willing to work with them to find a solution, which can help de-escalate the situation.
D: Calling for the security team to make frequent rounds may increase the patient’s agitation and sense of being controlled, which can escalate the situation further.
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