Question

a client, who is on a 30-day commitment to a drug rehabilitation unit, asks the nurse if he can go for a walk on the grounds of the treatment center. when he is told that his privileges do not include walking on the grounds, the client becomes verbally abusive. which approach should the nurse take?

call a staff member to escort the client to his room.
tell the client to talk to his healthcare provider about his privileges.
remind the client of the unit rules.
calmly address the clients inappropriate behavior.

Explanation:

Analyze the client's behavior and immediate nursing priority

The client is exhibiting verbally abusive behavior after being denied a privilege. In psychiatric and substance abuse settings, the immediate nursing priority when a client becomes verbally abusive is to maintain safety and establish clear, calm boundaries regarding acceptable behavior.

Evaluate the options

• Call a staff member to escort the client to his room: This is an escalatory measure that unnecessarily restricts the client's movement and may provoke further aggression before attempting verbal de-escalation.
• Tell the client to talk to his healthcare provider about his privileges: This avoids the immediate issue of verbal abuse and passes the responsibility to another provider rather than addressing the behavior directly.
• Remind the client of the unit rules: While rules are important, simply repeating rules does not address the active verbal abuse or set a boundary for interpersonal behavior.
• Calmly address the client's inappropriate behavior: This is the correct therapeutic approach. It sets immediate, calm, and clear behavioral boundaries (de-escalation) without being defensive, punitive, or escalatory.

Answer:

• Call a staff member to escort the client to his room.
• Tell the client to talk to his healthcare provider about his privileges.
• Remind the client of the unit rules.
• Calmly address the client's inappropriate behavior. (Correct answer)