Which principle has the highest priority when addressing a behavioural crisis in an inpatient setting?
Suspend the patients' rights until the crisis is resolved
Rights of an individual patient are superseded by the rights of the majority
Patients should have opportunities to regain control without intervention if the safety of others is not compromised
Swift intervention is justified to maintain the safety and integrity of all patients as well as a therapeutic milieu.
The Correct Answer is D
Choice A reason: Patients' rights are never fully "suspended." Even during a crisis, patients retain the right to the least restrictive intervention and to be treated with dignity. While some rights (like freedom of movement) may be temporarily limited for safety, the legal and ethical framework of patient rights remains active.
Choice B reason: This is a utilitarian perspective that does not align with psychiatric nursing ethics. Care must be individualized. The nurse's duty is to balance the safety of the collective with the rights and clinical needs of the individual, rather than simply dismissing one for the other without specific justification.
Choice C reason: While "least restrictive" care is a goal, waiting for a patient to "regain control" during a behavioral crisis can be dangerous. If a patient is actively destructive or threatening, delaying intervention increases the risk of escalation, injury, and the destruction of the therapeutic environment (milieu).
Choice D reason: In a behavioral crisis, the priority is the safety of the patient, other patients, and the staff. Swift, organized intervention (such as de-escalation, chemical restraint, or physical restraint) is necessary to prevent injury and maintain the stability of the unit's therapeutic environment, ensuring that the milieu remains safe for all.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Allowing a large group of people to visit simultaneously can overwhelm an elderly patient experiencing post-operative delirium. Excessive sensory input and multiple voices can increase agitation and confusion, making the environment more chaotic rather than providing the intended comfort or memory triggers.
Choice B reason: Consistent, calm, and familiar sensory input like a loved one's voice or familiar music provides a grounding effect for a delirious patient. This approach maintains a connection to the patient's identity and reality in a non-threatening way, helping to reduce agitation through a predictable environment.
Choice C reason: Providing complex stimulation or previously enjoyed activities may be counterproductive during an acute episode of agitation and disorientation. The patient currently lacks the cognitive capacity to process complex tasks or engage in activities, and the added stimulation might exacerbate the patient's current state of delirium.
Choice D reason: Limiting contact entirely can increase the patient's fear and sense of isolation. Family presence is often a key factor in reorienting a patient with delirium. While visits should be structured and calm, complete restriction removes a vital support system that can help stabilize the patient.
Correct Answer is A
Explanation
Choice A reason: Drug dependence, or physical dependence, is a physiological state where the body has adapted to the presence of a drug. The hallmark of dependence is the emergence of withdrawal symptoms when the substance is discontinued. This can occur even when a drug is taken exactly as prescribed.
Choice B reason: Drug addiction (substance use disorder) involves behavioral components such as compulsive use, loss of control over consumption, and continued use despite harmful consequences. The patient’s report that the drug "made her feel bad" suggests a lack of the psychological "craving" or reward-seeking behavior typical of addiction.
Choice C reason: Substance abuse traditionally refers to the use of a substance in a way that is inconsistent with legal or medical guidelines, often resulting in social or occupational impairment. The scenario describes a physiological reaction to stopping a medication, which is a medical phenomenon rather than a behavioral pattern.
Choice D reason: Drug abuse is a general term for the improper use of substances. Since the client was taking the narcotic "for pain," likely under medical supervision, and stopped it because it made her feel bad, her situation is a matter of physiological dependence rather than intentional misuse or abuse.
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