A nurse is assisting in the care of a client who states, "I am overwhelmed by stress, and nobody is helping me." Which of the following represents a therapeutic response by the nurse?

A. An adult client is confined with physical restraints after throwing chairs at other clients and staff. Physical restraints are highly restrictive and should be used as a last resort when safety is at risk.

B. An adolescent is taken to a secure, quiet room after threatening and lashing out at other clients and staff. Seclusion is restrictive but less so than physical restraints; however, other interventions should be attempted first.

C. An 8-year-old child is asked to return to their room after yelling at other children during a group therapy session. This is the least restrictive intervention, as it involves verbal redirection rather than confinement or medication.

D. An adult client is given clozapine, an antipsychotic medication, after punching a wall with their fist and telling everyone that they intend to hurt them. Medication can be restrictive when used for behavior control rather than for medical necessity.

A. Avoid eye contact with the client to prevent the client from feeling awkward. Avoiding eye contact may come off as dismissive and can hinder rapport-building.

B. Remain silent after asking the client a question to allow the client a chance to respond. Using therapeutic silence gives the client time to gather their thoughts and feel heard.

C. Ask questions that only require one-word answers to prevent anxiety about answering detailed questions. Open-ended questions encourage communication and help establish trust.

D. Have music on in the background to distract the client from being anxious. Music might be a distraction rather than a rapport-building tool, as it may prevent active listening.