Author Question: A patient was responding to auditory hallucinations earlier in the morning. The patient approaches ... (Read 102 times)

jon_i · **on:** Jul 19, 2018

A patient was responding to auditory hallucinations earlier in the morning. The patient approaches the nurse, shaking a fist and shouting, Back off and then goes into the day room. As the nurse follows the patient into the day room, the nurse should:

a. make sure adequate physical space exists between the nurse and the patient.
b. move into a position that allows the patient to be close to the door.
c. maintain one arm's length distance from the patient.
d. sit down in a chair near the patient.

Question 2

The staff development coordinator plans to teach the use of physical management techniques when patients become assaultive. Which topic should be emphasized?

a. Practice and teamwork
b. Spontaneity and surprise
c. Caution and superior size
d. Diversion and physical outlets

alvinum · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

ANS: A
Making sure space is present between the nurse and the patient avoids invading the patient's personal space. Personal space needs increase when a patient feels anxious and threatened. Allowing the patient to block the nurse's exit from the room is not wise. Closeness may be threatening to the patient and provoke aggression. Sitting is inadvisable until further assessment suggests the patient's aggression is abating. One arm's length is inadequate space.

Answer to Question 2

ANS: A
Intervention techniques are learned behaviors that must be practiced to be used in a smooth, organized fashion. Every member of the intervention team should be assigned a specific task to carry out before beginning the intervention. The other options are useless if the staff does not know how to use physical techniques and how to apply them in an organized fashion.