After fasting from 10 p.m. the previous evening, a client learns ...

[clippers!]

After fasting from 10 p.m. the previous evening, a client learns that the procedure has been cancelled. The client curses at the nurse and accuses the nurse of being incompetent. The nurse's best response would be
 
  a. You have no right to say that to me. You are nasty.
  b. I can understand that you're upset, but I feel uncomfortable when I am cursed at.
  c. Perhaps we shouldn't get so angry when things don't work out the way we think they should.
  d. to leave the room and refuse to return to answer the call light when the client calls.

Question 2

A client on a psychiatric unit is found pacing the halls and angrily punching at the wall. The nurse's primary goal should be to
 
  a. assertively tell the client to stop the behavior.
  b. suggest that the client write in a journal to help relieve anxiety.
  c. speak in a loud voice in order to alert other staff members.
  d. maintain safety while helping the client.

[hollysheppard095]

Answer to Question 1

ANS: B
Assertive behaviors range from making a direct, honest statement about one's beliefs to taking a very strong, confrontational stand about what will and will not be tolerated in the relationship. Assertive responses contain I statements that take responsibility. This behavior is in contrast to aggressive behavior, which has a goal of dominating while suppressing the other person's rights. Aggressive responses often consist of you statements that fix blame on the other person. We statements should be used only when the nurse actually means to look at an issue collaboratively. Thus, the statement, Perhaps we both need to look at this issue a little closer. may be appropriate in certain situations. However, the statement, Perhaps we shouldn't get so angry when things don't work out the way we think they should. is a condescending statement thinly disguised as a collaborative statement. What is actually being expressed is the expectation that both parties should handle the conflict in one waythe nurse's way. Some nurses were socialized to act passively. Passive behavior is defined as a response that denies our own rights in order to avoid conflict.

Answer to Question 2

ANS: D
The nurse should help the client own the angry feelings by getting the client to verbalize things that make him or her angry. Acknowledging a client's anger may prevent an expression of abusive ranting. It is essential that the nurse use empathetic statements or active listening to acknowledge the client's anger and maintain a nonthreatening demeanor before moving on to try to discuss the issue. The goal is to maintain safety while helping the client. Psychiatric clients can be unpredictable and at this point would not be likely to respond positively to a suggestion such as writing in a journal. Speaking assertively or in a loud voice may escalate the situation, and the client is already out of control.

[clippers!]

Excellent

[Mochi]

TYSM