A nurse in a mental health unit is discussing restraints and seclusion with a group of newly hired nurses. At which of the following times should a nurse discuss the restraint and seclusion policy with a client?
Upon admission
While administering chemical or physical restraints
When a client becomes agitated
During debriefing after restraint removal
The Correct Answer is A
A. Upon admission: The best time to discuss policies on restraints and seclusion is at admission, when clients are calm and able to understand their rights.
B. While administering chemical or physical restraints : Explaining the policy during restraint use can increase client distress and agitation.
C. When a client becomes agitated: Discussing restraint policies while a client is already agitated is ineffective and could escalate distress.
D. During debriefing after restraint removal : While debriefing is important, waiting until after restraints are removed does not allow for proactive education.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Avoid including the client's religious affiliation when discussing treatment options. Religious beliefs can impact medical decisions, so omitting this information could overlook important care considerations.
B. Include each piece of collected demographic data during change-of-shift report. Not all demographic data are relevant to patient care, and oversharing may lead to unnecessary biases.
C. Record the client’s spirituality as normal in the plan of care. Spirituality is personal and subjective, so labeling it as “normal” is inappropriate and not bias-free.
D. Provide relevant demographics during a treatment team meeting. This ensures demographic information is included only when it impacts care, avoiding bias while maintaining patient-centered treatment.
Correct Answer is D
Explanation
A. Interrupt the client's statement to clarify thoughts or ideas. Interrupting can make the client feel unheard and disrupt the flow of conversation.
B. Show emotion when a client is disclosing sensitive information. While empathy is important, the nurse should remain professional and composed to provide objective support.
C. Keep direct eye contact to a minimum. Avoiding eye contact may appear disinterested or disengaged.
D. Avoid looking at other clients on the unit. Maintaining focus on the client demonstrates active listening, engagement, and respect.
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