Author Question: A client with a potential for violence is exhibiting aggressive gestures, making belligerent ... (Read 37 times)

savannahhooper · **on:** Jul 22, 2018

A client with a potential for violence is exhibiting aggressive gestures, making belligerent comments to the other clients, and is continuously pacing in the hallway. Which of the following comments by the nurse would be therapeutic at this time?

1. What is causing you to become agitated?
2. Why are you intent on upsetting the other clients?
3. Please stop so I don't have to put you in seclusion.
4. You are going to be restrained if you do not change your behavior.

Question 2

The nurse is reviewing the health record of an infant with a diagnosis of congenital heart disease. The nurse notes documentation in the record that the infant has clubbing of the fingers. The nurse understands that this finding is caused by:

1. Chronic fatigue
2. Poor oxygenation
3. Poor sucking ability
4. Consistent sucking on the fingers

nicoleclaire22 · **Reply #1 on:** Jul 22, 2018

Answer to Question 1

1

Rationale: The appropriate response is to ask the client what is causing the anger. This helps make the client aware of the behavior and may assist the nurse in planning appropriate interven-tions. Please stop so I don't have to put you in seclusion. and You are going to be restrained if you do not change your behavior. constitute threats to the client, which are inappropriate. Why are you intent on upsetting the other clients? is confrontational and could further escalate the client's behavior.

Answer to Question 2

2

Rationale: The child with congenital heart disease may develop clubbing of the fingers. Clubbing of the fingers is thought to be caused by anoxia or poor oxygenation. Chronic fatigue, poor sucking ability, and consistent sucking on the fingers are unrelated to this occurrence.