An emergency code was called after a patient pulled a knife from a pocket and threatened, "I will kill anyone who tries to get near me." The patient was safely disarmed and placed in seclusion. Justification for use of seclusion was that the patient:
a. was threatening to others.
b. was experiencing psychosis.
c. presented an undeniable escape risk.
d. presented a clear and present danger to others.
ANS: D
The patient's threat to kill self or others with the knife he possessed constituted a clear and present danger to self and others. The distracters are not sufficient reasons for seclusion.
You might also like to view...
The nurse is caring for a child who experiences frequent ear infections. The child's mother wants to know why this is occurring. Which anatomical differences in the pediatric patient increase the risk for otitis media? (Select all that apply.)
A. Impaired drainage B. Longer, thinner eustachian tubes C. Shorter, horizontal eustachian tubes D. Typical lying-down position of infants E. Underdeveloped cartilage lining
The nurse obtaining a blood pressure in both of the client's arms determines that there is a difference of 15 mmHg in the systolic readings between the arms and repeats the assessment with the same results. Based on this data, which does the nurse suspect?
A. Unilateral arterial obstruction. B. Anxiety. C. Shock. D. Inaccurate technique.
A client with prostate cancer is being treated with leuprolide (Lupron). The nurse would counsel the client regarding which side effect?
1. Increased risk of infection 2. Decreased libido and hair loss 3. Nausea with possible vomiting 4. Increased risk of bleeding
Before giving a beta-adrenergic blocker glaucoma agent, you would notify the physician if the client discloses a history of what condition?
a. Hypertension b. Tachycardia c. Rheumatoid arthritis d. Bradycardia