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Difficulty: EasyMental Health Concepts

During a group therapy session at a community clinic, a client suddenly stands up, kicks a chair, and starts shouting at the other participants. To manage this escalating behavior, which actions are appropriate for the practical nurse (PN) to implement? Select all that apply.

  1. Direct the other participants to leave the immediate area.Answer
  2. B
    Approach the client and gently place a hand on their shoulder to provide comfort.
  3. Maintain a clear, unobstructed path to the nearest exit door.Answer
  4. D
    Ask the client to logically explain the reason for the sudden outburst.
  5. Speak to the client using a calm, low-pitched, and non-confrontational voice.Answer
  6. F
    Warn the client that physical restraints will be applied immediately if the shouting continues.

Answer

The correct actions include directing other participants away from the area, maintaining a clear path to the exit, and speaking to the client in a calm, non-confrontational voice.
The correct actions focus on immediate safety and de-escalation. By removing bystanders, the nurse protects other clients from harm. By maintaining an open path to the door, the nurse ensures a safe exit and prevents the client from feeling cornered. Finally, employing a calm, low-pitched tone serves as a non-threatening de-escalation technique that helps reduce the client's overall agitation.

Step-by-Step Solution

1
Assess the immediate environment for safety risks.
The client's shouting and physical actions pose a direct risk to bystanders in the room.
Milieu safety is always the first priority during a behavioral crisis.
2
Implement immediate physical safety measures.
Other participants are removed from the room, and the nurse ensures an escape route remains open.
This protects others from harm and prevents the agitated client and the staff from feeling physically trapped.
3
Attempt non-threatening verbal de-escalation.
The nurse communicates using a calm, low-pitched tone of voice.
Non-threatening verbal communication can help diffuse the client's anger without provoking further defensiveness.

Key Concept

Crisis De-escalation and Milieu Safety
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Topics

Mental Health Concepts

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