A patient who is displaying manic behavior enters the unit's dayroom and declares in a loud, threatening voice, "I have friends, and if you don't show me proper respect, you'll be sorry!" The nurse's initial response should be to approach
the patient, address him formally, and say in a: a. soft voice, "You will always have proper respect here. Let's sit over here and talk.".
b. soft voice, "You are really frightening the other patients. Please go to your room.".
c. firm voice, "You are out of control. I expect you to go to your room immediately.".
d. firm voice, "You seem to be escalating again. I've brought an injection that will calm you and slow your thinking.".
A
When dealing with a patient who is escalating, the nurse initially assesses the patient's ability to use self-control and to respond to verbal cues. Speaking in a calm, soft voice and calling the patient by his or her formal title (unless the patient has insisted on being called by a first name), the nurse attempts to deescalate the patient by engaging him or her in a conversation that allows the expression of concerns. The remaining options either appear to threaten the client or have the nurse determine the topic of the conversation rather than focusing on the client's concerns.
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