• Question 1
A 70-year-old client is admitted to the locked psychiatric
unit, diagnosed with delirium. Later in the day, he tries
to get out of the
... [Show More] locked unit several times. He yells, "I
have to leave and get to my barber. I see him every
Wednesday. Let me out!” The most therapeutic
response by the nurse would be:
Sele
cted
Answ
er:
"You need to come and take a shower
before you can go get your hair cut."
Answers:"You need to come and take a shower
before you can go get your hair cut."
"Please stop banging on the door. Your room
is right over there. "
"The door is locked so that you don’t leave
and get hurt." "It's Monday and you’re in
the hospital. I'm your nurse."
Response Feedback
:
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The
best
resp
onse
is to
orie
nt
the
client to the day, place and the people around
him. Telling him to stop banging on the door and
to go to his room is a non-therapeutic response.
Explaining why the door is locked does not
provide orientation and is irrelevant to his
concern about needing to get to the barber.
Promising that he can go to the barber after a
shower does not present reality.
• Question 2
Which intervention is most effective in managing
excessive demands from a client with borderline
personality disorder?
Sele
cted
Answ
er:
Be consistent in responses to client demands.
Answers:Assign two staff members per shift to this client.
Hold a quick staff meeting whenever
the client has a complaint
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Resp
onse
Feed
back
:
Be consistent in responses to
client demands. Be flexible and
willing to change your mind
Because people with borderline personality
disorder have emotional lability and inconsistency
in behavior, it’s important for the nurse to be
consistent in responses and limits. The person
with borderline personality will often test
boundaries and rules; being consistent and not
changing one’s mind frequently will help the
individual feel safe in the environment. Assigning
two people per shift can contribute to the
tendency to pit two people against each other in
order to create conflict. Holding a quick staff
meeting in response to client complaints does not
keep firm boundaries and allows staff to be
manipulated. [Show Less]