The nurse is attempting to de-escalate a client who is becoming increasingly agitated on the unit. Which of the following interventions would be appropriate for this type of client? (SELECT ALL THAT APPLY)
Use a calm voice.
Speak louder than the client so as to be heard.
Reduce stimuli for the client.
Attempt to redirect the client.
Reprimand the client for upsetting everyone.
Correct Answer : A,C,D
Choice A Reason:
Use a calm voice.
Using a calm voice is essential in de-escalating an agitated client. A calm and steady tone can help soothe the client and reduce their anxiety. It also demonstrates that the nurse is in control of the situation and is there to help, which can be reassuring for the client.
Choice B Reason:
Speak louder than the client so as to be heard.
Speaking louder than the client is not appropriate as it can escalate the situation further. Raising one’s voice can be perceived as confrontational and may increase the client’s agitation. It is important to maintain a calm and composed demeanor to help de-escalate the situation.
Choice C Reason:
Reduce stimuli for the client.
Reducing stimuli is an effective intervention for an agitated client. Excessive noise, bright lights, and other environmental stimuli can exacerbate agitation. Creating a quieter and more controlled environment can help the client feel more at ease and reduce their agitation.
Choice D Reason:
Attempt to redirect the client.
Attempting to redirect the client can be helpful in de-escalating agitation. Redirecting the client’s attention to a different topic or activity can help distract them from the source of their agitation and provide a sense of control. This technique can be effective in calming the client and preventing further escalation.
Choice E Reason:
Reprimand the client for upsetting everyone.
Reprimanding the client is not an appropriate intervention. It can increase the client’s feelings of frustration and agitation. Instead, the focus should be on understanding the client’s needs and providing support to help them calm down.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is d.
Choice A Reason:
The statement “Bureaucratic” is incorrect. Bureaucratic leadership is characterized by strict adherence to rules and procedures, with decisions made based on established policies. While this style ensures consistency and compliance, it does not typically involve the direct and decisive intervention seen in the scenario described. Bureaucratic leaders focus more on following protocols rather than making quick, authoritative decisions.
Choice B Reason:
The statement “Laissez-Faire” is incorrect. Laissez-Faire leadership is a hands-off approach where leaders provide minimal direction and allow team members to make their own decisions. This style is the opposite of what is demonstrated in the scenario, where the nurse takes immediate control of the situation. Laissez-Faire leaders typically avoid intervening directly and prefer to let issues resolve themselves.
Choice C Reason:
The statement “Democratic” is incorrect. Democratic leadership involves participative decision-making, where leaders seek input and feedback from team members before making decisions. In the scenario, the nurse does not seek input from the group but instead makes a unilateral decision to handle the matter and move on. This approach is not characteristic of democratic leadership, which values collaboration and consensus.
Choice D Reason:
The statement “Autocratic” is correct. Autocratic leadership is characterized by individual control over decisions, with little input from group members. The nurse’s behavior in the scenario—taking charge of the situation and making a quick decision without consulting the group—is indicative of an autocratic leadership style. Autocratic leaders are decisive and often make decisions independently, focusing on efficiency and control.
Correct Answer is ["A","C","D"]
Explanation
Choices A, C, and D: Changes to behavior and personality, Impaired judgment, Muscle stiffness and shuffling gait.
Choice A Reason:
Changes to behavior and personality are hallmark symptoms of frontotemporal dementia (FTD). This condition primarily affects the frontal and temporal lobes of the brain, which are responsible for behavior, personality, and language. Patients often exhibit socially inappropriate behaviors, apathy, and a decline in personal hygiene. These changes are among the earliest and most noticeable symptoms of FTD.
Choice B Reason:
While a past history of head trauma can be a risk factor for various types of dementia, it is not specifically associated with frontotemporal dementia. FTD is more commonly linked to genetic factors and specific protein abnormalities in the brain. Therefore, a history of head trauma is not a typical aspect of the medical history for FTD patients.
Choice C Reason:
Impaired judgment is a common symptom of frontotemporal dementia. The degeneration of the frontal lobes affects executive functions, including decision-making, problem-solving, and judgment. Patients may make poor decisions, exhibit risky behaviors, and have difficulty understanding the consequences of their actions.
Choice D Reason:
Muscle stiffness and a shuffling gait can occur in some forms of frontotemporal dementia, particularly in cases where the condition overlaps with motor neuron disease or Parkinsonism. These physical symptoms are less common than behavioral and cognitive symptoms but can still be present in some patients.
Choice E Reason:
A diagnosis of hypertension is not specifically related to frontotemporal dementia. While hypertension is a common condition that can coexist with any form of dementia, it is not a characteristic feature of FTD. The primary symptoms of FTD are related to changes in behavior, personality, and cognitive functions rather than vascular issues.
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