A client diagnosed with paranoid personality disorder becomes violent on a unit. Which nursing intervention is most appropriate?
Use clear, calm statements and a confident physical stance
Provide objective evidence that violence is unwarranted.
Empathize with the clients paranoid perceptions.
initially restrain the client to maintain safety
The Correct Answer is A
A. Use clear, calm statements and a confident physical stance:
This is the most appropriate choice. Clear and calm communication, along with a confident physical stance, can help to de-escalate the situation. It demonstrates assertiveness and can potentially prevent further escalation of violence.
B. Provide objective evidence that violence is unwarranted:
While providing objective evidence may be helpful in some situations, individuals with paranoid personality disorder may not respond well to attempts to prove that their perceptions are unwarranted. It could potentially escalate the situation.
C. Empathize with the client's paranoid perceptions:
While empathy is important in communication, empathizing with paranoid perceptions in a way that validates or reinforces them may not be the best approach. It could inadvertently validate the client's distorted thoughts and potentially escalate the situation.
D. Initially restrain the client to maintain safety:
Physical restraint should be a last resort and used only when the safety of the client or others is at immediate risk. Initial restraint can escalate aggression and may not be the most appropriate intervention in the early stages of a violent episode.
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Related Questions
Correct Answer is A
Explanation
A. To emphasize that the client is capable of consuming food without purging: This is the correct purpose of the intervention. By recalling a time when the client was able to consume food without engaging in purging behaviors, the nurse aims to highlight the client's capability to eat without resorting to unhealthy practices.
B. To incorporate specific foods into the meal plan to reflect pleasant memories: While incorporating pleasant memories into the meal plan can be a positive aspect of treatment, the primary purpose of the intervention described is to focus on the client's ability to eat without purging.
C. To assist the client to become more compliant with the treatment plan: While promoting compliance with the treatment plan is important, the specific intervention described is more about exploring the client's past experiences with eating without purging to reinforce the possibility of achieving healthier eating habits.
D. To gain additional information about the progression of the disease process: The intervention is not primarily aimed at gaining information about the progression of the disease process. Instead, it is focused on emphasizing the client's capacity to eat without engaging in purging behaviors.
Correct Answer is C
Explanation
Individuals with OCD often engage in compulsive behaviors, such as repetitive cleaning, as a way to alleviate or decrease anxiety associated with obsessive thoughts. In the context of OCD, obsessions are intrusive and distressing thoughts, images, or urges that cause significant anxiety, while compulsions are repetitive behaviors or mental acts performed in response to the obsessions.
A. Decrease the time available for interaction with people:
While individuals with OCD may isolate themselves due to their symptoms, the primary motivation for repetitive behaviors like cleaning is to manage anxiety, not necessarily to avoid interaction with others.
B. Prevent aggressive and impulsive behaviors:
OCD compulsions are not typically aimed at preventing aggressive or impulsive behaviors. They are driven by the need to reduce distress related to obsessive thoughts.
C. Decrease anxiety:
This is the correct answer. Compulsive behaviors in OCD are often ritualistic actions performed to reduce the anxiety associated with obsessive thoughts. Cleaning, in this case, is a way for the individual to feel a sense of control and alleviate anxiety.
D. Manipulate others
The primary motive behind OCD compulsions is to manage personal anxiety, not to manipulate others. Individuals with OCD often recognize that their compulsions are excessive or irrational, but they feel driven to perform them to alleviate anxiety.
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