A patient tells the nurse, “I am going to stab my neighbour when I leave,” and describes where a knife is kept. Which action is most appropriate?
Correct answer: C. Protect the potential victim and notify the treatment team
- A. Maintain confidentiality and document the statement later
- B. Challenge the patient to prove the threat is serious
- C. Protect the potential victim and notify the treatment team
- D. Tell the patient that violent thoughts are unacceptable
Explanation
A specific threat, target, and available weapon indicate an immediate risk of violence. The nurse should maintain safety, alert the responsible mental health team, and follow institutional procedures for protecting the patient and others rather than relying on confrontation or secrecy.
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About Psychiatric Emergencies
Psychiatric emergencies include suicidal behavior, homicide risk, severe agitation, panic, acute psychosis, delirium, overdose, and withdrawal states. Students examine rapid risk assessment, crisis intervention, de-escalation, environmental safety, emergency medication, observation levels, and the immediate priorities that differ from routine psychiatric nursing care.
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