NCSBN NCLEX Review Questions and Answers with complete solution

A severely injured client is moved into an examination area of the emergency department. The family member who accompanied the client to the ED is screaming at the nurse, saying that someone better start doing something right away. What is the best response by the nurse? 1. "I need you to go to the waiting area. You can come back when you're more in control." 2. "I'm going to give you a few minutes alone so you can calm down." 3 "I can't think when you are yelling at me. Talk to me in a normal voice." 4. "I know you are upset. But please control yourself and sit down. Otherwise I will have to call security." Correct Answer- "I know you are upset. But please control yourself and sit down. Otherwise I will have to call security." Most violent behavior is preceded by warning signs, such as yelling or swearing. The challenge for nurses is to apply interventions that de-escalate a person's response to stressful or traumatic events. The keys to effective limit setting are using commands to express the desired behavior and providing logical and enforceable consequences for noncompliance. Nurses should acknowledge the agitated person's feelings and be empathetic, reminding him or her that they are there to help.