Examkin

Question

Difficulty: EasyBehavioral Interventions

A client in an outpatient clinic waiting area is becoming visibly frustrated due to a prolonged appointment delay. The client begins pacing rapidly, sighing loudly, and complaining to other visitors about the wait. Which action should the nurse take first?

  1. A
    Ask the client, "Why are you becoming so angry over a short delay?"
  2. Calmly approach the client and offer to discuss their concerns in a quiet, private room.Answer
  3. C
    Immediately request a prescription for chemical restraints to prevent potential violence.
  4. D
    Assign an unlicensed assistive personnel (UAP) to monitor and assess the client's agitation level.

Answer

Calmly approach the client and offer to discuss their concerns in a quiet, private room.
The correct answer emphasizes using the least restrictive alternative and verbal de-escalation. By approaching the client calmly and offering a quiet space, the nurse validates the client's frustration while removing them from an audience, which is an effective behavioral intervention to prevent further escalation.

Step-by-Step Solution

1
Analyze the client's behavior and the clinical environment.
The client is exhibiting early, non-violent signs of agitation (pacing, loud sighing, complaining) in a public setting.
Recognizing early signs of escalation allows the nurse to intervene proactively before the behavior becomes dangerous.
2
Identify the safest, least restrictive nursing intervention.
Verbal de-escalation and moving the client to a less stimulating area are prioritized over restrictive measures.
Nursing standards mandate using the least restrictive alternative first. A private room addresses the client's needs while protecting the safety of the milieu.

Key Concept

Least Restrictive Behavioral Interventions
Rate this question

Topics

Behavioral Interventions

More questions from this topic