A severely depressed patient who has been on suicide precautions tells the nurse, "I am feeling a lot better, so you can stop watching me. I have taken too much of your time already." Which is the nurse's best response?
"I am glad you are feeling better. The team will consider your request."
"Because we are concerned about your safety, we will continue with our plan."
"I wonder what this sudden change is all about. Please tell me more."
"You should not try to direct your care. Leave that to the treatment team."
The Correct Answer is B
A. While acknowledging the patient's feelings is important, ensuring safety is the priority, and the response should emphasize the ongoing concern for safety.
B. Prioritizing patient safety and care is crucial, especially in situations involving suicidal risks.
C. Encouraging the patient to elaborate further is essential; however, the priority is to maintain the safety precautions.
D. Directing the patient to not participate in their care isn't supportive or therapeutic, especially when safety is a concern.
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Related Questions
Correct Answer is C
Explanation
A. Restraining the client should be a last resort and is not the initial action to take when managing an agitated client.
B. Seclusion should also be considered as a last resort, and de-escalation techniques should be attempted before secluding the client.
C. Speaking calmly and providing simple directions can help de-escalate the situation by promoting a calm environment and reducing stimuli that may exacerbate the client's agitation.
D. While medication might be necessary in some cases, it's not the first action to take when a client becomes agitated.
Correct Answer is B
Explanation
A. While assessing coping skills is essential, in a crisis situation, determining immediate risks to the client's safety takes precedence.
B. Assessing for psychotic thinking is crucial to address immediate safety concerns. Psychosis can present significant risks and requires immediate attention.
C. While support systems are important for long-term recovery, determining immediate safety concerns is a priority.
D. Identifying the cause of the crisis is relevant but may not be the immediate priority when the client's safety is at risk due to potential psychotic thinking.
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