AIIMS Delhi NO- 2019
Mental Health Nursing
Medium
Priority action of patient agitation management?
Appeared in: AIIMS Delhi NO- 2019
Explanation
- The immediate priority in managing an agitated patient is to ensure the safety of the patient and others while attempting to de-escalate the situation.
- Decreasing environmental stimuli (like noise, bright lights, and crowds) reduces sensory overload, which is a common trigger for agitation and confusion.
- Moving the patient to a safer, quieter place removes them from triggers and protects them and others from potential harm.
- This approach represents the least restrictive intervention, which should always be the first step in managing behavioral disturbances.
Why Other Options Were Wrong
- Option A: Arguing with an agitated patient is counterproductive. It creates a confrontational dynamic and will almost always escalate the patient's agitation and aggression.
- Option B: Leaving an agitated patient alone without ensuring their safety is a form of neglect and abandonment. The patient could harm themselves or others.
- Option D: This option is incorrect because a valid and appropriate priority action is provided in option C.
Related Visual
Clinical Relevance
- Nursing practice connection: Safe nursing care depends on performing Management of Patient Agitation in the correct sequence, documenting the action clearly, and monitoring for the expected response.
- Mastering de-escalation techniques is a core nursing competency for ensuring patient and staff safety in all clinical settings.
- Effective environmental management and verbal de-escalation can prevent the need for more restrictive interventions, such as chemical (medication) or physical restraints, which carry their own risks.
- What if? - If verbal de-escalation and environmental changes are ineffective and the patient's agitation worsens, the nurse should call for assistance (e.g., other staff, security), administer prescribed PRN medications for agitation, and prepare for the potential use of restraints if the patient becomes an immediate danger to self or others.
How to Approach the Question
- First, identify the question as asking for the 'priority action'. This means you must determine the most important, first step.
- In any question involving patient distress or behavioral changes, recall that safety is the highest priority for both the patient and staff.
- Evaluate each option against the principles of therapeutic communication and safety. Does the action calm the situation or escalate it? Does it protect the patient or endanger them?
- Eliminate options that are clearly harmful or non-therapeutic, such as arguing (Option A) or abandoning the patient (Option B).
- Select the option that proactively creates a safe, controlled, and therapeutic environment, as this is the foundational step for all further interventions.
Concept Tested & Keywords
- Concept Tested: Management of Patient Agitation
- Stem keywords: Priority action, patient agitation, management
- Lead-in keywords: Priority action
- Negative lead-in flag: false
Question ID
Q9bwdidTceEkIh4-VaEd_g
Reference Book
E6 Nursing Fundamentals Potter Perry 12e Part 6 p. 157-159
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 8843-8845
Practise the full AIIMS Delhi NO- 2019
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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