During community lunch, a manic patient tells another patient, "Push yourself away from the table. You're too fat for your own good!" How should the nurse intervene?
a. Say to the patient, "You may remain at lunch only if you apologize."
b. Tell the patient, "You must leave lunch and go to your room now."
c. Calmly tell the patient that insulting others is not permitted.
d. Extinguish the behavior by ignoring it.
C
The nurse must protect vulnerable patients and keep them from being drawn into the manic patient's angry behavior. By stating that the behavior is not permitted, the nurse sets limits and does not enter into an argument. The distracters will further anger the patient, may cause escalation, or may allow for loss of control.
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