A nurse is caring for a client who becomes verbally abusive when the nurse enters her room. Which of the following actions should the nurse take?

Leave the client's room

Maintain eye contact until the behavior stops.

Tell the client her behavior is disappointing.

Punish the client for the behavior.

Answer and Explanation

The Correct Answer is A

It is essential for the nurse's safety and well-being to remove themselves from a situation where the client is exhibiting verbally abusive behavior. Leaving the room allows the nurse to distance themselves from the confrontational environment and ensures their physical and emotional safety. Continuing to engage with the client may escalate the situation further and put the nurse at risk.

Incorrect:

B. Maintain eye contact until the behavior stops: Maintaining eye contact may be perceived as confrontational or provocative, which can further escalate the situation. It is advisable for the nurse to disengage from the client's presence to avoid potential harm.

C. Tell the client her behavior is disappointing: Engaging in a confrontational or judgmental response can exacerbate the client's anger or aggression. It is important for the nurse to maintain a professional and therapeutic approach while ensuring personal safety.

D. Punish the client for the behavior: Punishment is not an appropriate response to verbally abusive behavior. It can damage the nurse-client relationship and potentially worsen the client's emotional state. Promoting a supportive and therapeutic environment is key in managing challenging behaviors.

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Correct Answer is A

Explanation

A situational crisis is a type of crisis that occurs in response to a specific event or situation that disrupts a person's usual coping mechanisms. In this case, the sudden death of the client's partner has caused significant distress and an inability to cope with work and family responsibilities. The client's feelings of paralysis and inability to function indicate a response to the specific situation they are facing.

Incorrect:

B- Developmental crisis refers to crises that arise during normal stages of growth and development, such as adolescence or midlife crisis.

C- A maturational crisis involves a crisis that occurs as a result of the normal process of aging and the associated challenges and changes that come with it.

D- Adventitious crisis refers to crises that arise from unpredictable, uncommon events that are out of the ordinary, such as natural disasters or accidents.

A. "It sounds like you're having a difficult time." B. "Why do you think you are so anxious?" C. "Everyone has trouble sleeping at times." D. "Have you talked to your provider about this yet?"

Correct Answer is A

Explanation

The response "It sounds like you're having a difficult time" acknowledges the client's distress and validates their experience. It demonstrates empathy and shows the nurse's willingness to listen and provide support. This response encourages the client to express their feelings and concerns further, facilitating open communication and a therapeutic relationship.

The response "Why do you think you are so anxious?" may come across as confrontational or intrusive. It puts the client on the spot and may make them feel defensive or uncomfortable. It is important to create a supportive environment where the client feels safe to share their experiences without judgment.

The response "Everyone has trouble sleeping at times" minimizes the client's concerns and may invalidate their feelings. It does not address the client's anxiety or offer any support or guidance.

The response "Have you talked to your provider about this yet?" is a helpful question to explore whether the client has sought professional help. However, it should be used after acknowledging the client's difficulties and showing empathy. It can be part of a conversation about accessing appropriate care and resources.

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A nurse is caring for a client who becomes verbally abusive when the nurse enters her room. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client following the recent, sudden death of his partner. The client says, "I feel paralyzed and can't seem to cope with work or family responsibilities anymore." Which of the following types of crisis is the client demonstrating?

Correct Answer is A

Explanation

A nurse is caring for a client who reports a state of Increasing anxiety and the inability to sleep and concentrate. Which of the following is an appropriate response by the nurse?

Correct Answer is A

Explanation

A nurse is caring for an older adult client who has dementia and is agitated. The client says, "I have to go home and see my mother." The nurse replies, "You miss your mother." Which of the following therapeutic techniques is the nurse using?

A nurse is caring for a client who escapes anxiety-causing thoughts by ignoring their existence. The nurse should recognize this behavior as which of the following defense mechanisms?

A nurse is assisting in the admission process for a client who has a history of violent behavior. The client stands up and begins clenching her fists and arguing with the nurse. Which of the following actions is the priority?

A nurse working in a long-term care facility is admitting a client who has dementia. Exhibits Which of the following interventions should the nurse include in the plan of care? Select all that apply.

A nurse is caring for a client who has a major depressive disorder. Which of the following actions should the nurse take when developing a relationship with the client?

A nurse is caring for a newly admitted female client who has depression and refuses to get out of bed, dress, or participate in group therapy. Which of the following is an appropriate nursing response?

A nurse in a long-term care facility is caring for an older adult client who is anxious and has trouble sleeping at night. Which of the following nursing measures should the nurse implement?

A nurse on a mental health unit is participating in a community meeting with a group of clients. Which of the following actions should the nurse take?