An 11-year-old, who is diagnosed with oppositional defiant disorder, becomes angry and disruptive over the rules of the day treatment program. The nurse should de-escalate the situation by:
calling staff to place the child in the locked seclusion room.
placing the child in physical restraints.
providing a prn anxiolytic medication.
suggesting that the child go into the gym and shoot some baskets.
The Correct Answer is D
D. It offers the child a constructive way to release pent-up energy and frustration in a safe and non- confrontational manner. Physical activity can be a helpful tool in managing anger and disruptive behavior, as it allows the child to channel their emotions into a productive activity.
A. This option is not appropriate because it involves isolating the child in a locked room, which could further escalate the situation and may traumatize the child. Seclusion should only be used as a last resort in situations where the child or others are at risk of harm.
B. Physical restraints should only be used as a last resort in situations where the child poses an immediate danger to themselves or others. Using physical restraints can escalate the situation and may cause physical and psychological harm to the child.
C. Medication may be prescribed to manage symptoms of oppositional defiant disorder. However, using a PRN (as needed) anxiolytic medication to manage acute agitation should only be done under the guidance of a healthcare provider.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
C. After ECT, the client may be disoriented, confused, or drowsy due to the effects of anesthesia and the procedure itself. Orienting the client to their surroundings and situation helps promote their safety and comfort. Monitoring vital signs, including blood pressure, heart rate, respiratory rate, and oxygen saturation, is crucial to assess the client's immediate post-procedural status and detect any complications.
A. Offering reassurance can help alleviate any anxiety or confusion the client may experience. However, while this intervention is important, it may not be the first priority immediately upon admission to the Post Anesthesia Care Unit (PACU).
B. Hydration is important after any medical procedure, including ECT. However, immediately after ECT, the client may still be recovering from anesthesia and may not be fully alert or able to safely drink fluids.
D. Assisting the client with mobility is important but it may not be the first intervention performed in the PACU after ECT. The priority immediately upon admission to the PACU is to ensure the client's safety.
Correct Answer is ["C","D","E"]
Explanation
C. Identifying community resources is essential as it provides the client with accessible support during crises.
D. Educating the family about creating a safe and structured environment is also important because it involves the client's support system in their care, which can help prevent future crises.
E. Assisting the client in developing more effective coping mechanisms is vital for long-term management and recovery, as it empowers the client to handle stressors more healthily.
A. Isolating the client from all stressful situations is not practical or beneficial as it does not teach coping mechanisms or resilience.
B. Having a one-to-one sitter might be necessary in some inpatient settings but is not feasible or indicated for outpatient care.
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