Which principle has the highest priority when addressing a behavioral crisis in an inpatient setting?
Rights of an individual client supersede the rights of the majority of clients.
Clients should have every opportunity to regain control regardless of the crisis.
Swift intervention is justified to maintain the integrity of a therapeutic milieu.
Resolve the crisis with the least restrictive intervention possible.
The Correct Answer is D
Choice A rationale
While individual rights are critically important, they do not supersede the safety and well-being of the entire therapeutic milieu. In a behavioral crisis, the primary goal is to ensure the safety of all clients and staff. Therefore, an intervention, even if it restricts a client's rights temporarily, may be necessary to prevent harm. The principle of using the least restrictive method is paramount, but it is applied within the context of maintaining safety.
Choice B rationale
A client's opportunity to regain control is a desirable outcome, but it is not the highest priority during a crisis. The immediate priority is de-escalation and ensuring safety for everyone involved. If a client's behavior poses an immediate risk of harm, a swift intervention is necessary, even if it limits the client's immediate ability to self-de-escalate. The goal of regaining control is a secondary objective once safety has been established.
Choice C rationale
Maintaining the integrity of the therapeutic milieu is a high priority, but it does not justify using a more restrictive intervention than necessary. The principle of using the least restrictive intervention possible is a fundamental ethical and legal standard. It mandates that a crisis be managed with interventions that are safe, effective, and minimally intrusive. Intervening swiftly is important, but it must be done with the least restrictive means possible.
Choice D rationale
The principle of using the least restrictive intervention possible is the highest priority in a behavioral crisis. This ethical and legal standard dictates that nurses must first attempt less invasive measures, such as verbal de-escalation, before moving to more restrictive actions like seclusion or physical restraint. This approach respects the client's autonomy and dignity while ensuring the safety of all clients and staff in the inpatient setting.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
While a questionnaire could be a useful tool, it was not Dr. Hans Selye's primary contribution. His work was foundational in defining the physiological response to stress itself, not just in creating a measurement instrument. He described the biological, not just the psychological, mechanisms involved in the body's reaction to stressors.
Choice B rationale
The Social Readjustment Rating Scale (SRRS) was developed by psychiatrists Thomas Holmes and Richard Rahe, not Hans Selye. This scale measures stress based on life events and is a tool to assess the psychological impact of stressors. Selye's work focused on the physiological, nonspecific response of the body to any stressor, regardless of its nature.
Choice C rationale
Dr. Selye's seminal work established the General Adaption Syndrome (GAS). He described the three distinct stages that the body undergoes in response to a stressor: the alarm stage (initial shock and mobilization of resources), the resistance stage (coping with the stressor), and the exhaustion stage (depletion of resources and potential for illness).
Choice D rationale
Selye described the resistance stage as the body's continued physiological response to cope with the stressor, where it attempts to return to homeostasis. This stage is not defined by the use of psychological defense mechanisms to avoid confrontation, but rather by the sustained physiological effort of the body to adapt to the ongoing stress.
Correct Answer is B
Explanation
Choice A rationale
Noncompliance with medication at home, while a concern, does not necessarily warrant hospitalization on its own unless it leads to a clear and present danger to self or others. The standard of care often involves less restrictive interventions, such as outpatient care, medication management support, or case management, to address noncompliance before resorting to inpatient treatment.
Choice B rationale
Hospitalization for mental illness is generally reserved for clients who pose a clear and present danger to themselves or others. This is due to the principle of least restrictive environment, which mandates that individuals be treated in the least restrictive setting possible. When an individual's behavior escalates to the point of imminent harm, inpatient care is necessary to ensure safety.
Choice C rationale
Limited support systems in the community can increase the risk of relapse and poor outcomes, but it is not a primary criterion for psychiatric hospitalization. Community-based services, such as assertive community treatment (ACT) teams, case managers, or partial hospitalization programs, are typically employed to address inadequate support without the need for inpatient admission.
Choice D rationale
The development of new symptoms during the course of an illness, unless they signify an immediate risk of harm, is usually managed in an outpatient setting. A healthcare provider would likely adjust the treatment plan, such as changing medication or therapy, and monitor the client's response. Hospitalization is not the initial or default response for symptom fluctuation.
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