An angry client has just thrown a chair across the room and is racing to pick up another chair to throw. Which is the most appropriate action by the nurse?
Call for an emergency response from trained personnel.
Calmly call the client by name and encourage verbal expression of anger.
Approach the client and firmly say. "Stop. put it down."
Assist the client to use problem-solving techniques instead of aggression
The Correct Answer is A
The safety of both the client and others is the top priority in this situation. The client's aggressive behavior poses a significant risk, and immediate action is necessary. Calling for an emergency response from trained personnel, such as security or other staff members experienced in handling aggressive behavior, can help ensure the situation is properly managed and de-escalated in a safe manner.
Option B may not be appropriate in this situation, as trying to engage the client in verbal expression of anger while they are in an agitated and aggressive state can potentially escalate the situation further.
Option C is not recommended, as approaching the client in a confrontational manner may further escalate their anger and aggression.
Option D, while it may be beneficial in a different context and when the client is in a more stable state, is not appropriate when the client is actively engaged in aggressive behavior. The focus at this moment should be on ensuring the immediate safety of everyone involved.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["2"]
Explanation
To calculate the amount of naloxone to administer, you can use the following formula:
Amount to administer (mL) = Total dose required (mg) / Concentration of drug (mg/mL)
Given:
Total dose required = 0.4 mg
Concentration of drug = 0.2 mg/mL
Let's calculate the amount to administer:
Amount to administer (mL) = 0.4 mg / 0.2 mg/mL
Now, perform the calculation:
Amount to administer (mL) = 2 mL
So, the nurse should administer 2 mL of naloxone intravenously as a bolus dose to the client.
Correct Answer is A
Explanation
Every individual has the right to refuse medical treatment, including medications, as long as they are competent to make that decision. It is essential to respect the client's autonomy and right to make decisions about their own health care. When a client refuses medication, the nurse should document the refusal, inform the healthcare provider, and explore the reasons behind the refusal if possible.
The other options are not appropriate for the following reasons:
B- Obtaining a discharge order for nonadherence: While it is essential to address nonadherence to medication, discharging the client solely for refusing the medication may not be the best course of action. Instead, the nurse should work collaboratively with the healthcare team to address the client's concerns and explore alternative treatment options.
C- Restraining the client and giving the medication intramuscularly: Restraints should only be used as a last resort when a client presents an imminent danger to themselves or others, and it must be done in accordance with facility policies and legal regulations. Using restraints to administer medication against a client's will is a violation of their rights and is not an appropriate response to medication refusal.
D-Informing the client that refusing the medication means not getting any better: This response may be seen as coercive and manipulative. It is not ethical to use fear or guilt to persuade a client to take medication against their will. Instead, the nurse should provide information about the potential benefits and risks of the medication and address the client's concerns or fears about the treatment. Ultimately, the decision to take the medication should be left to the client after they have been fully informed about their options.
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