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Practice Question

A nurse in a mental health facility is caring for a client who becomes upset and breaks a chair when a visitor does not arrive. The client remains agitated following initial verbal attempts to calm him down. Which of the following interventions should the nurse implement first?

Answer Choices:

Correct Answer:

Offer the client an antianxiety medication.

Rationale:

🔴 When verbal de-escalation fails and the client remains agitated but not yet violent, the next least restrictive and therapeutic intervention is to administer a prescribed antianxiety (anxiolytic) medication.

🔴 Medications such as lorazepam or diazepam can reduce escalating agitation and help prevent the situation from progressing to aggression or violence.

🔴 This action respects the client's autonomy while also protecting safety and avoiding the need for more restrictive measures like seclusion or restraints, which are used only when less invasive methods fail.

🔴 Offering medication also reinforces a collaborative approach to managing emotional dysregulation, a common challenge in mental health settings.

🔴 According to the continuum of behavioral intervention, medication is an appropriate intermediate step before physical interventions.

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This question is from LPN Custom Mental Health which contains 43 questions.

More Questions from This Exam
As part of the plan of care for a client with borderline personality disorder, the nurse reviews the day's schedule with him each morning. While doing so, the client states. "Why don't you shut up already! I can read it myself, you know!" Which of the following is an appropriate nursing response?

Answer Choices:

A. I know you can read it yourself, but will you?"
B. "We do this every day. Why are you so angry with me this morning?
C. “I expect you to speak to me in a civil tone of voice."
D. Fine. Here is the schedule. I expect you to be on time for your therapy sessions.
A nurse in a mental health facility is caring for a client who becomes upset and breaks a chair when a visitor does not arrive. The client remains agitated following initial verbal attempts to calm him down. Which of the following interventions should the nurse implement first?

Answer Choices:

A. Plan with the client for how he can better handle frustration.
B. Place the client in a monitored seclusion room until he is calm.
C. Offer the client an antianxiety medication.
D. Restrain the client to prevent injury to himself or others.
A nurse in an acute care mental health facility is contributing to the plan of care for a client who is newly diagnosed with schizophrenia and is verbalizing paranoid delusions. Which of the following interventions should the nurse include in the plan?

Answer Choices:

A. Set limits on the amount of time the client talks about delusions,
B. Schedule a variety of competitive stimulating group activities for the client
C. Tell the client that the delusions are not real
D. Avoid asking the client about triggers for the delusions
A nurse is reinforcing teaching with a client who has a prescription for amitriptyline. (Elavil) Which of the following client statement indicates an understanding of the teaching?

Answer Choices:

A. "I should sit on the side of the bed before standing up in the morning
B. I may experience an increased libido."
C. I will avoid drinking caffeinated beverages."
D. I can no longer eat pepperoni pizza."
A nurse is reinforcing teaching with a client who has a prescription for amitriptyline. (Elavil) Which of the following client statement indicates an understanding of the teaching?

Answer Choices:

A. "I should sit on the side of the bed before standing up in the morning
B. I may experience an increased libido."
C. I will avoid drinking caffeinated beverages."
D. I can no longer eat pepperoni pizza."
From Exam
LPN Custom Mental Health

43 Questions

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Question Details
  • Category: LPN Nursing Exam(s)
  • Subcategory: LPN ATI Exams
  • Domain: Mental Health
  • Answer Choices: 4
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