An angry client has just thrown a chair across the room and is racing to pick up another chair to throw. Which is the most appropriate action by the nurse?
Call for an emergency response from trained personnel.
Calmly call the client by name and encourage verbal expression of anger.
Approach the client and firmly say. "Stop. put it down."
Assist the client to use problem-solving techniques instead of aggression
The Correct Answer is A
The safety of both the client and others is the top priority in this situation. The client's aggressive behavior poses a significant risk, and immediate action is necessary. Calling for an emergency response from trained personnel, such as security or other staff members experienced in handling aggressive behavior, can help ensure the situation is properly managed and de-escalated in a safe manner.
Option B may not be appropriate in this situation, as trying to engage the client in verbal expression of anger while they are in an agitated and aggressive state can potentially escalate the situation further.
Option C is not recommended, as approaching the client in a confrontational manner may further escalate their anger and aggression.
Option D, while it may be beneficial in a different context and when the client is in a more stable state, is not appropriate when the client is actively engaged in aggressive behavior. The focus at this moment should be on ensuring the immediate safety of everyone involved.
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Correct Answer is D
Explanation
Option D is the most helpful statement when working with a client who has frequent angry outbursts. It acknowledges that anger is a normal emotion that everyone experiences at times. Additionally, it provides a positive perspective on anger, suggesting that it can be used constructively to solve problems.
Anger itself is not a negative emotion; it becomes problematic when it is expressed inappropriately or disruptively. By validating the client's feelings and reframing anger as a potential tool for problem-solving, the nurse can help the client explore healthier ways to cope with and express their emotions.
Options A, B, and C are not as helpful in this situation:
A. "You can reduce your anger by hitting a punching bag." - While physical activity can help release pent-up emotions, this statement focuses solely on a physical outlet for anger and does not address the underlying issues causing the frequent angry outbursts.
B. "You need to learn how to be less assertive in your communications." - This statement suggests that the client's assertiveness is the problem, which may not be the case. Instead, the nurse should focus on helping the client develop healthier ways to express their emotions and communicate effectively.
C. "You need to learn to suppress these angry feelings." - Encouraging the suppression of emotions is not a healthy coping mechanism. Suppressing anger can lead to increased stress and may result in more intense outbursts later on. The nurse should help the client learn constructive ways to manage and express their anger.
Correct Answer is D
Explanation
When a school nurse suspects that a child is being sexually abused, the priority action is to ensure the child's safety and well-being. Option D, accurately and thoroughly documenting the findings and reporting to the appropriate authorities, is the most critical step in protecting the child.
Child abuse, including sexual abuse, is a serious concern that requires immediate attention and intervention. In many jurisdictions, healthcare professionals, including school nurses, are mandated reporters, which means they are legally obligated to report suspected cases of child abuse to child protective services or other appropriate authorities.
Options A, B, and C are not appropriate as the child's safety is the top priority:
A. Discussing the findings with the parents and giving them the opportunity to explain could potentially place the child at further risk if the parents are involved in the abuse or are unwilling to address the situation.
B. Talking to the child and finding out if they are experiencing sexual abuse or inappropriate touching should not be the first step without involving child protective services or other appropriate authorities. The child may be frightened or reluctant to disclose abuse directly to the nurse, especially if the abuser is a family member or someone known to the child.
C. Talking with another co-worker to confirm the assessment may delay the necessary action and reporting to protect the child.
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