The nurse enters a client's room and finds the client using a sharp part on the bed's mattress to cut her arm. The client stops when the nurse enters and appears to be embarrassed. The client denies suicidal intent, and no skin is broken.
The nurse appears to have interrupted the behavior. How should the nurse intervene in this situation? A) Place the client on suicide precautions immediately.
B) Begin teaching the client about alternatives to self-mutilation so she has other choices.
C) Sit down, give reassurances, and help the client explore triggers to the behavior.
D) Tell the client that self-mutilation helps people feel real.
Question 2
A client was restrained following a violent outburst in which she hit another client in the face and has just been let out of restraints. How did the nurse decide it was time to let the client out of restraints?
A) The nurse assessed that the client was shamed and embarrassed by the behavior.
B) The nurse assessed that the client had regained an adequate level of self-control.
C) Following hospital polices closely will provide the guidance for ending the use of restraints.
D) The psychiatrist did not write an order for continued use of restraints.
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Nurse collaboration
Henri Matisse, Harmony in Red (The Red Room).
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