A charge nurse is teaching new staff members about factors that increase a client’s risk to become violent.

Which of the following risk factors should the nurse include as the best predictor of future violence?

Banana slices are soft, easy to chew, and can be picked up by the toddler’s fingers, which promotes independence in eating. According to the CDC, foods that toddlers should avoid include:

• Added sugars and no-calorie sweeteners, such as sugar-sweetened and diet drinks
• High-salt foods, such as canned foods, processed meats, frozen dinners, fast food, and junk food
• Unpasteurized juice, milk, yogurt, or cheese
• Foods that may cause choking, such as hard or crunchy foods, sticky foods, stringy cheese, and foods that are not cut up into small pieces

Choice A is wrong because popcorn is a choking hazard for toddlers.

It is hard, crunchy, and can get stuck in the airway. The NHS advises not to give whole nuts and peanuts to children under 5 years old.

Choice B is wrong because grapes are also a choking hazard for toddlers.

They are round, slippery, and can block the airway. The NHS recommends cutting grapes into quarters before giving them to young children.

Choice D is wrong because hot dogs are high in salt and can cause choking if not cut up into small pieces. The Extension warns against giving hot dogs to young toddlers.

The correct answer is Choice D, "We can provide a copy of your records, but the therapist's notes are not included."

Rationale for Choice A:

• Puts the client on the defensive:Asking "Why are you interested in seeing your therapist's notes?" can make the client feel like they need to justify their request,potentially leading to defensiveness or withdrawal.
• May not uncover true motivation:The client may not feel comfortable revealing their true reasons for wanting to see the notes,and this approach could hinder open communication.
• Undermines client autonomy:It's important to respect the client's right to access their own information,even if it's not always beneficial.Questioning their motives could make them feel less empowered in their treatment.

Rationale for Choice B:

• Paternalistic and dismissive:Saying "I don't think you will benefit from reviewing your therapist's notes right now" assumes that the nurse knows what's best for the client without exploring their perspective.
• Discourages open communication:It shuts down conversation and may prevent the client from expressing their concerns or needs.
• Could damage therapeutic relationship:By dismissing the client's request,the nurse risks eroding trust and rapport,which are essential for effective therapy.

Rationale for Choice C:

• Assumes dissatisfaction with treatment:Asking "Are you not happy with your treatment?" immediately focuses on potential problems rather than understanding the client's motivations.
• May not be accurate:The client's request may not stem from dissatisfaction with treatment but rather from curiosity,a desire for control,or other reasons.
• Could create unnecessary anxiety:Raising concerns about treatment satisfaction without proper exploration could create anxiety or doubts in the client's mind.

Rationale for Choice D:

• Clear and informative:It directly addresses the client's request while providing accurate information about the availability of records.
• Protects therapist's notes:It upholds the therapist's right to maintain confidentiality of their thought processes and clinical impressions.
• Offers alternative solutions:It suggests that the client can access other parts of their record,potentially addressing their underlying need for information.
• Professional and respectful:It maintains professional boundaries and respects the client's right to information without disclosing protected notes.