A nurse on a mental health unit enters the day room and observes a client hit another client. Which of the following statements should the nurse make?
"I'm taking away your TV privileges and putting you in seclusion."
"Hitting others is unacceptable behavior."
"Your behavior will disappoint your provider."
"Why did you hit another client?"
The Correct Answer is B
Choice A reason:
Taking away TV privileges and placing the client in seclusion could be perceived as punitive rather than therapeutic. It may escalate the situation and does not address the immediate need to ensure safety and de-escalate the aggression.
Choice B reason:
Stating that hitting others is unacceptable is a clear and direct way to address the behavior. It sets a firm boundary and communicates the expectations for behavior within the unit, which is essential in managing aggressive situation.
Choice C reason:
Saying that the behavior will disappoint the provider personalizes the issue and may not be effective in the moment. The focus should be on the immediate safety of all clients and the unacceptability of the behavior, rather than on the potential emotional response of the provider.
Choice D reason:
Asking why the client hit another client immediately after the incident may not be productive and could lead to further justification of the behavior or additional aggression. It's important to first address the behavior and ensure safety before exploring the reasons behind it.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
This response may invalidate the client's experience and can be perceived as dismissive of the client's delusional thoughts. It does not acknowledge the client's current reality or provide any therapeutic communication. An intervention is required to guide the nurse in offering a more empathetic and validating response.
Choice B Reason:
Asking the client to clarify what they mean encourages communication and shows a willingness to understand the client's perspective. It is a therapeutic approach that can help the nurse gain insight into the client's thoughts and provide appropriate support.
Choice C Reason:
This response could potentially validate the client's delusional thinking by engaging in the content of the delusion. It might lead to further discussion about the delusion rather than redirecting the client to reality, which could be counterproductive.
Choice D Reason:
Expressing empathy by acknowledging that the client's feelings must be frightening is a therapeutic response. It validates the client's emotions without confirming the delusional content and can help the client feel understood and supported.
Correct Answer is B
Explanation
Choice A Reason:
This statement reflects an attempt to de-escalate a potential conflict by taking responsibility for an action that may have caused distress. However, it does not directly invite dialogue or understanding between family members. Effective communication in family therapy aims to foster open and empathetic dialogue, where members feel heard and understood.
Choice B Reason:
Asking for clarification on emotions connected to specific events is a hallmark of effective communication. This statement opens the door for the family member to share their feelings and for others to understand the perspective behind the emotions. It encourages a non-confrontational exchange of thoughts and feelings, which is essential in family therapy to promote healing and understanding.
Choice C Reason:
This statement is an example of a threat, which can lead to increased tension and conflict within the family. It is counterproductive to the goals of family therapy, which include improving communication and resolving conflicts in a constructive manner. Effective communication should be free of coercion and intimidation.
Choice D Reason:
While this statement may reflect a feeling or concern within the family dynamic, it is framed as an accusation rather than an invitation to discuss the behavior or its impact. Effective communication involves expressing one's own feelings and needs without making judgments about others' actions.
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